Services Checkout Please complete the following CAC Client Application and Agreement before submitting payment. Please note this form takes approximately 10-15 minutes to finish and cannot be saved if not completed in its entirety. Primary Applicant Information Have an account? Login Here! First name – Wife Last name – Wife Email Choose a password for your account Phone number Date of birth Age Marriage status Please Select Married Husband and Wife Single Mom Date of marriage Are you a US citizen? Please Select Yes No Ethnicity Please Select Black or African American Caucasian American Indian Hispanic Asian Multi Ethnic Indian Pacific Islander Other Occupation Highest level of education completed Please Select High School Diploma Some College Bachelors Masters Doctorate GED Other Are you bilingual? Please Select Yes No If yes, what languages do you speak? Do you have a criminal history? Please Select Yes No If yes, please briefly explain: Are you an active/practicing Christian? Yes Husband’s Information First name – Husband Last name – Husband Date of birth Age Phone number Are you a US citizen? Please Select Yes No Ethnicity Please Select Black or African American Caucasian American Indian Hispanic Asian Multi Ethnic Indian Pacific Islander Other Occupation Highest level of education completed Please Select High School Diploma Some College Bachelors Masters Doctorate GED Other Are you bilingual? Please Select Yes No If yes, please list languages spoken Do you have a criminal history? Please Select Yes No If yes, please briefly explain: General Information Do you reside in the United States? Please Select Yes No If no, what is your country of residence? Home Street Address City State Select State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code What is your annual household income? Number of Children Please select None 1 2 3 4 5 or more Are you a multi-ethnic/multi-racial family? Please select Yes No Please list the name, age, and relationship of anyone living in your home other than your children: How did you hear about CAC? Please Select Friend or Family Referral Agency Referral Social Media Google/Internet Search Other Who referred you? Do you have a preferred CAC Adoption Consultant? Please Select No Preference Susan VanSyckle Fallon Palacios Kelly Todd Katie Fenska Jonnilyn Spinks Dawn Wright Samantha Pryor MacKenzie Juliane Ann Noblitt Jaclyn Miller Jonathan Adam Rebekah McGee Have you completed your profile book? Please Select Yes No If yes, what was the name of the company or profile you used? Have you started or completed your Home Study with an agency? Please select YES we started our Home Study but do not have it completed or approved yet YES we have a completed and approved Home Study NO we have an agency but have not started the process yet NO we need agency recommendations If yes, list your Home Study provider: If you have you completed your Home Study, list your approval date: Have you adopted before? Please Select Yes No If yes, which agency? Maximum Budget Amount for Adoption Expenses: Please Select $45K-$50K $40K-$45K $38K-$40K $38K or less *Note this amount falls outside of average adoption fees and may need to be increased through adoption fundraising, grants and/or funding. $50K+ Current Funds Available for Adoption Expenses (Outside of home study, profile book, consulting, or travel costs): Are you currently working with an adoption agency, attorney, facilitator, referral agency, adoption professional and/or adoption consultant? Please Select Yes No If yes, list their name and the role they are playing in your adoption: I am/We both are active and practicing Christians: Yes Church name Client Agreements CLIENT AGREEMENT, TERMS OF CONTRACT AND SERVICES* In this Client Agreement (hereinafter referred to as the “Agreement”), Clients are requesting to receive the following consulting services for the purposes of one adoption from Christian Adoption Consultants, LLC (hereinafter referred to as “CAC”). By electronically signing below, Clients understand and agree to the terms of this Client Agreement. Terms: Clients understand this Client Agreement is in effect for up to 14 months for the purpose of one adoption or successful frozen embryo transfer from the date signed unless terminated earlier under the Agreements section. Clients may request to extend their services through a Contract Renewal for an additional 6 months for an additional fee if approved. Clients also understand that CAC agrees to provide consulting services until Clients (1) receive placement for one adoption through domestic adoption OR (2) have a successful frozen embryo transfer through an *embryo adoption, (based on the adoption program selected) or for up to 14 months, whichever occurs first. *For Clients choosing CAC’s Embryo Adoption Program, embryo adoption is considered complete for the purposes of this agreement at the time of successful frozen embryo transfer (with a subsequent positive hCG test). Additional support services can be purchased for an additional fee if needed. Definition: Embryo “adoption” is neither legally nor technically considered an adoption. It is governed by contract (ownership) law versus traditional adoption law. Adoption is defined as the placement