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Surrogacy Agreement 1. THIS MEMORANDUM DOES NOT AND CANNOT CONSTITUTE A LEGALLY BINDING AGREEMENT.
NO PROVISION OF THIS MEMORANDUM CAN BE LEGALLY ENFORCED BY ANY PERSON. This Memorandum is entered into on (Date) between the following parties: 05/06/16 Surrogates Name : Serena Healy Husband / Partner’s Name: Christopher Healy Address 30 Whitfield Avenue, Broadstairs, Kent, CT10 3HX Intended Parent 1 Ryan Copperthwaite Intended Parent 2 Joanna Copperthwaite Address 28 Offham Road, West Malling, Kent ME196AR BACKGROUND A The Surrogate (as named above) has agreed to act as a surrogate mother for the Intended Parents (as named above) and will be the birth mother of any Child born as a result of the surrogacy arrangements set out in this Memorandum. B The parties have agreed that the Intended Parents will raise any such Child in their home. C The Surrogate, (if applicable, the Surrogate's Partner), and the Intended Parents have agreed to enter into this Memorandum to record the Arrangements agreed between them. OPERATIVE PROVISIONS Meanings of terms used in this Memorandum. The following terms when used in this Memorandum shall have the meanings set opposite them. "Child" any child to be born pursuant to the surrogacy arrangements set out in this Memorandum and any reference to "Child" shall also mean children, if more than one child is born pursuant to the surrogacy arrangements set out in this Memorandum; "COTS" the organisation known as Childlessness Overcome Through Surrogacy; "the Support Worker" the person whose services have been supplied through COTS and who has provided information to the Surrogate and the Intended Parents and who has witnessed the signatures of all parties to this Memorandum; "Straight Surrogacy" straight surrogacy where the surrogate will carry the biological child of herself and the intended father conceived using artificial insemination. ‘Host Surrogacy’’ Host surrogacy is where the surrogate will carry the biological child of both intended parents conceived by using IVF. This can also be done using donor egg or sperm. "Intended Parents" “I.P’s” the Intended Parents "Parental Order" an order made pursuant to Section 30 of the Human Fertilisation and Embryology Act 1990, under which the Intended Parents become the legal parents of the Child; "the Arrangement" the surrogacy arrangements set out in this Memorandum. 2. SURROGACY 2.1 The Arrangement will be STRAIGHT SURROGACY HOST SURROGACY 2.1.1 The intended parents and surrogate agree that conception will take place at the home of the surrogate intended parents home (Host) clinic 2.2 All parties have been informed and fully understand the risks involved in pregnancy and childbirth. YES 2.3. The Surrogate confirms that she will not consider any Child born as a result of the Arrangement to be her own child/ren and the child/ren born will reside with and be raised as children of the Intended Parents. AGREE 2.4. If the Surrogate breaches Clause 2.3 and decides to keep the Child, all provisions of this Memorandum shall immediately terminate and, in particular,
no further amounts will be payable under Clause 10and 11 (Expenses). All monies paid must be returned. AGREE 2.5. The Surrogate confirms and agrees that in such circumstances, she will not be entitled to make any claim against either the Intended Father or the Intended Mother for maintenance or other money whatsoever, whether for maintenance of The Child or for herself or her family. AGREE 33. PRE-SURROGACY CHECKS AND TESTS 3.1 All parties to this Memorandum shall undergo/ has undergone HIV, and Hepatitis ‘B’ & ‘C’, Syphilis (VDRL), Chlamydia, Gonorrhea, and CM Virus’ We also require a copy of the husband’s cystic fibrosis If you are of Jewish descent you will need to be tested for Tay Sachs. If of African etc descent you will need to be tested for Sickle Cell Anaemic. Also any other medical or genetic tests which may be relevant or recommended by medical advisers and will provide copies of the results of those reports to COTS. The Intended Parents will pay for all such tests. DONE DONE 3.2 The surrogate confirms that she is / will be, immunised against Rubella before attempting conception. 3.3 All parties to this Memorandum shall have criminal record checks. DONE DONE 3.4. The parties hereby give COTS their permission for any relevant information regarding one party being passed to the other and vice versa . I.P. AGREE SURROGATE AGREE 4. PRE-SURROGACY ARRANGEMENTS 4.1. If the Surrogate so requests, she is entitled, before any attempt to conceive take place:- 4.1.1. to visit the Intended Parents' home; and/or AGREE 4.1.2. to meet the existing children (if any) of the Intended Parents. AGREE 4.2. If the Surrogate does not wish to exercise her rights under Clause 4.1 above, she is in any event entitled, if she so wishes, to be informed by the Intended Parents of where the Child and any existing children are being and will be brought up. AGREE 4.3. If the Intended Parents so requests, they are entitled, before any attempt to conceive takes place:- 4.3.1. to