Consent to the placement of my child for adoption with identified prospective adopter(s) and, if the placement breaks down, with any prospective adopter(s) chosen by the adoption agency. Section 19 of the Adoption and Children Act 2002
| Published date | 21 March 2018 |
| Subject Matter | Adoption forms |
A102 Consent to the placement of my child for adoption with identified prospective adopter(s) and, if the placement breaks down, with any
prospective adopter(s) chosen by the adoption agency (04.13)
Consent to the placement of my child for adoption with
identified prospective adopter(s) and, if the placement
breaks down, with any prospective adopter(s) chosen by
the adoption agency
Section 19 of the Adoption and Children Act 2002
Name of child………….................……………...............
Before signing this form you are advised to seek legal advice about consenting to placement for adoption
and the effect on your parental rights. Publicly funded legal advice may be available from the Civil Legal
Aid. You can get information about this or find a solicitor through CLA Direct on www.gov.uk/legal-aid
Name and address of the adoption agency in the matter:
……………………………………
……………………………………
……………………………………
……………………………………
……………………………………
……………………………………
I consent to __________________________________ (my child), who is the child to whom the attached certified
copy of the entry in the Register of Live Births relates, being placed for adoption with
*[_____________________________________________(the named prospective adopter(s))]
*[the prospective adopter(s) identified as _________________________________________]
*(complete as appropriate)
If, for whatever reason, the placement breaks down, I also consent to my child being placed for adoption with any
prospective adopter(s) that may be chosen by the adoption agency.
If my child is adopted, I understand that I will no longer legally be treated as the parent and that my child will
become a part of the adopter(s)’ family. I also understand that my consent to plac ement for adoption means that
the adoption agency will have parental responsibility for my child and my own parental rights will be restricted.
When my child is placed with the prospective adopter(s), they will also have parental responsibility.
I understand that, once I have signed this form and consented to my child’s placem ent for adoption, my right to
change my mind and ask for my child’s return will be limited and may be lost altogether. I also understand that I
may not remove my child from the adoption agency or the prospective adopter(s) and that, if I do, I may be liable to
prosecution.
I understand that I may withdraw my consent at any time until the prospective adopters start an adoption
application in the court. If I do withdraw my consent and want my child returned to me, I understand that I must
notify the adoption agency that I have changed my mind and I must, at all times, act through the agency and not
approach the prospective adopter(s) directly.
If I withdraw my consent, I understand that whether or not my child is returned to me will depend on a number of
factors:
If at the time my child has not been placed with the prospective adopter(s), the agency will return my child to
me within seven days of receiving my notification, unless they still consider that my child ought to be adopted.
In that case, an application may have been or may be made to the court for a placement order and my child will
only be returned to me if the court gives permission.
If at the time the prospective adopters(s) have not yet applied to the court for an adoption order then
either an application may have been or may be made to the court for a placement order and my child will
only be returned to me if the court gives permission;
or the agency will give the prospective adopter(s) notice that they must return m y child to the agency within
fourteen days, and the agency will then return the child to me.
If at the time the prospective adopter(s) have already applied to the court for an adoption order, I understand
that I will not be able to ask the agency for my child to be returned. I will be entitled to be told when the
prospective adopters make their application to the court, but I will only be able to oppose the making of the
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