of a child after birth who is not genetically your child, but is a term most people can relate to when discussing receiving donated embryos for the purposes of reproduction. For the purposes of this agreement, embryo adoption will be the terminology used when referring to the legal transfer of frozen embryos from the donors (also referred to as placing family) to the adoptive couple (also referred to as the receiving family). During the Term, CAC will provide the selected services (the “Services”). IL and OR Residents ONLY: Please note that your adoption consulting services will be provided through Hope for Adoption (HFA), a licensed, approved adoption agency that has partnered with CAC to offer consulting services. HFA contracts adoption consulting services through CAC to meet and exceed Illinois and Oregon state standards. The application process is virtually the same, the fees are the same, and the service is the same- you are just contracting for services through the additional partnership between HFA and CAC. HFA is not providing home study or placement services through this agreement and is not liable for the outcome of the adoption process. Client(s) understand that local, state, or federal laws and agency policies and procedures can change at any time and HFA/CAC is not liable for these changes. Client(s) understand, acknowledge, and agree. DISCLOSURES* The Clients understand the following disclosures are made by CAC. CAC does NOT: (1) Facilitate domestic adoptions or act as a licensed adoption agency, attorney, or facilitator which includes: communicating with the expectant or birth mother/father/family on behalf of the hopeful adoptive parents. (2) Guarantee a placement or adoption of a child(ren) and/or frozen embryo. (3) Take birth family surrenders/consents or arrange for the placement of a child or have any activity with the placement of a child(ren) or offer any legal services. (3) Offer medical advice or treatment and always recommend clients consult with their doctors regarding any medical treatments. Client(s) understand, acknowledge, and agree. PAYMENT AND FEES* CAC fees are non-refundable, non-transferable, and due up-front when the Client Agreement is received. Clients fully and completely understand this policy and will not request a refund or transfer for any reason. The only reason a refund will be granted is if the client’s application is not accepted by CAC. Client(s) understand, acknowledge, and agree. CLIENT EDUCATION AND TRAINING AGREEMENT* Clients agree to read CAC’s Adoptive Parent Guide or Guide to Embryo Adoption (based on their adoption package) and complete a Certificate of Completion as their first step in receiving services from CAC. Client(s) understand, acknowledge, and agree. STATEMENT OF FAITH* Clients acknowledge to be active and practicing Christians. Client(s) understand, acknowledge, and agree. CODE OF CONDUCT* Clients agree to conduct themselves in an ethical, moral, and Christ-like manner. Clients understand that if at any time during the adoption process that Clients’ behavior/actions are not consistent with the Christian faith or standards of good parenting, in the sole opinion of CAC, CAC can terminate the Client Agreement, stop all services, and no refund will be given. Such behaviors may include, but are not limited to: threats of violence, emotional instability, deceit and/or intent to falsify information, hide criminal and child abuse/neglect history, malicious intent, lying, uncontrollable anger, extreme negativity, and/or extreme profanity. Clients also understand that if they display negative behavior that could be deemed as “unfit,” CAC will report such behavior to the Client’s home study provider, adoption agency/attorney, embryo adoption program, and/or post-placement supervisory agency. Clients agree to notify CAC as soon as possible when any major life event occurs or circumstances change such as separation, divorce, pregnancy, change in adoption plans, health issue, criminal event/history and/or child abuse/neglect status, significant loss of income, and/or change of residence, etc. Clients understand that in certain circumstances such as the event of separation/divorce or criminal/child abuse/neglect history status change, or any other significant life change or event that could have an adverse effect on Clients’ ability to parent, CAC may terminate the Client Agreement, discontinue services, and no refund will be given. Clients also understand that if they receive an unfavorable home study, CAC will terminate the Client Agreement, discontinue services, and no refund will be given. Client(s) understand, acknowledge, and agree. ETHICS* Clients certify that by signing this agreement, it signifies their intent to personally pursue a domestic or embryo adoption. Clients agree to be honest when communicating their adoption preferences and agree to only choose one path to adoption at a time and present to one (1) situation at a time in domestic adoption. Clients also understand and agree that they will NOT present to a situation (or embryo donor) that does not fit the criteria approved for in their home study. Further, Clients agree that once there has been an official acceptance of a match with an agency or attorney