visit the Surrogate’s home; and/or AGREE 4.3.2. to meet her partner and any children (if applicable) of the surrogate’s. AGREE 4.4. There is to be a reasonable period of time between meeting and the first attempt. AGREE 5. COUNSELLING 5.1 If the Surrogate requires one-to-one telephone or face-to-face crisis counselling, arising out of a miscarriage or stress relating to the Arrangement or to her pregnancy, then the Intended Parents will pay up to a maximum of £100 to cover the costs of such counselling (in addition to the amount specified in Clause 10 & 11. Any further amount required to be paid for such counselling shall be deducted from the amount payable to the Surrogate pursuant to Clause 10 & 11. AGREE 5.2. If counselling for all parties together is required at any stage or time, whether by telephone or face-to-face, the Intended Parents will pay a maximum of £500 to cover the cost. This will not be deducted from the amount payable to the Surrogate pursuant to Clause 10 & 11 AGREE 6. CONCEPTION ARRANGEMENTS 6.1 The Surrogate must abstain from sexual intercourse from time of agreement until pregnancy is confirmed.. AGREE 6.2 The period referred to in 6.1 above starts on the date when the Surrogate and the Intended Parents first agree to attempt conception and continues until after:- pregnancy resulting from the Arrangement has been confirmed or the date on which the last attempt at conception has failed. AGREE 6.3 The Parties agree that following …… attempts at pregnancy they will review the situation and decided whether or not to continue. 7. PREGNANCY - ARRANGEMENTS 7.1 From the date of this Memorandum, the Surrogate will make every effort to take care of her physical and psychological health, which will include taking folic acid, eating a balanced and nutritious diet. AGREE 7.2 The Intended Parents each confirm to the Surrogate that if one of them dies the other will bring up the Child. AGREE 7.2.1. Following confirmation of the pregnancy, the Intended Parents will / will not/ have lodged a letter of wishes or intent with their solicitor stating that named individual/s as set out in 7.2.2. below, will undertake the roles of trustees/guardian of the Child should both Intended Parents die before the birth of the Child or after the birth but before any Parental Order has been made. 7.2.2. Name/ s......................................................................................................................................................................... All parties are aware that if the child/ren is going to be brought up by anyone other than the surrogate or Intended Parents, they can only do so with the surrogate’s consent as a Private Fostering arrangement. 7.2.3. If the surrogate so requests she is entitled to meet the person/s named above AGREE 7.2.4. The Intended Parents confirm that they:- will seek / will not seek / have sought legal advice regarding both of them making a will providing for their unborn child. 7.2.5. The Surrogate confirms that, in the event of the Intended Parents dying before the Parental Order is made, [subject to the Intended Parents lodging the letter mentioned above 7.2.2], she will make no claim on the estate of the Intended Parents. AGREE SCANS ETC 7.3. The surrogate will have a Triple Blood Test Carried out. AGREE 7.3.1. The surrogate and I.P.’s only wish NHS scans unless medically advised. These are just the normal scans every pregnant woman has. YES 7.3.3. The surrogate will have a Nuchal Translucency Scan. AGREE 7.3.4. The surrogate will have a Detailed Anomaly Scan. AGREE 7.3.5. The Surrogate will have an amniocentesis test:- if so advised by the relevant doctor at the appropriate time will not have test carried out. 7.4. The Surrogate will make herself available at any time during the pregnancy and after the birth to assist and take part in any medical investigations or tests as may be deemed appropriate by medical advisers which relate to the health or future health of the Child. AGREE 7.5. The Surrogate and the Intended Parents shall each ensure that the hospital at which the Child is to be born is aware of the Arrangement. Intended parents and surrogates should draw up a birth plan and give a copy to COTS and hospital. AGREE 7.5.1. In addition, the Surrogate will inform her own GP and midwife of the Arrangement. including notifying the Health Visitor AGREE 7.5.2. In addition, the Intended Parents will inform their own GP’s and midwife of the Arrangement. Including notifying the health visitor AGREE 7.6. Regular and frequent contact shall be maintained between the parties during the period of this Memorandum, including both before and during the pregnancy. AGREE 7.7. Immediately prior to the first insemination, the Intended Parents will insure the life of the Surrogate for the sum of £200,000 for a period of two years. The beneficiary of the insurance shall be the Surrogate's estate and the Intended Parents will, if requested by the Surrogate, arrange for a new will to be prepared for her. A copy must be sent to COTS. AGREE 8. PREGNANCY - PROBLEMS 8.1. If the foetus is found