or donor, withdrawing from that match could immediately cancel services from CAC and terminate this Client Agreement with no refunds. CAC will have the sole opinion of whether to terminate this agreement based on the reason or situation surrounding the Client’s withdrawal from the match. Clients agree there is no way an agency can guarantee an unborn child’s gender and even sometimes their ethnicity. There are no guarantees from fertility clinic/medical facility on the success of frozen embryo transfers. Occasionally, the birth/genetic father is unknown so the race of the child could also be unknown. In domestic adoption, if the expectant mother has received sonograms, these are not always accurate. Social and medical history reports provided can not be guaranteed. Clients agree not to accept a match with an adoption situation unless they accept these possibilities. Clients agree that if they are unable to consider situations due to life circumstances, they will communicate this information expediently to the consultant. Client(s) understand, acknowledge, and agree. CLIENT COMMUNICATIONS AND DOCUMENTS* Clients understand and agree they will not request information regarding potential situations (or donor information in embryo adoption) and other CAC services to be withheld from their spouse. Any communication with CAC by one spouse will not be considered privileged or confidential to the other spouse. Clients also agree to establish a joint adoption email (shared by husband and wife) for the purposes of their adoption at the beginning of services. Clients understand and agree they are responsible for responding to communication from Consultants. IF Clients are completely unresponsive to communication efforts for over 90 days, CAC will terminate the Client Agreement, discontinue services, and no refund will be given. All Client resources and education provided electronically by CAC are available 24/7 and only accessible online. Client(s) understand, acknowledge, and agree. PROFILE/LIFEBOOK DESIGN SERVICE AGREEMENT* If purchasing a package that includes the profile or lifebook design service, Clients accept and understand this service includes the layout, creative design, picture selection, and written narrative of a 20+ page Adoption Profile or Lifebook. The client will receive a digital file (pdf copy) of the profile or lifebook and will be responsible for any cost of printing copies as well as mailing the profiles to the appropriate agencies/attorneys (if needed). Clients are responsible for professional photographs. Clients may pay an additional fee of $275 to expedite the profile/lifebook design service if needed. Clients accept and understand that CAC partners with Adored Design, Inc. for some design services. Adored Design, Inc (Adored) is a sister company to CAC and they provide profile/lifebook design services through a partnership contract with CAC. Clients accept and understand that Adored operates as a creative design company and in no way, claims to be or operates as a licensed adoption placement agency, attorney, or facilitator. Limitations: By choosing the profile/lifebook design service, Clients are hiring an experienced designer and agreeing to allow them to make the best creative decisions for the Client’s profile or lifebook which includes copy editing, themes, colors, fonts, typeset, etc. Clients will have a chance to communicate any design (color or style) preferences when photos are submitted, although CAC/Adored can not guarantee those preferences will be accommodated. Clients agree to submit professional/quality photos per CAC/Adored detailed request for kinds of photos needed, quantity, etc. Clients agree to organize and send to their designer per CAC/Adored profile/lifebook design process. Two (2) rounds of basic edits are included (with a combined 1 hour of edit time). Additional edits requested by the client will be billed at $100/hour. Design layout changes cannot be made once the profile is complete. Client Obligations: Clients agree that CAC’s/Adored’s ability to perform its obligations under this Agreement is dependent on the Client’s timely fulfilling obligations. CAC/Adored can not be held liable for any costs, charges, or losses sustained by the Client arising directly from any failure of the Client to fulfill its obligations under this Agreement. The Client warrants that all assets, concepts, materials, photographs, content, specifications, information, and instructions provided by Client may be exploited without violating any laws or infringing the rights of any third parties. Liability: Clients are responsible for obtaining all legal clearances required for the performance of services, including being free to enter into this Agreement, and Clients are not a party to or bound by, any contract, the terms of which would be inconsistent with or contrary to the terms of this Agreement. Clients agree to assume ALL liability and responsibility and hold harmless CAC/Adored and any representative liable for state laws, changes to state laws, and/or regulations preventing payment for services provided. CAC/Adored can not be held responsible for delays or nonperformance caused by activities or factors beyond its control, failure by the Clients to timely furnish information or approve/disapprove work, or faulty performance by the Clients or others, including third-party contractors hired by CAC/Adored or the Clients. CAC/Adored shall not be liable for any indirect, third-party, incidental, special, consequential, exemplary, or punitive damages arising out of this Agreement. The services and work product of design are sold “as-is.” In all circumstances, the maximum liability of CAC/Adored to Clients for damages for any and all causes whatsoever, and Client’s maximum remedy, regardless of the form of action, whether in contract, tort, or otherwise, shall be limited to the net profit of CAC/Adored. In no event shall CAC/Adored be liable for any lost data or content, indirect, incidental, special, consequential, exemplary, or punitive damages arising out of or relating to the material or the services provided by the designer, even if CAC/Adored has been advised of the possibility of such damages, and notwithstanding the failure of essential purpose of any limited remedy. Designer Acknowledgement: Clients acknowledge and understand CAC/Adored is comprised of multiple designers. Clients understand they will be assigned to a specific designer and remain with the same designer throughout the term of this Agreement in order to provide continuity of services. In the event the designer is unable to complete services, Clients will be transferred to another capable CAC/Adored designer to provide services. Clients also understand that Designers may operate as independent contractors and CAC/Adored can not be held liable for the contractor’s actions. CAC/Adored shall retain all rights to their training materials, proprietary materials, illustrations, graphics, or other artwork. Release: Clients agree that photographs may be altered or modified and used in order to provide the services. The clients also understand that CAC/Adored does not have to make changes to the profile or lifebook once it is complete without billing additional fees. Clients also understand and acknowledge that the cost of printing and shipping the profile is an additional expense that can be completed through the recommended printer or through another third-party printer. Typical reprint costs are $6.00 per profile. Hardcover lifebooks are $50.00 per copy. Please select: Client(s) understand, acknowledge, and agree. Client(s) are NOT choosing a Profile Design Service at this time. PAPERWORK PREPARATION AGREEMENT* If purchasing a package that includes the agency paperwork preparation services, Clients accept and understand that this service includes the preparation of application paperwork for the agencies/attorneys to whom the Client chooses to apply. CAC will prepare the paperwork only for selected agencies listed on CAC’s recommended agency/attorney list. Clients will be responsible for mailing costs and select information. Online applications can only be completed by clients. Clients are responsible for the accuracy of the applications and submitting them in a timely fashion to the agencies/attorneys. CAC is not responsible or liable for changes made by the agencies/attorneys to their applications or application process. Client(s) understand, acknowledge, and agree. LIMITATIONS* Clients accept and understand this Agreement and acknowledge that CAC operates as an adoption guidance, education, and consulting service, and in no way, claims to or operates as a licensed adoption placement agency, attorney, medical facility, or facilitator. Clients also understand CAC provides adoption guidance and advice only and CAC cannot guarantee any specific placement or situation. Clients understand CAC does not work directly with expectant/birth mothers but offers embryo adoption services including coordinating services between donors and recipients. Client(s) understand, acknowledge, and agree. RISK AND LIABILITY* Clients understand and agree that adoption is a risk. In addition, Clients agree to assume ALL liability and responsibility for the outcome of the adoption process and hold CAC harmless. In addition, Clients agree CAC is not liable for state laws, changes to state laws, and/or regulations preventing payment for consulting services. Clients agree CAC cannot be held liable for the actions or negligence of adoption agencies, attorneys, representatives, contractors, medical facilities/clinics, and/or adoption professionals. Clients also agree CAC cannot be held liable for a failed match, disrupted placement, or unsuccessful frozen embryo transfer for any reason. Client(s) understand, acknowledge, and agree. CONSULTATION ACKNOWLEDGMENT* Clients acknowledge and understand CAC is comprised of multiple adoption consultants. Clients understand they will be assigned to a specific consultant and remain with the same consultant throughout the term of this Client Agreement in order to provide continuity of services. In the event the consultant is no longer a part of CAC, the Client will be transferred to another capable CAC consultant to provide services. Clients also understand that Consultants and/or Adoption Advocates may operate as independent contractors and CAC can not be held liable for the contractor’s actions. Client(s) understand, acknowledge, and agree. CONFIDENTIALITY