to be disabled or handicapped, depending on the severity, the Surrogate:- will terminate the pregnancy continue with the pregnancy decide at time after all parties have discussed and agreed on what to do. 8.2. If, the I.P’s. ask the Surrogate to continue with the pregnancy of a disabled or handicapped Child, they do so on the understanding that the child will be their responsibility AGREE 8.2.1. This will not apply if, under Clause 8.1, the Intended Parents asked the Surrogate to terminate the pregnancy but the Surrogate refuses to have a termination. AGREE 8.2..2. If nothing is detected but the child is born disabled or handicapped the IP’s will bring up the child. AGREE 8.3. If the Child is stillborn or dies before leaving hospital or dies after leaving hospital but before the Intended Parents have obtained a Parental Order, the Intended Parents will make all necessary arrangements for the funeral and carry out such other arrangements as may be agreed between them and the Surrogate, (this will not apply if the Surrogate has changed her mind and decided to keep the Child before the death of the Child.) AGREE 8.4. If the Surrogate suffers a miscarriage, the parties agree that further attempts to conceive:- will be undertaken not undertaken decided at time after all parties have discussed and agreed on what to do. 8.4.1. If miscarriage occurs the surrogate will provide written confirmation to the Intended parents from her hospital or GP. AGREE 8.4.2. If necessary the intended parents will pay for confirmation. AGREE 8.4.3. It is agreed that the following people will be at the birth of the child:-
Delete those not applicable Intended Mother Intended Parents Surrogate’s Partner Member of Surrogate’s Family Surrogate’s Friend 9. POST BIRTH ARRANGEMENTS 9.1. The Surrogate will part with the Child and hand him/her to the Intended Parents immediately following the birth. YES 9.1.2 . The surrogate may, if she so wishes, having handed the child over to the Intended Parents, spend a short time with the child before the IP’s takes their child home. YES 9.2. If the child has to stay in hospital the Intended Parents will take over the day to day care of the child:- YES 9.2.1 . If the surrogate has to stay in hospital with the child then the surrogate and the intended parents will ask the hospital staff to look after the child if the intended parents are not allowed to stay in the hospital. YES 9.2.3 . If the surrogate has to stay in hospital after the birth and is not provided with an amenity room of her own, the I.P’s will pay for an amenity or private room if available. YES 9.4. Following the birth of the child, the child will be registered in the Intended Parent surname. AGREE 9.4.1 When registering the birth the surrogate will inform the registrar that the child has been born as a result of a surrogacy arrangement and will identify his/her genetic parents AGREE 9.5. The parties agree that following a period of 6 weeks from the date of the birth of the Child, but before the Child is 6 months; the Intended Parents will seek a Parental Order. AGREE 9.5.1 . The Surrogate and the Surrogate's Partner agree not to oppose the making of a Parental Order AGREE 9.6. After the birth all parties will maintain contact:- 9.7. The Surrogate may, if she so wishes, write letter / provide photographs of her and her family for the child AGREE 9.7.1 . The Intended Parents undertake to give the Child any letters and/ or photographs that the surrogate has provided, at an appropriate time. AGREE 10. PRE PREGNANCY EXPENSES The following expenses will be paid in addition to agreed surrogacy expenses. 10.1 The intended parents will pay all costs in respect of surrogate’s Life Insurance and Wills pursuant to clause 7.7. (Including solicitor’s fee for a will) AGREE 10.1.2 STRAIGHT SURROGACY £50 per month in which one or more inseminations takes place AGREE 10.1.3. HOST SURROGACY £100 for each embryo transfer (regardless of number of embryos), not involving drugs AGREE 10.1.4. HOST SURROGACY £150 for each embryos transfer (regardless of number of embryos), involving a drug cycle AGREE
NOTE ALL EXPENSES PAID TO SURROGATE PRIOR TO A PREGNANCY BEING CONFIRMED ARE NONREFUNDABLE* 10.1.5. HOST & STRAIGHT Where the surrogate has made herself available for insemination/embryo transfer but the intended parents cancel she will be paid the above sum. If she cancels no payment will be made. AGREE 10.1.6. Any travelling expenses, loss of earnings and childcare costs incurred by herself and her partner (if applicable) to attend clinic/hospital for scans, or tests requested by intended parents. AGREE 10.1.7 Any travel and/or accommodation for the surrogate and her partner to travel once to the intended parents’ home to see where the child will reside. AGREE NOTE: The travel expenses to be paid will be cost of petrol used if the Surrogate travels by car or the rail and/ or bus fares or, if there is no other transport available, the cost of a taxi. Such travel expenses shall be paid in advance where possible. No taxi fares should be incurred without prior consent of the Intended Parents. 10.1.8. The I.P’s agree to pay directly for the cost of any reports required by anybody in connection with this arrangement. YES 10.1.9 The IP’s agree to pay for any other additional medical checks, not mentioned in this agreement, including drugs for the surrogate’s treatment, home study report if required by clinic, ovulation, and pregnancy kits. AGREE 11. PREGNANCY EXPENSES 11.1 The Intended Parents will pay to the Surrogate a total amount of £................ as expenses for the pregnancy. 11.2 If requested by the IP’s the surrogate will provide written confirmation of her pregnancy from her GP. or clinic and give copies to the intended parents. AGREE 11.2.1. The Intended Parents will if necessary pay for the written confirmation. AGREE 11.2.2. 2% of the amount specified in 11.1 above per month AGREE 11.2.3. The balance of the amount specified in Clause 11.1 on will be paid on REGISTRATION OF THE BIRTH AGREE 11.3. If miscarriage, termination or ectopic pregnancy occurs, then the following amount should be paid to the Surrogate. 8 to 12 weeks - £300 13 to 15 weeks - £500 16 to 18 weeks - £800 19 to 21 weeks - £1,000 22 to 24 weeks - £2,000 25 to 28 weeks - £3,000 28 to 32 weeks - £,5000 AGREE 11.3.1. 33 weeks to full-terms including still birth £7,500 or negotiable AGREE 11.3.2. If the surrogate has to have her fallopian tube/s removed the couple agree to pay her £1,500 if one is removed or £3,000 if both are removed AGREE 11.4 In the event of a multiple birth:- £3,500 for twins, £5,000 For triplets, £7,500 for more than 3 babies in addition to the amount specified in Clause 11.1 will be paid to the Surrogate by the Intended Parents if born by normal delivery. AGREE 11.5 If the Child is born by caesarean, the Intended Parents will pay to the Surrogate £1,500 in addition to the amount specified in Clause 11.1 AGREE 11.6 If surrogate has a multiple pregnancy and birth by caesarean the Intended Parents will pay to the Surrogate £5,000, for twins, and an additional £1,000 for each additional baby, in addition to the amount specified in Clause 11.1 AGREE 11.7 If the surrogate requires surgery for removal of the placenta the IP’s will pay the surrogate £500 in addition to the amount specified in clause 11.1 AGREE 11.8 If the surrogate requires emergency surgery for a hysterectomy following a live birth the IP’s will pay the surrogate £5,000 in addition to the amount specified in clause 11.1 AGREE 11.9 If the Surrogate is ill during the pregnancy, the Intended Parents shall pay up to a maximum of £500 to cover childminding etc. No amount shall be payable unless and until the Surrogate's doctor or hospital has confirmed in writing that the surrogate is unable to look after her children. If extra childminding is required the amount is deducted from the overall figure in 11.1 AGREE 11.10 If a surrogate who is in paid employment, has to take early maternity leave as a result of a multiple pregnancy, or illness relating to the pregnancy and as such loses a percentage of her salary, overtime, or bonus, the intended parents will pay up to a maximum of £1000 to compensate this loss. No amount shall be payable unless and until the surrogate’s doctor or hospital has confirmed in writing that this is the case, and proof of employment will be requested. This is only applicable to those surrogate’s who are employed and will be in place of, and not in addition to clause 11.9 AGREE 11.11 Where the intended parents ask the surrogate to stop work, they will be responsible for compensating her for any loss of earnings. Over and above the specified amount in 11.1 AGREE 11.12 The IP’S will pay for surrogate, surrogate’s partner and children to attend the AGM. Maximum of £150 for tickets, travel & accommodation. AGREE 12 PUBLICITY 12.1 The Intended Parents will / will not undertake any publicity , or seek publicity for the Surrogacy Arrangement or for any matter covered by this Memorandum AGREE 12.2 The Surrogate will / will not undertake any publicity, or seek publicity for the Surrogacy Arrangement or for any matter covered by this Memorandum. AGREE 13 OTHER Agreement completed by Skype, Next Steps THIS MEMORANDUM has been signed by all the parties to it (and witnessed as mentioned below) and comes into effect on the date specified on the first page of this Memorandum, which is the date at which the last person signed it. 10 SIGNED BY (The Surrogate) SIGNED BY (Intended Parent 1) SIGNED BY (Intended Parent 2) SIGNED BY (The Surrogate’s Husband/ Partner) Counsellor / Witness Date of Meeting Witness Name Marina Bailey
Witness Address: Swaledale, Worksop, Notts, S81. ! de written confirmation of her pregnancy from her GP. or clinic and give copies to the intended parents. AGREE 11.2.1. The Intended Parents will if necessary pay for the written confirmation. AGREE 11.2.2. 2% of the amount specified in 11.1 above per month AGREE 11.2.3. The balance of the amount specified in Clause 11.1 on will be paid on REGISTRATION OF THE BIRTH AGREE 11.3. If miscarriage, termination or ectopic pregnancy occurs, then the following amount should be paid to the Surro