AGREEMENT* Clients agree that all the information obtained from CAC is a paid service to be used only for the sole purpose of the Client’s personal adoption and is considered confidential only to paying clients. In addition, ALL of the documents and communication Clients receive from CAC are part of our paid services and are the property of CAC. Sharing and/or distributing this information obtained from CAC in any manner, at any time, is strictly prohibited and in violation of this Agreement. This confidential information includes, but is not limited to, the CAC Adoptive Parent Guide, Agency and Attorney List, Embryo Adoption Program and Donor referrals, adoption situations, and all CAC email/phone/communication and advice. Clients understand and agree that this Confidential Agreement will remain in effect even after Client’s adoption is complete. Clients agree that sharing and/or distributing any confidential information provided by CAC could result in legal action against them. Client(s) understand, acknowledge, and agree. NON-COMPETE AGREEMENT* Clients agree during the term of this Agreement and for a period of 36 months immediately following the termination/fulfillment of this Agreement, whether such termination is by CAC or the Clients, that Clients will NOT engage in, consult/contract with, or hold any position as a shareholder, director, officer, consultant, advisor, advocate, independent contractor, employee, partner or investor, or otherwise assist as a part of any business entity in any state of the US, that is engaged in any activities which are competitive with the business of providing adoption consulting, profile design, and all business activities reasonably related to Christian Adoption Consultants, LLC. Client(s) understand, acknowledge, and agree. INDEMNIFICATION, LEGAL VENUE, AND MEDIATION* Clients shall indemnify, defend (at their own cost and expense), and hold CAC/Adored and its officers, employees, contractors, and agents harmless from and against any and all claims, suits, demands, damages, losses, and expenses arising from any breach, misrepresentation or other act or omission of the Clients. Clients understand and agree that this Agreement shall be governed by and construed in accordance with the laws of Georgia and the venue for any and all action or legal proceedings pertaining to this Agreement shall lie in Cherokee County, Georgia. Clients also agree that prior to any action or legal proceeding pertaining to the Agreement or CAC services, they shall enter Christian mediation which shall be conducted in Cherokee County, Georgia. Client(s) understand, acknowledge, and agree. MARKETING AND PHOTO RELEASE* Clients give permission for CAC to use photos, share quotes, stories, experiences, etc. provided by Client for marketing purposes. Please select: Client(s) understand, acknowledge, and agree. Client(s) opt out and DO NOT give permission CLIENT ACKNOWLEDGEMENTS AND PERMISSIONS* By electronically signing this agreement on September 30, 2023, Clients agree to all the terms and conditions and provide permission for CAC to process non-refundable payment to receive services. Clients also understand this agreement contains the entire Agreement of the parties and supersedes any and all previous Agreements, written or oral. This Agreement may only be amended or modified in writing and signed by both parties. Headings in this Agreement are for convenience only and do not confer rights or obligations, nor alter any terms of this Agreement. The provisions of this Agreement, that by their terms call for payment or performance subsequent to the expiration or termination of this Agreement, shall survive beyond termination. Client(s) understand, acknowledge, and agree. Client Electronic Signature – By typing or signing my name, I am using my Electronic Signature to legally sign and give my consent on the date of submission.* Spouse Electronic Signature – By typing or signing my name, I am using my Electronic Signature to legally sign and give my consent on the date of submission.* Date Signed Billing Information Billing Address: City: State: Please select your stateAlabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas United States Minor Outlying Islands Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Other… Zip: Country: Canada France French Guiana French Polynesia Greece Iceland Italy Norway United Kingdom United States United States Minor Outlying Islands Virgin Islands, British Virgin Islands, U.S. Credit Card: Expiration Date: (01) Jan (02) Feb (03) Mar (04) Apr (05) May (06) Jun (07) Jul (08) Aug (09) Sep (10) Oct (11) Nov (12) Dec 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 2038 2039 2040 2041 2042 2043 Security Code: Submit Order Gold Standard Consulting & Membership + Personal Adoption Consultant + Phone & Email Support + Confidential Adoptive Parent Guide + 6 Hour Training Certificate + Personalized Agency/Attorney List + Birth Parent Perspective Consultation + Adoptee Perspective Consultation + Adoption Risk Assessment + Home Study Recommendations + Profile Recommendations + Up to 14 Months of Service and Support Terms and Conditions Apply Have a Client Code? Apply Client Code Product Price: $4,198.00 Discount: Total Price: