Amended 1/4/16

ADOPTION SERVICES CONTRACT

Client Name:________________________________ Date:________________________

Country Program:____________________________ Service:______________________

TABLE OF CONTENTS

1.Recitals 2. Agreements 2.1 Recitals 2.2 Definitions 3. General Obligations of Client 3.1 Client Policies 3.2 Full Disclosure and Consent for Release of Confidential Information 3.3 Spouse/Partner Disclosure and Release of Information 3.4 Prompt Disclosure of Changes in Family Situation 3.5 Concurrent Adoption Applications 3.6 Disclosure of Pregnancy 3.7 Respect in Verbal and Written Communication 3.8 Confidentiality of Child’s Information 3.9 Internet Usage and Communications 3.10 Parent Education 3.11 Refrain from Unauthorized Foreign Contact 3.12 Requirement to Inform CAS if Client Elects Not to Proceed 3.13 Material Breach 3.14 Waivers 4. General Obligations of CAS 5. Home Study 5.1 Conducting the Home Study 5.2 Home Study Completed by Cooperating Agency 5.3 Responsibilities of the Client 5.4 Responsibilities of CAS 5.5 Ownership of the Home Study Report 6. Supplemental Evaluations, Counseling, or Treatment 7. Child Care Standards: Basic Safety, Care, and Behavioral Management Guidelines 8. Post-Placement and Post-Adoption Requirements, Services, and Supervision 8.1 Nature of Post-Placement and Post-Adoption Services and Supervision

8.2 Post-Placement and Post-Adoption Supervision and Report Requirements 8.3 Medical Care of Child Post-Placement 8.4 Additional Client Responsibilities 8.5 Services Provided by Cooperating Agency 8.6 Documentation Required After Child Placement 9. Guardianship Plan 10. Adoption Fees 10.1 Payment of Adoption Fees 10.2 Non-refundable 10.3 Additional Fees 10.4 No Payment to Other Persons or Entities 10.5 Fees Upon Placing Adoption Process on Hold 10.6 Fees Upon Request of Closure of Case 11. Complaint and Grievance Policy 12. Referral and Assignment of Child; Risks of Unknown Physical, Emotional, and Developmental Conditions 13. FEDEX Account Number 14. Confidentiality and Privacy 15. Case Updates 16. Travel 17. Disruption or Dissolution of Child Placement and Post- Adoption Crisis Support 18. Mandated Reporting 19. Charitable Contributions 20. Modifications of Adoption Services Contract 21. Termination of Adoption Services Contract 21.1 Effect of Termination; Survival 22. Entire Contract 23. Waiver/Subsequent Enforcement 24. No Non-Party Beneficiary 25. Choice of Law and Venue 26. Severability 27. Limitation on Liability 28. Risks Inherent in Intercountry Adoption; Release

THIS ADOPTION SERVICES CONTRACT (the “Agreement”) is made by and among Carolina Adoption Services, Inc.

(“CAS”), a North Carolina non-profit 501(c)(3) corporation, and ____________________________________ (“Client”)

whose address is: _______________________________________________________________________________.

CAS and Client are collectively referred to herein as the “parties” and individually as the “party.”

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1. RECITALS

A. Client is a natural person(s) who wishes to adopt a child or children (the “child”) born in a country (the “foreign country”) other than the United States of America (“U.S.”). Client acknowledges and is aware that the relationship established by adoption is one of parent and child, and that if Client is successful in adopting, Client will incur towards the adopted child all obligations, duties and responsibilities of a legal parent. B. CAS is a private, non-profit, licensed children’s charity and adoption agency which arranges and facilitates intercountry adoptions. C. Concurrently with or previous to executing this Agreement, Client has completed and submitted to CAS a written Adoption Application, and has paid the non-refundable application fee. D. The parties now wish to enter into an agreement regarding prospective adoption services and to define their respective rights and obligations relating thereto. The provisions of this Agreement are intended to govern those matters which are within the control of the parties. The parties acknowledge that the prospective intercountry adoption will involve a nation(s) other than the U.S., and regulations established by such other nation(s) and the U.S. government, among other entities, and that, therefore, the process is subject to uncertainty, unpredictability, and circumstances beyond the control of either party—including but not limited to changes in foreign governmental or agency policies and regulations, changes in U.S. policies and regulations, closure of foreign adoption programs, changes in foreign travel schedules and length of stay, and changes in the procedures and requirements involved in the adoption process. The parties specifically acknowledge that the ultimate success or failure of the adoption process may depend on factors beyond the control of the parties, and that any failure of the adoption process is not necessarily caused by the fault or breach of any party.

2. AGREEMENTS

In consideration of the payment(s) by Client of the required fees, and the mutual covenants and promises contained herein, intending to be legally bound, the parties agree as follow: 2.1. Recitals. The Recitals set forth above are restated and incorporated by reference herein. 2.2. Definitions.

2.2.1. Cooperating Agency. A “cooperating agency” is a social service agency which is licensed to provide adoption services, home study services, and/or post-placement services and engaged to provide such services in connection with this Agreement.

2.2.2. Adoption Committee. The “Adoption Committee” is comprised of CAS staff and lead by the Director of Social Work to consider cases where waivers to agency policy are requested and to address client concerns. Adoption Committee members also serve to provide home study reviews and approvals.

3. GENERAL OBLIGATIONS OF CLIENT

Client acknowledges and agrees that any obligations and responsibilities not expressly listed herein as being the responsibility of CAS shall be the obligation and responsibility of the Client. The Client agrees to undertake all steps necessary for the adoption and placement of the

child, including without limitation the following obligations and responsibilities. Failure of Client to fulfill these obligations and responsibilities may result in suspension or termination of services and/or termination of this Agreement and forfeiture of any fees paid to CAS.

3.1. Client Policies. Client agrees to adhere to the list of client policies attached hereto as Schedule 3.1 and incorporated herein by reference.

3.2. Full Disclosure and Consent for Release of Confidential Information. CAS requires Client to provide extensive personal and background information at the time of Client’s submission of the Adoption Application. CAS has an obligation to collect this information to fully assess the family on behalf of the foreign country and the child to be placed. CAS requires full disclosure throughout the adoption process. Providing misinformation or withholding information pertaining to personal and background information requested, including without limitation current or past medical treatment, previous involvement with adoption or foster care, counseling, substance abuse, child maltreatment, violation of laws, arrests or other relevant aspects of family background, can be grounds for termination of services and/or termination of this Agreement at any time during the process and forfeiture of any fees paid to CAS. CAS is obligated to release information about each adoptive family to the foreign entity, cooperating agency, U.S. or foreign government adoption authorities as part of the adoption process. The Client authorizes CAS to obtain any information CAS deems necessary from professional and personal sources including, but not limited to, medical and counseling professionals, family members, references, employers, accountants, law enforcement, past adoption or foster care agencies and/or any other source to thoroughly evaluate the Client and prospective adoptive family. The Client further authorizes CAS to release any and all records, documents, and information CAS may have concerning the Client and adoptive family, and to fully discuss the Client and adoptive family with any cooperating agency, any government or adoption authorities, any adoption agency and/or attorney facilitating a concurrent adoption, as applicable, officials, courts, attorneys, or personnel in the U.S. or the foreign country. This authorization applies to all Client applicable records, information, and discussions as are reasonably necessary, in CAS’s sole discretion, to provide the adoption services specified in this Agreement. The Client hereby waives their rights of confidentiality and acknowledge that the records and information to be released may include confidential information which could not be released without this written consent, including information that is specific to counseling, family planning, employment, criminal history, drug, alcohol or psychiatric treatment, child maltreatment, history or allegations of abuse, neglect, or violence, and/or HIV testing and medical diagnosis and treatment. The Client also authorizes CAS to release records and information pertaining to an incomplete or denied home study to a cooperating agency, other licensed adoption agencies and U.S. government adoption officials. The Client hereby releases CAS, its employees and agents, from all legal responsibility or liability that may arise from the release of records and information authorized herein. A Release of Information agreement and a Release to Disclose Health Information are attached hereto as Schedule 14 and incorporated herein by reference.

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3.3. Spouse/Partner Disclosure and Release of Information. The Client authorizes CAS to speak with either spouse or partner about any information learned about the other spouse or partner throughout the adoption process. By signing this agreement, each spouse or partner authorizes CAS to disclose and discuss with the other spouse or partner any confidential information CAS may learn or obtain concerning either spouse or partner. Each spouse or partner hereby releases CAS, its employees and agents, from all legal responsibility or liability that may arise from the release of information authorized herein. Each spouse or partner acknowledges that the information to be released may include confidential information which could not be released without this written consent, including information that is specific to counseling, family planning, employment, criminal history, drug, alcohol or psychiatric treatment, child maltreatment, history or allegations of abuse, neglect, or violence, and/or HIV testing and medical diagnosis treatment.

3.4. Prompt Disclosure of Changes in Family Situation. At all

times while this Agreement is in effect, Client agrees to notify CAS and any relevant cooperating agency, within five business days (unless otherwise specified herein), of any and all significant changes in their family’s situation. The Client understands and agrees that the changes in the adoptive family’s situation may impact this Agreement, their eligibility to adopt from a particular country, and/or may result in their Adoption Application being placed on hold. The time on hold will be determined by CAS, in its sole and absolute discretion, and will vary on a case-by-case basis. This is a continuing obligation on the part of the Client to keep CAS and any relevant cooperating agency informed of any changes in information, including without limitation the following:

3.4.1. Any actual or prospective change in employment, financial status, work or home address, work or home telephone numbers, marital status, physical and mental health status of members of the adoptive family, or family composition, including but not limited to any pregnancy of the Client;

3.4.2. Any efforts by Client to pursue, or being offered or receiving a child from any source other than CAS, including adoption or foster care; Client agrees to immediately provide a written statement to CAS informing CAS should they accept a child from another source;

3.4.3. Any violations of the law or arrests involving the Client or anyone living in the home; any criminal charges, other than minor traffic infractions, of the Client or anyone living in the home;

3.4.4. Any complaint made to or by any child protection agency or any allegations or charges of child abuse or neglect brought against the Client or anyone living in the home; or any investigation relating to allegations or claims of child abuse or neglect concerning the Client or anyone living in the home;

3.5. Concurrent Adoption Applications. Client understands and agrees that concurrent adoptions, through any source, are only allowed in exceptional situations and by approval of CAS’s Adoption Committee in its sole and absolute discretion. Client understands that CAS cannot work with clients who are seeking adoptive placements through other placing sources simultaneously without an express waiver of this condition by CAS. Client agrees to withdraw any

adoption application with any other adoption agency upon CAS’s acceptance of their Client application. Client who initiates a concurrent adoption with another country program at CAS is responsible for paying all fees associated with both country programs, including the agency fees. Client will be responsible for completing a full home study for both country programs. The Client applications will be considered distinctly separate adoption processes. If the Client accepts a child from either of the CAS programs and the Client has not yet been assigned a child from the alternative CAS program, CAS may place the latter adoption application on hold. The exact amount of time on hold will be determined by CAS in its sole and absolute discretion and will vary depending on the country the Client is applying to adopt from, the timeframe of the adoption process, and the average age of the child referred from the country. Client understands and agrees that waiver of the prohibition on concurrent adoption applications, whether with CAS or another adoption agency(ies), is on a case-by-case basis upon approval by the Adoption Committee of CAS, in its sole and absolute discretion. If a waiver is granted by CAS, Client must also provide CAS a written statement from the other adoption agency(ies), if applicable, on its letterhead declaring that the other adoption agency is aware of the Client‘s concurrent adoption application with CAS and will inform CAS immediately upon Client’s acceptance of a child. Client also authorizes CAS to release any information to and obtain any information from any adoption agency and/or attorney or cooperating agency facilitating a concurrent adoption. Client also understands and agrees that if the Client accepts a referral of a child from CAS, Client must not accept a referral of another child, from any source, until they have completed CAS’s post-placement supervision (generally three visits). If the Client accepts a child from another source or from a CAS program, and the Client has not yet been referred a child from an alternative CAS program for which it has a pending adoption application, CAS may place the adoption Client application on hold, in CAS’s sole and absolute discretion. The exact amount of time on hold will vary depending on the country the Client is applying to adopt from, the timeframe of the adoption process, and the average age of the child referred from the country. The Client understands and acknowledges that a child adopted through CAS must have at least one year’s age different from any and all children in the home.

3.6. Disclosure of Pregnancy. Client certifies that she is not currently pregnant. Client understands and agrees that CAS policy requires at least one year’s age difference between any and all children in the home, whether by birth, adoption or otherwise. Client understands and agrees that if the Client becomes pregnant or accepts a child from another source, and the Client has not yet been assigned a child from CAS, CAS may place the adoption application on hold, in its sole and absolute discretion. The exact amount of time on hold will vary depending on the country the Client is applying to adopt from, the timeframe of the adoption process, and the average age of the child referred from the country. If a pregnancy should occur after the Client accepts the referral of a specific child from CAS, the Client will immediately notify CAS and CAS will reach a decision via the Adoption Committee.

3.7. Respect in Verbal and Written Communication. Client understands and agrees that CAS, CAS staff and the Client have a shared responsibility to treat each other with mutual

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respect in all communication including emails, telephone calls, and personal meetings. Client agrees to use respect in all communication with CAS. Client will not make unreasonable demands or speak in an aggressive or disrespectful manner to staff. When voicing dissatisfaction, Client agrees to remain calm and non-threatening. Client further acknowledges that Client is not permitted to dictate deadlines with respect to any aspects of the adoption process or how or when information is communicated to the foreign country, or its government, agencies, representatives or agents.

3.8. Confidentiality of Child’s Information. Client acknowledges

and agrees that all information relating to a child’s information and identity is confidential and only intended for the Client’s use and information before the adoption is finalized. Client agrees not to disclose and to keep confidential any identifying information concerning the child they are referred or may adopt until such time as the adoption is final.

3.9. Internet Usage and Communications. Client understands

and agrees that information provided over the Internet, including through adoption bulletin boards, web forums, blogs, and social media outlets, is accessible to everyone, including foreign government officials and agencies. Client understands and acknowledges that posting or sharing negative or damaging information via the Internet could be damaging to the international adoption process as a whole. Client acknowledges and agrees to password protect their personal websites and adoption blogs for the sake of personal safety and privacy. Client acknowledges and agrees to restrict any information Client shares or posts via the Internet about the adoption process or about the child they are referred or may adopt to non-identifying information during the adoption process.

3.10. Parent Education. An Educational Agreement is

attached hereto as Schedule 3.10 and incorporated by reference. Client understands and agrees that they are required to complete ten (10) hours of specific education training through the Because they Waited program from Heart of the Matter Seminars (a link is provided on the CAS website) or comparable education training pre-approved by CAS. The ten (10) hours of training must be completed prior to the completion of the home study. Client further understands that CAS recommends that Client complete a total of thirty (30) hours of education and agrees to work towards obtaining the full thirty (30) hours of recommended training. Client agrees to complete and submit a verification of educational training completed. Client further agrees to assume responsibility for all costs to any third parties necessary to complete the educational. Client acknowledges that CAS may grant in its sole and absolute discretion, but is under no obligation, to exempt the Client for all or part of the training required and understands that CAS may consider the Client’s previous training, education and personal experiences relating to intercountry adoption and parenting when determining whether an exemption from all or part of the required training may be granted. Countries may have different education requirements and CAS reserves the right to change the required education requirements. If the Client is adopting from China, the Client understands and agrees that they must complete twelve (12)

hours of specific education training as required by the China Center for Children’s Welfare and Adoption (“CCCWA”).

3.11. Refrain from Unauthorized Foreign Contact. All communications with persons, agencies or entities involved in the adoption process in foreign countries (collectively, the “Foreign Entity”) must be made through CAS. Client understands and agrees that contact with and/or gifts to the Foreign Entity can jeopardize Client’s proposed adoption and can cause substantial harm to pending adoptions to other families, to CAS’s relations with such Foreign Entities, and to the future of intercountry adoption in general in such countries. Client therefore agrees to strictly observe the following:

3.11.1. All communication throughout the adoption process regarding the Client’s adoption case will be through CAS. Client agrees, at all times while this Agreement remains in effect, and except as otherwise specifically allowed by this Agreement, to refrain from, and shall not cause, solicit, or allow any third party, other than parties contemplated by this Agreement, to make on Client’s behalf or directly contact the Foreign Entity, other government official, the birth parent, relative or guardian of the any child referred to the Client, foster home, children’s home, orphanage, attorneys, or any other facilitating agency in the foreign country from which the Client is seeking to adopt. Client further agrees not to ask or use relatives, friends, or acquaintances that live in the foreign country to obtain information. Client agrees not to use an independent attorney or investigator in the foreign country to intervene in the adoption process of their behalf.

3.11.2. At all times while this Agreement remains in effect, the Client must refrain from providing, promising, or causing, soliciting or allowing any third person to provide or promise on Client’s behalf, any gift, money or other consideration to any birth parent, relative, guardian of any child referred to the Client, or to any Foreign Entity, other government official, foster home, children’s home, orphanage, attorneys, or any other facilitating agency in the foreign country from which the Client is seeking to adopt.

3.11.3. The Client agrees to share any questions or concerns with CAS for submission to any Foreign Entity. Client further understands that expediting services are not generally available through the adoption process with foreign agencies.

3.11.4. These restrictions continue in effect after a child has been referred and placed with the Client and terminates only when an adoption of the child by the Client has been finalized.

3.12. Requirement to Inform CAS if Client Elects Not to Proceed. In the event the Client decides not to continue with the adoption process at any stage of the process, the Client will notify CAS immediately.

3.13. Material Breach. Client understands and agrees

that any breach of any of the obligations, terms or responsibilities of this section 3 or the Client Policies listed on Schedule 3.1 is a material breach of this Agreement.

3.14. Waivers. If Client seeks a waiver of any of the

obligations, requirements or responsibilities of this section 3

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which may be waivable, Client understands and agrees to comply with CAS’s policy regarding such waivers and that all decisions made by CAS or the Adoption Committee are made in CAS’s sole and absolute discretion and are final.

4. GENERAL OBLIGATIONS OF CAS

In consideration of the payment by Client of the required fees and of the agreements contained herein, CAS agrees to provide adoption services to the Client as specified in this Agreement. A list of client rights is attached hereto as Schedule 4.1 and incorporated by reference. CAS shall ensure that adoption services are provided ethically and in the best interests of the children which prevent, to the best of its ability, abduction, exploitation, sale, or trafficking of children. CAS does not compensate any individual or entity who provides adoption services with an incentive fee or contingent fee for each child located or placed for adoption. The Client acknowledges and understands that CAS’s obligations to the Client under this Agreement are limited by CAS’s legal obligation to act at all times in the best interests of any child referred or to be placed with Client under this Agreement. Nothing in this Agreement obligates CAS to provide any report or consent which is favorable to the Client if, in CAS’s sole discretion and professional judgment, a favorable report or consent is not warranted. CAS shall provide professional and caring services and will diligently manage the Client adoption case. CAS will maintain communication with the Client, educate and update the Client about their adoption process, notify the Client in a timely manner of significant adoption milestones, ensure issues with CAS’s control are resolved in a timely manner. CAS shall keep Client personal information and files strictly confidential except as required by law or as specified in this Agreement. CAS is obligated to provide services to Client only in accordance with the provisions of this Agreement, and only upon satisfaction by Client of all conditions precedent, including payment by Client of all fees required herein and in the Explanation of Fees and Services.

5. HOME STUDY

A home study is an educational and investigative process for determining whether the Client meets applicable minimum standards for adoption and is otherwise suitable to parent an adopted child. The home study process will begin after CAS has approved the Client’s Application for Services, after the Client has paid the required fee, and prior to placement of any child with the Client for the purpose of adoption. In addition to the terms contained here, the Client and CAS will enter into a Home study Agreement. To the extent there is a conflict between the terms of this Agreement and the Home study Agreement, the terms of the Home study Agreement will control.

5.1 Conducting the Home Study. The adoption process will proceed only upon completion of a written home study report for the Client and upon CAS’s approval of such report. If the Client is approved for home study services, CAS or a cooperating agency will conduct the home study. If the home study is prepared by CAS, the Client will have an opportunity to review a draft of the home study. CAS may decline to prepare or approve a home study report for Client if CAS, in its sole and absolute discretion, does not believe

that Client satisfies applicable minimum standards for adoptive homes or otherwise is unsuitable to adopt. Should a home study result in a “non-approval,” a written explanation of CAS’s decision will be made available within 5 business days. If CAS or any cooperating agency declines to prepare or approve a home study report, this Agreement will automatically terminate, and no further adoption services will be provided by CAS. The Client understands and agrees that the preparation of and approval of a home study report does not guarantee that any child will be referred to or placed with the Client, or that any adoption will necessarily take place or be finalized. CAS reserves the right to revoke or modify any home study approval or consent if, at any time prior to finalization of the adoption, CAS receives or obtains information which leads CAS to believe that an adoptive placement with the Client would not be in a child’s best interests Regardless of any termination of this Agreement, whether by CAS or by the Client, CAS may, in its sole discretion and based on the best interests of potentially affected children, complete and provide any unfavorable home study report or recommendations concerning the Client to applicable immigration, child-caring, and other government officials. The Client hereby authorizes such disclosure by CAS and agrees that this authorization may not be revoked or withdrawn, notwithstanding any other provision of this Agreement.

5.2 Home Study Completed by Cooperating Agency. In the event a home study is conducted by someone other than CAS, CAS requires the cooperating agency to submit a draft of the Client’s home study for review to ensure that CAS, federal and foreign requirements have been met. If adopting internationally, the agency completing the home study must have a signed agreement with CAS in order to accept such home study. An original home study including a copy of the cooperating agency’s license is required in order to fully accept the home study for submission to the foreign country. A Home study Approval Letter will be sent to the Client acknowledging that all requirements have been met within the home study.

5.3 Responsibilities of the Client. Clients whose Application for Services has been approved are required to complete a home study. If the Client resides outside of North Carolina, or outside a state served by CAS or its affiliates, the Client must initiate the home study process by selecting and contacting a cooperating agency from the names provided by CAS or otherwise approved by CAS and licensed in the Client’s state of residence. When the home study is prepared by a cooperating agency other than CAS, a formal agreement must be in place between CAS and the cooperating agency before the Client can begin the home study process. The Client is responsible for obtaining a home study that satisfies CAS’s home study requirements as well as the requirements of the sending country, CAS’s state of operation, applicable Hague Convention requirements, and the requirements of the U.S. Citizen and Immigration Services (“USCIS”). The Client is responsible for paying all costs and fees associated with the home study, whether conducted by CAS or a cooperating or approved agency, to the home study agency. Client is responsible for completing home study updates, amendments and addendums, as required by state licensing, USCIS, or the Foreign Entity if the original home

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study expires. In addition, home study updates may be required for other reasons, including without limitation if the Client has a significant change in their family situation, there is a change in the age, gender, or health status of the child desired, the Client moves, the Client experiences a change in employment status. The Client is responsible for obtaining, paying for and transmitting to CAS such update, amendment or addendum. Failure to fulfill these responsibilities is a material breach of this Agreement and may result in the suspension or termination of the adoption process or this Agreement, including forfeiture of any fees paid to CAS.

5.4 Responsibilities of CAS. If the Client is approved for home study services provided by CAS, CAS will assign a social worker to complete the home study and post adoption reports for families residing in North Carolina, South Carolina, and Virginia. CAS social workers who conduct the home studies may be independent contractors who are expected to adhere to NASW Standards of Practice, regulations of the Hague Convention on Inter-country Adoptions, as well as the agency’s policies and procedures.

5.5 Ownership of Home Study Report. Any written home study report prepared for Client by CAS is the sole property of CAS and may not be copied or distributed, or used for any non-CAS adoption, without the express advance written permission of CAS. 6. SUPPLEMENTAL EVALUATIONS, COUNSELING, OR

TREATMENT

CAS, USCIS or the foreign country may require Client to obtain independent psychological or medical evaluations, counseling or treatment prior to the completion of a home study or the placement of a child. CAS recommendations may include without limitation psychological testing, marriage or individual counseling, infertility counseling, substance abuse evaluations, parenting classes. Foreign countries may also require additional evaluations before making a decision about accepting the Client adoption application. The cost of these services will be the responsibility of the Client. Client agrees to comply with recommendations of CAS, USCIS, or the foreign country to obtain independent evaluations, counseling, or treatment and understand and agree that they are responsible for the costs and expenses incurred. Refusal to comply with these requests may result in suspension or termination of services and/or termination of this Agreement and forfeiture of any fees paid to CAS. 7. CHILD CARE STANDARDS: BASIC SAFETY, CARE,

AND BEHAVIORAL MANAGEMENT GUIDELINES

See Client Policies attached hereto as Schedule 3.1 to this Agreement and incorporated by reference herein.

8. POST-PLACEMENT AND POST-ADOPTION REQUIREMENTS, SERVICES, AND SUPERVISION

8.1 Nature of Post-Placement and Post-Adoption Services and Supervision. Post-placement services and supervision occur and are to be fulfilled from the time the child is placed in the home until the adoption is finalized. Post-adoption services and supervision occur and are to be fulfilled once an adoption is finalized. The number and nature of post-placement and post-adoption requirements may differ from case to case, depending on the laws and rules of the sending country, the Client’s home state, and other applicable

jurisdictions, and depending on the needs and circumstances of each individual placement. Specific post-placement and post-adoption requirements for the specific country program selected is provided in the country-specific information pages attached hereto as Schedule 10.1 and incorporated herein by reference. Supervision provides an opportunity for the Client to express joys and concerns about their family’s and child’s adjustments. CAS and the family’s social worker may continue providing education about the common adjustments families face after their child arrives home and provide community and adoption resources that may be helpful for the child and family. CAS may also help connect families who have experienced similar situations and can be sources of ideas, support and encouragement for one another. Supervision reports provide the government adoption authorities in the child’s birth country with information concerning the child’s adjustment and serve as an important testimony to the benefit of international adoption for children.

8.2 Post-Adoption and Post-Placement Supervision and Report Requirements. In addition to the specific post-adoption requirements of the sending country, CAS requires a minimum of three post-adoption visits with a social worker, at months 1, 3 and 6, and written reports and photos to be submitted to CAS after the child is placed with the Client. All family members are expected to be present for the visits, which will occur in the home or as required by applicable state law. Client may be asked to travel to the social worker’s location for one or more post-adoption visits. Several foreign countries have additional post-adoption report requirements with which the Client must comply. These reports are referred to as, “Country Reports” throughout this Agreement. CAS will provide the Client with a format for these reports, accept them from the Client, maintain a copy in the Client’s adoption record at CAS, and submit them to the appropriate foreign government agency in a timely manner. Some countries require the reports to be completed by a social worker rather than a family-generated report. The list of current requirements of CAS, your state of residence, or the sending country is subject to change as a result of changing laws in either your state of residence or the child’s country of origin. For complete information on the specific sending country’s post-adoption requirement, refer to the country-specific information pages attached hereto at Schedule 10.1. In some countries, information regarding the adoptive parents, the adoptee, the court proceedings as well as post-adoption reports are considered Public Record and accessible by birth parents and relatives. Though it is rare, this might result in the Client receiving communication from birth parents or relatives. The Client agrees to contact CAS should this occur to determine the appropriate action.

8.3 Medical Care of Child Post-Placement. The Client agrees to assume full responsibility for the care, custody, medical treatment, dental care and mental health treatment of their child upon placement and through the age of majority. The Client agrees to obtain a thorough examination of their child within thirty (30) days of the child’s arrival in the U.S. In addition, CAS recommends that the Client place the child under the care of a licensed physician for routine health care. The Client agrees to inform CAS of any serious injury or illness of the child about which the Client becomes aware during the adoption process.

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8.3.1 Health Insurance Requirement. CAS requires and the Client agrees to provide health insurance coverage for each family member and to provide proof that their health insurance carrier will provide coverage for their adopted child upon placement with their family. The Client is required and agrees to assume full responsibility for all medical expenses incurred by their child upon his or her placement with their family, whether that occurs overseas or in the U.S. If their current health insurance will not provide immediate coverage upon placement of their child with the family for the purpose of adoption, the Client must arrange to obtain medical insurance that will. Client must be diligent about researching their coverage to be sure their health insurance provider will cover pre-existing conditions and any undiagnosed medical conditions which may be present after placement or preexisting condition diagnosed before placement. Group Health Insurance plans governed by ERISA protect adoptive and foster families from pre-existing conditions clause provided the Client meets the plan’s requirements (OMNIBUS Reconciliation Act 1993). The Client is responsible for reviewing their plan’s individual requirements and regulations.

8.3.2 Immunizations and Medical Treatment. CAS recommends and the Client agrees to immunize their adopted child in accordance with physician recommendations and also agrees to their child receiving medical treatment and blood transfusions should their child require it.

8.4 Additional Client Responsibilities. The Client is solely responsible for complying with all post-placement and post-adoption requirements, including those of CAS, of the sending country, and of the Client’s state of residence and other applicable jurisdictions. The Client agrees to accept post-placement and post-adoption supervision, complete the minimum three post-adoption visits and reports with the social worker, and comply with any and all additional supervision requirements set by the state and the foreign country, such as submitting family reports and photos. At the recommendation of CAS and based on the assessed needs of the child and family, the Client agrees to meet with their social worker for additional post-placement or post-adoption visits at their expense. At the time of receiving a referral, the Client will receive a Post-Placement/Post-Adoption Agreement as a part of the Referral Acceptance Packet. This agreement will outline the total number of CAS-required visits and Country Reports visits. Fees associated with the reports, the post-adoption administrative cost, as well as a required deposit, will be set at the presiding rate at time of referral. Fees are based on a per child rate. The Client agrees to be responsible for the costs and fees incurred for the visits and post-placement and post-adoption administration, including without limitation any translation fees and shipping fees related to sending the reports to the child’s country of origin, whether such services are provided by CAS or a cooperating or approved agency. Fees are subject to change. Should there be an increase in the fee for visits and post-placement or post-adoption administration between the point of payment and the time in which services are rendered, the Client agrees to be responsible for the difference. The Client agrees the Country Report deposit will only be refunded if the Country Reports are completed and submitted in a timely manner. The Client agrees the Country Report deposits will be considered non-refundable if any one report is more than 3 weeks late or if 3 or more reports are late.

The Client must provide the social worker performing the post-placement and post-adoption services with reasonable access to the Client’s home and family during normal working hours, even if this requires the Client to take time off from work.

8.5 Services Provided by Cooperating Agency. If the Client resides outside of North Carolina, or outside a state served by CAS or its affiliates, the Client must select and contact a cooperating agency from the names provided by CAS or otherwise approved by CAS and licensed in the Client’s state of residence to perform the post-placement and post-adoption services. When such services are to be provided by a cooperating agency other than CAS, a formal agreement must be in place between CAS and the cooperating agency before the Client can begin the post-placement and post-adoption services.

8.6 Documentation Required After Child Placement. The Client acknowledges and agrees to the following:

8.6.1 CAS requires and the Client agrees to provide to CAS all Clients to submit copies of all medical, adoption or guardianship documents received in their child’s birth country to CAS.

8.6.2 CAS requires and the Client agrees to finalize their child’s adoption, or re-finalize if the adoption was completed in the child’s birth country, in a U.S. Court according to the laws of the Client’s state of residence as soon as possible. CAS requires and the Client agrees to provide to CAS a copy of the U.S. final adoption decree to CAS as soon as possible.

8.6.3 CAS requires and the Client agrees to obtain documentation of U.S. Citizenship for their child and to provide proof of their child’s U.S. Citizenship to CAS. This can be done either by applying for a U.S. passport or a Certificate of Citizenship and provided to CAS. Either of these documents must be in their child’s full, legal English name. If the adopted child travels home on an IR-4 visa, the child will not be eligible to apply for U.S. Citizenship until the Client finalizes/re-finalizes the adoption in a U.S. court.

8.6.4 CAS requires and the Client agrees to obtain a Social Security number for their child and to provide evidence of such (i.e. last 4-digits) to CAS.

8.6.5 CAS requires and the Client agrees to complete Embassy/Consulate Registration, if required by child’s country of origin. Client agrees to pay a Consulate Registration Deposit when adopting from a country with this requirement and understands that the deposit is non-refundable if proof of Embassy/Consulate Registration is not provided to CAS within six (6) months of placement.

8.6.6 The Client agrees to notify CAS of any moves or significant changes in the family’s situation prior to the adoption being finalized/re-finalized in a U.S. court or the completion of post-adoption supervision, whichever is later. If the adoption is not finalized in the child’s birth country, the Client agrees not to move to a new residence without first notifying CAS. Some countries strictly forbid the family from moving until the adoption is finalized.

8.6.7 The Client understands that if they choose not to abide by these CAS post-adoption requirements, they are violating the requirements of CAS and the terms of this Agreement. They may still have to complete this step in the future if a U.S. final adoption decree or Proof of Citizenship is required by any Government, agency, school or business. The Client also understands that there may be a risk to their child’s inheritance rights by not having a State-issued legal adoption document widely recognized in the United States. The Client will not hold CAS responsible in any way should there be any

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repercussions from their failure to abide by CAS’s post-adoption requirements.

9. GUARDIANSHIP PLAN

CAS requires and Client agrees that Client will identify and formalize a viable guardianship plan for their child should something happen to the Client after the adoptive placement. Some countries, such as China, may have additional specific requirements regarding a guardianship plan. Client agrees to comply with the sending country’s requirements, as applicable. The Client further understands that CAS strongly encourages the Client to establish as will, which includes a guardianship plan, prior to travel.

10. ADOPTION FEES

10.1. Payment of Adoption Fees. Client is solely responsible for paying or arranging the payment of all fees and expenses associated with services rendered pursuant to this Agreement in the amounts and at the times specified in the Explanation of Fees and Services attached hereto as Schedule 10.1 and incorporated by reference herein. Client shall comply fully with all fee policies and procedures established by CAS and/or set forth in the Explanation of Fees and Services, and such policies and procedures are incorporated by reference herein and made part of this Agreement. CAS shall provide regular billing statements to Client. Payment is due within thirty (30) days of the date of the billing statement. A year-end statement is available upon request. Client understands and agrees that all fees are due as or before services are rendered and agrees to pay the fees to CAS in a timely manner consistent with the policies and procedures of CAS. CAS is not obligated to provide services until the appropriate fees are fully paid. Client understands and agrees that Client must pay the final balance due prior to adoption placement. The Client must pay the entire balance due to CAS prior to travel to the country to pick up the child. Client understands and agrees that if fees are not paid according to the policies and procedures of CAS, the Client will not be able to advance to the next step of the adoption process. 10.2. Non-refundable. Client understands and agrees that all fees associated with the adoption are non-refundable except as expressly set forth herein. The chart below identifies instances when a portion of the fee may be refunded; fees not included on the chart below are nonrefundable. All requests for refunds must be in writing to the CAS Executive Director. Any refund to which the Client may be entitled will be paid within sixty (60) days of the CAS Executive Director’s receipt of written request. Outstanding amounts due to CAS pursuant to the fee scheduled or otherwise for services rendered will be withheld from any refunds. The Executive Director of CAS, in his/her sole discretion, retains the right to assess individual cases and determine refunds for unique and exceptional circumstances. Travel-related costs and other expenses personally incurred by or paid by the Client shall not be refundable or reimbursable by CAS.

Home study Fee Nonrefundable after the first social worker visit If a Client closes their case after submission of the Home study History but prior to the first social

worker visit, refunds for unexpended funds will be pro-rated based on a professional service fee. Nonrefundable regardless of the recommendation in the home study report.

Professional Services Fee: Part B

50% of the Professional Services fee is refundable if the Client withdraws within 4 weeks after the home study is approved; no refund thereafter.

International Fee

Nonrefundable when paid to CAS regardless if the Client withdraws, declines referral, or is not approved by the government officials abroad or the U.S. government or its agencies. If the Client(s) unreasonably or arbitrarily withholds their acceptance of a child for adoption Carolina Adoption Services shall have the sole and complete discretion to retain some or all of the fees and terminate all further obligations to the Adoptive Parent(s) pursuant to the Agreement.

Country Report Deposit(Paid upon acceptance of referral)

Deposit is 100% refundable if the Client withdraws before the child arrives home. Deposit will only be refunded if the country reports are completed and submitted in a timely manner. Deposits will be considered non-refundable if any one report is more than 3 weeks late or if 3 or more reports are late.

Refundable Consulate Registration Deposit

100% of the deposit is refundable upon timely & successful registration with the appropriate consulate and documentation of such is provided to CAS within six (6) months of placement.

Post-Placement/Post-Adoption Fee

Nonrefundable once a post-adoption visit is scheduled.

Finalization Fee Finalization fee is considered earned and therefore non-refundable after the placement. To avoid additional fees the family should finalize adoption within 12 months.

10.3. Additional Fees. Client understands and agrees that the fees set forth in the Explanation of Fees and Services, or as otherwise required in the adoption process, may be subject to change. Client agrees that CAS shall not be held responsible for changes in adoption fees or expenses incurred by Client. The foreign country may raise the amount of fees needed to complete the process of adoption or guardianship while caring for the needs of the child. If the foreign country increases its fees the Client will be responsible for the new fees. The USCIS and Department of State may increase the fees needed to complete Client applications and fingerprints at any time. The Client will be responsible for the fees current at the time they submit the Client application or are fingerprinted

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The Client will be notified by CAS of any fee changes that may occur during their adoption process. The Client understands and agrees that Client is responsible for paying the fee that is current at the time the service is billed to the Client, even if such fee is different from that disclosed in the Explanation of Fees and Services. If the additional fees exceed $1,000, CAS will obtain and record the consent of the Client before expending such fees and holding the Client responsible for the fees, unless the Client has waived the consent requirement in advance. 10.4. No Payment to Other Persons or Entities. While this Agreement is in effect, Client shall make no payment of any kind for adoption services or fees to any person or entity other than (a) CAS, (b) such persons, cooperating agencies, or other entities as CAS shall specifically designate, (c) any legal counsel retained by Client, and/or (d) any physician or medical professional retained by the Client. Client is specifically prohibited from making any payment to any official or employee of any foreign nation or orphanage, any birth parent of a prospective adopted child, and any relative or friend of or person in a position to influence such birth parent. CAS prohibits its employees and agents from giving or receiving money or other consideration, directly or indirectly, to a child’s birth parent(s), other individual(s), or an entity as payment for the child or as an inducement to release the child. Furthermore, permitted or required contributions and fees shall not be remitted as payment for the child or as an inducement to release the child. 10.5. Fees Upon Placing Adoption Process On Hold. The Client may place their adoption application on hold for up to 90 days without forfeiting their agency fees. During the on-hold period the Client will continue to receive the agency monthly updates, newsletters and special announcements, but will not have access to program staff. If the Client decides to re-activate their application in this timeframe, they are responsible for completing any new paperwork required, which may include filing new USCIS forms, completing a new home study and processing a new dossier. CAS will apply 100% of the family’s previously paid CAS agency fees to the reactivated adoption if the case resumes within 90 days. For any services rendered, Client will be charged at the rate that is current at the time of billing for the service. 10.6. Fees Upon Request of Closure of Case. If the Client requests in writing that their case be closed, they are eligible to re-open their case within in 12 months without a new Client application fee. All other fees upon re-opening of their case will be assessed at the current rate at time of billing for the service.

11. COMPLAINT & GRIEVANCE POLICY

The Complaint and Grievance Policy is set forth on Schedule 11 attached hereto and incorporated by reference, and the Client understands and agrees to follow the complaint and grievance process in the event that the Client has a complaint regarding their adoption process.

12. REFERRAL AND ASSIGNMENT OF CHILD; RISKS OF UNKNOWN PHYSICAL, EMOTIONAL, AND

DEVELOPMENTAL CONDITIONS

The Client acknowledges and agrees that Client has been fully informed about the risks inherent in intercountry adoption due to lack of information regarding birth parents

and background information; information may be limited, incomplete, and/ or erroneous. A non-exhaustive list of Risks of Unknown Physical, Emotional and Developmental Conditions is attached hereto as Schedule 12 and incorporated herein by reference.

13. FEDEX ACCOUNT NUMBER

CAS requires and Client agrees to establish an account with FEDEX and to provide the account number to CAS for the purpose of processing and transporting Client’s documents for international adoption. Client understands and agrees that any shipment of documents by CAS shipped on Client’s behalf will be charged to the Client’s FEDEX account when possible, otherwise the Client will be billed for the shipping fees by CAS. A separate FEDEX instruction sheet and agreement is attached hereto as Schedule 13 and incorporated herein by reference.

14. CONFIDENTIALITY & PRIVACY

All CAS staff, contract service providers, interns, board members and volunteers shall ensure Client information is kept confidential and private to the greatest possible extent, except as required for the purpose of the adoption process. Staff working with South Carolina Clients are also subject to 20-7-690, 20-7-780, and R114-4950, Codes of Law of South Carolina. If during their employment or contractual period, employees, contract service providers, interns and volunteers acquire confidential or proprietary information about the agency and its Clients, such information is to be handled in strict confidence and not to be discussed with individuals not subject to the organization’s confidentiality policy. Authorized personnel can view specific information on a “need-to– know” basis. CAS staff that are not directly involved with the Client’s case are not permitted to view Client files without express consent from the agency director or his/her designee. Agency records are available for onsite review by authorized auditing personnel and contractors, state licensure staff, accreditation reviewers, Department of State & Immigration Personnel due to the nature of their role. All records shall be safeguarded in accordance with applicable state licensing regulations in order to assure confidentiality of any materials from the case record during quality assurance activities. These reviewers must sign a Confidentiality Statement prior to reviewing agency records. Clients have a right to add a statement to their case record about the services being provided to them or services they wish to receive. If personnel insert a statement in response, such statements are inserted with the knowledge of the Client and he/she is given the opportunity to review such a response. Copies of any response to this statement by CAS must be provided to the Client. The agency also adheres to the regulations stipulated under HIPAA (Privacy Act), in that relevant information of Clients is kept confidential and protected. By law, there are some situations when information about the Client may be shared without the Client’s permission. These include: internal communications, non Client-identifying information, medical emergency, court order, criminal activity, audit & accreditation, child abuse/neglect investigations. CAS may obtain legal counsel regarding the confidentiality of records and Client information and the conditions under which they may be subpoenaed or

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otherwise obtained or released, as necessary, when courts, public officials, investigative entities, law enforcement bodies, or others seek special or unusual information about an individual or family. Client understands that, unless otherwise required by law, consent is not necessary where the request for information or documents is pursuant to a subpoena. When CAS receives a request for the release of confidential information about a person or family served, or the release of confidential information is necessary for the provision of services, the organization, and prior to releasing such information:

a. Determines if the request is valid and in the best interest of the person or family;

b. Obtains the informed, written consent of the person or family served;

c. If the person is an adult or minor who is incapable of providing informed consent, obtains consent from his/her parent or legal guardian. CAS prohibits, during the completion of the adoption process:

a. Required or coerced use of public statements by persons served that express gratitude to CAS;

b. The use of photographs, videotapes, audio-taped interviews, artwork, or creative writing for public relations or fundraising purposes without the informed consent of that person, or his/her parent or legal guardian. Case records are confidential and access to case records is limited. Clients have the right to review their case records, unless prohibited by law or determined to be harmful to the person served, and such reviews are:

a. Consistent with all applicable legal requirement; b. Conducted in the presence of professional personnel on the

CAS premises; and c. Carried out in a manner that protects the confidentiality of

family members and others whose information may be contained in the record. A Release of Information agreement and a Release to Disclose Health Information are attached hereto as Schedule 14 and incorporated herein by reference.

15. CASE UPDATES

CAS has regular communication with the foreign governments, agencies and other entities and systems in place to obtain information relating to intercountry adoption. CAS will make each family aware of updates on their case and the child referred to their family in a timely manner if such updates are received. CAS understands each Client’s desire for information, especially if their case has faced unexpected delays. The Client understands and acknowledges, however, that CAS is working with foreign governments, agencies, and other entities outside of CAS’s control and CAS cannot intervene in the process that is in place to facilitate adoptions with that country. Intervening could greatly jeopardize CAS’s relationship with that country and cause delays for the Client process and for other adoptive children in the future. If medical concerns arise for the child the Client wishes to adopt, CAS will endeavor to share the Client physician’s concerns with the foreign placement agency or government adoption authority. The Client understands and acknowledges that CAS cannot guarantee a response to every question or that action will be taken in the foreign country. Final medical decisions rest with the medical

professionals directly caring for the child in the foreign country.

16. TRAVEL

Different countries impose different travel requirements on adopting parents. In some cases, the Client may be required to travel to the sending country to take custody of and accept the adoptive child. In some cases, the Client may be required to travel to the sending country on more than one occasion, for example to first see the child and later to take custody of and accept placement of the child. In the event the Client is required, or elects, to travel to the sending country for adoption-related purposes, the following provisions apply:

16.1. The Client is responsible for obtaining and paying for U.S. passports and ensuring the passports are valid for at least six months before and after the dates of the adoption trip. Client is also responsible for obtaining visas for traveling to the foreign country, as applicable. The Client understands that CAS has no control over and cannot influence the processing of the Client’s U.S. passport applications or visa applications.

16.2. The Client understands and acknowledges that the Client is solely responsible for paying all costs of any and all travel and travel activities of the Client, any travel companions, and the referred child, including but not limited to airfare, airport taxies or transportation, exit fees, accommodations, meals, local taxis or other transportation, entertainment, guides, and travel insurance.

16.3. The Client understands and acknowledges that before the adoption is final, the child referred to a Client is not legally a child of the Client. There are possible risks that the adoption will not be completed. Families working under Hague Convention Regulations must clearly know, understand and strictly follow the procedures regarding visitation and legal proceedings. A violation of the Hague Convention Regulations places the completion of the adoption at risk.

16.4. The Client acknowledges that visitation of the child by the Client in non-Hague countries is at the discretion of the agency, foreign facilitator and/or the government officials in the child’s country.

16.5. The Client understands and acknowledges that CAS cannot ensure the safety of the Client or other travel companions when traveling in the U.S. or overseas. Travel to a foreign country may involve risks and hardships, including, but not limited to, crimes, accidents, exposure to illness or disease, unsanitary or unsafe food and water, inadequate or non-existent medical and dental services, and political instability. The Client and any travel companions will carefully consider these risks before electing to travel overseas, or electing to participate in a program that requires overseas travel.

16.6. The Client understands and acknowledges that adoption or immigration processing may be delayed in the sending country, and that travel may be delayed or stays in the sending country may be extended. The Client agrees to remain solely responsible for all travel expenses even in the event that any travel is delayed or in the event extension of travel requires the Client to remain in the sending country longer than anticipated.

16.7. As a courtesy, and if requested, CAS will provide the Client with a country-specific travel guide that provides information and preparation relevant to traveling to the

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foreign country. The Client understands and agrees that such travel information or recommendations with respect to travel agents or guides are not the employees or agents of CAS, and that CAS cannot and does not guarantee or assure the cost, reliability, accuracy of availability of any such travel arrangements, information, schedules, accommodations, or guides.

16.8. CAS will conduct a travel conference call before each Client’s trip to review the in-country process and address the Client’s questions.

16.9. Client agrees to inform CAS of any medical issues that may impact their travel to and stay in the foreign country (e.g., medications, medical equipment, and physical limitations).

16.10. Client understands and agrees that the Client may need to take large sums of cash to the foreign country and accept responsibility for the security of the money. When possible, CAS will wire adoption-related fees that need to be paid in the foreign country, but wiring such fees is not always possible.

16.11. The Client releases and agrees to hold CAS harmless from any liability for and waives any right, claim or remedy against CAS for any injury, death, damage, theft, inconvenience, delay, increase in length of stay or expense of travel, or any other loss or harm incurred during or related to any travel made in connection with this adoption process.

17. DISRUPTION OR DISSOLUTION OF CHILD PLACEMENT AND POST-ADOPTION CRISIS SUPPORT

CAS makes a commitment to each child and adoptive family by providing ongoing post-adoption support, and referral service as described herein. The Client understands and agrees, however, that CAS cannot take physical or legal custody of the child and that the responsibility of future placement of the child may weigh heavily on the Client. The Client agrees to assume all risks and financial and emotional obligations in the event of a disruption or dissolution, and agrees to release and hold CAS harmless from any or all injury, loss, claims, expenses, or other damages, resulting from a disruption or dissolution of child placement. Upon finalization of the adoption, whether it occurs in the foreign country or in the U.S., the child acquires all the rights, privileges, and immunities of a child born to the Client, and the Client has all the responsibilities, legal obligations and duties to the child the same as though the child were born to them.

17.1. Should the child’s well-being and safety be in question, CAS acts promptly and in accordance with any applicable legal requirements to notify the appropriate government agency with the authority to take the action necessary to ensure the child’s well-being and safety. The Client agrees to immediately notify the agency as well as their home study agency, if different from CAS, if the Client or its family experiences adjustment or other difficulties with the child. CAS can provide families with assistance in locating appropriate services which may help keep the family intact.

17.2. In the case of disruption (defined as a decision by the Client not to continue with finalization of the child’s adoption when the Client holds legal custody or guardianship from a foreign court), CAS will contact:

17.2.1. the cooperating agency to seek assistance in finding a suitable, alternative placement when appropriate until the networking agency makes a decision;

17.2.2. the foreign placing agency and government adoption authority agency as required by country law;

17.2.3. the state licensing entity as required by state law;

17.2.4. the U.S. State Department and foreign Central Authority as required by the Hague Convention;

17.2.5. the child if they are of proper age and maturity to consider their views or if required by state law.

17.3. In the case of dissolution (defined as a decision by the Client to dissolve the legal bond between the Client and child after a legal adoption has been completed and finalized, either abroad or in the U.S.), the Client understands and acknowledges that CAS cannot provide and is not responsible for providing clinical post-adoption counseling and services. When an adoptive placement is in crisis during post adoption supervision, CAS makes every effort to refer the Client to counseling by a professional with appropriate skills and professional expertise to assist the family in dealing with the problems that have arisen.

17.4. The Client understands and acknowledges that CAS does not return from the United States to the country of origin an adopted child whose adoption has been dissolved unless the Central Authority of the country of origin and the U.S. Secretary of State have approved the return in writing. CAS would only consider this option in an exceptional case where the child’s return to the country of origin is in the best interest of the child.

17.5. In either disruption or dissolution, the Client agrees that the Client is responsible for the care and physical well-being of the child and assumes full financial responsibility for paying for all expenses incurred to meet the child’s needs, including the possible placement of the child in respite care, foster care or another adoptive home if approved and all final paperwork has been completed.

18. MANDATED REPORTING

CAS staff members who work in health care or child welfare venues are mandated by State and Federal law to report suspected abuse or neglect whether it is upon a child or an elderly person. Since CAS is a licensed, child-placing agency, it requires all staff and Board members, regardless of their academic or professional qualifications, to immediately report any suspected abuse or neglect upon a child or elderly person to the State Department of Family and Child Services.

19. CHARITABLE CONTRIBUTIONS

As a non-profit 501(c)(3) organization, CAS welcomes all donations to assist us in our mission to improving the quality of life for orphans and vulnerable children overseas. CAS does not actively solicit donations from adoptive families prior to placement. All donations are considered confidential, and any information associated with a donation is not shared with the social work staff. This policy is to protect adoptive families and the agency from the perception of compromise during the adoption process. CAS will not be influenced by gifts or monetary donations. Tax-deductible donations received by CAS cannot be applied to any specific adoption case. Client acknowledges that CAS may refuse to accept funds from third parties in its sole discretion. The Client further

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acknowledges and agrees to abide by all provisions concerning internet usage, confidentiality and privacy included in this Agreement with respect to any fundraising in which the Client chooses to engage.

20. MODIFICATIONS OF ADOPTION SERVICES CONTRACT

This agreement may be supplemented, modified, or amended only in writing, dated, and signed by all parties. This provision may not be waived, modified, or supplemented except in the manner specified herein, provided, however, that CAS may change the schedule of fees without Client’s signature or agreement.

21. TERMINATION OF ADOPTION SERVICES CONTRACT

Client can, at any time and for any reason, decide to terminate this Agreement by providing written notice to CAS. Additionally, CAS reserves the right to terminate the Client Application for Services or this Agreement at any time during the process and at the sole discretion of the agency by providing written notice to the Client and is under no obligation to give cause or explanation. The Client understands and acknowledges that international adoption involves activities and other participants outside the control of either party—including but not limited to changes in foreign governmental or agency policies and regulations, changes in U.S. policies and regulations, closure of foreign adoption programs, changes in foreign travel schedules and length of stay, and changes in the procedures and requirements involved in the adoption process—which may result in or lead to termination of this Agreement. The Client should refer to the information contained herein regarding whether fees paid to CAS are or may be refundable upon any termination.

21.1. Effect of Termination; Survival. Termination of this Agreement, either automatically or by either party, shall have the effect of relieving both parties of any and all obligations of future performance under this Agreement. Notwithstanding the foregoing, termination shall not, however, affect or terminate the following provisions, which shall survive any termination or expiration of this Agreement: (1) any release from or limitation of liability, whether contained in this Agreement or elsewhere, (2) without limiting the foregoing, the provisions of Sections and subsections, as applicable, 3.2, 3.3, 11, 14, 16.11, 17. 21.1, 27, 28 in this Agreement, (3) any obligation to pay fees, costs or expenses that have already been incurred by or on behalf of the Client, (4) the rights of either party to enforce this Agreement with respect to any default or defect in performance that has not been cured, or (5) any parent/child relationship that may have been established by operation of law.

22. ENTIRE CONTRACT

This Agreement, including the Schedules and Exhibits attached hereto, constitutes the entire contract between the parties, and there are no representations, warranties, or commitments except as expressly set forth herein. This Agreement supersedes and replaces all prior or contemporaneous agreements, contracts, understandings, negotiations, applications, and discussions, whether written or oral, of the parties hereto relating to the transactions contemplated by this Agreement.

23. WAIVER/SUBSEQUENT ENFORCEMENT

The failure of either party to enforce any provision of this contract shall not be construed as a waiver or limitation of any party’s right to subsequently enforce and compel strict compliance with every provision of this contract.

24. NO NON-PARTY BENEFICIARY

None of the provisions of this Agreement are intended to nor shall be construed to, confer upon or to give any person other than the parties hereto, or their heirs, successors, or assigns, any rights or remedies under, or by reason of this Agreement.

25. CHOICE OF LAW AND VENUE

This Agreement, including all supplements, modifications, and other documents incorporated herein and all rights, obligations, and disputes arising out of it is governed by and construed consistent with North Carolina law without consideration of conflict of law principles. The parties agree that venue for any dispute arising under this agreement is in Guilford County, North Carolina, or any other jurisdiction in which both parties voluntarily appear.

26. SEVERABILITY

If, in any judicial or dispute resolution proceeding, a court or arbitrator shall refuse to enforce any provision of this Agreement, any such unenforceable provision shall be deemed eliminated from this Agreement for the purpose of such proceeding as is necessary to permit the remainder of this Agreement to be enforced.

27. LIMITATION ON LIABILITY

Any liability of CAS, its employees or agents, for any claim arising out of or relating to this Agreement, including but not limited to claims arising out of the alleged or actual negligence of CAS or its employees or agents, shall be limited to the total amount of fees paid by the Client to CAS. 28. RISKS INHERENT IN INTERCOUNTRY ADOPTION;

RELEASE

The Client understands and agrees that there are risks inherent in international adoption that can result in serious adverse consequences to the Client and the Client's family. CAS wants to prepare the Client for the possible difficulties, frustrations, and disappointments that can occur during the adoption journey. CAS will provide the Client with professional and trustworthy service and do all CAS reasonably can to make this a positive experience for the Client; however, the Client acknowledges that some factors are not in CAS’s control. The Client hereby releases CAS, and its representatives and agents, and holds CAS, and its representatives and agents, harmless from any and all responsibility or liability, whether direct, indirect, vicarious, or otherwise, for any type of injury, harm, damage or loss in any way caused by, contributed to, or arising out of acts of omissions of third parties or the Client’s own acts or omissions. The Client hereby releases and holds CAS, and its representatives and agents, harmless from any type of injury, harm, damage, or loss which in any way results from any obstacle, delay or impediment to placement, immigration, or adoption. This release specifically extends to, but is not limited to, any obstacle or impediment to placement,

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immigration, or adoption directly or indirectly caused by the actions or inactions of any foreign or U.S. agency, official, court, attorney, or facilitator. Any liability of CAS or its representatives and agents, for any claim arising out of or relating to this Agreement or the services contemplated herein shall be limited to the total amount of fees paid by the Client to CAS. Client understands and agrees that Client will be solely responsible for any additional fees or costs associated with any delay, interruption or obstruction of the placement, immigration, or adoption process, transfer of the Client to another one of CAS’s adoption programs, if applicable, and in obtaining a supplemental referral, if any.

28.1. No Guarantee of Placement. Client understands and acknowledges that efforts to adopt children from a foreign country may involve circumstances that are beyond CAS's control, which interfere with or prevent completion of the adoption process. The Client understands that CAS does not and cannot guarantee placement of a child with the Client or successful completion of the adoption process.

28.2. United States Citizenship and Immigration Services. The Client is responsible for completing all immigration paperwork and the Program Coordinator is available to answer questions. The immigration paperwork may include any of the following: I600A (non-Hague), I800A (Hague), I600, I800, I864W, I864A, I864, and DS260. The Program Coordinator will make reasonable efforts to assist the Client and is able to contact the National Benefits Center and foreign Embassy if the Client has signed and submitted to USCIS the Supplement 1 form granting permission for the Program Coordinator to contact immigration.

28.2.1. Client understands that CAS does not have any control over the processing time of a Client’s case with USCIS and that CAS does not have any say in the approval or denial of the Client by USCIS.

28.2.2. Client is responsible for obtaining pre-approval from USCIS to bring an adopted child into the U.S. Client understands that it is the Client’s responsibility to monitor USCIS expiration dates on the approval as well as the fingerprints. The Client is responsible for ensuring these remain valid and take necessary steps to renew them should they be within 3 months of expiration.

28.2.3. Client is responsible for completing the visa process on behalf of their child through the filing of the DS260 Petition as well as attending an interview at the US Embassy in your child’s country of birth. Client understands that there is no guarantee that their child’s visa may be granted. It is the client’s responsibility to adhere to all requests for additional information from the US Embassy and the Program Coordinator will provide reasonable support as needed.

28.3. Timeframes and Waiting Time. One of the main areas of uncertainty with respect to inter-country adoptions is the total length of time it takes to complete the adoption process. Client acknowledges that CAS does its best to provide accurate estimates of current time frames in the adoption process, but these can change from month to month, depending on many factors. CAS maintains regular contact with foreign staff and cooperating agencies to keep abreast of changes in country adoption laws, philosophy, and political climate toward inter-country adoption. Every month, CAS will email country and agency updates to the Client during the adoption process. This email will give updates on the current waiting times and announce any

changes in the country adoption program that could affect the Client’s adoption process.

28.4. Court and/or Government Process in Foreign Country. The Client understands and acknowledges that CAS cannot intervene in, or speed up, the court process or government process in another country. The U.S. government is also unable to intervene in the court process or government process in another country. CAS tries to give an accurate time frame based on what other families have experienced; the Client acknowledges, however, that the length of time the process takes is ultimately determined by the courts, government officials, attorneys, etc., in the country from which the Client is adopting and that the estimations provided by CAS may not be complete, accurate or may change from time to time. The Client acknowledges that foreign courts and offices do not run on American time and often face delays, changes in the required process, need for additional paperwork, bureaucratic barriers, and holiday closings. Attempts to circumvent this process or intervene in any way could have a negative impact on the Client’s adoption or future adoptions from that country.

28.5. Required Documents. The Client understands that foreign governments and agencies are very particular about the documents included in Client’s adoption applications and adoption dossiers. The Client understands and acknowledges, however, that if the foreign agency, court or government makes a decision to ask for additional paperwork or changes the format of the required paperwork, CAS and the Client must comply in order for the Client’s case to move forward. Client agrees to revise, update, deliver or obtain such other and additional documents or agreements as requested and required to complete the adoption per the regulations of the U.S. and foreign government or at the request of CAS. The Client understands they are solely responsible for the costs incurred with revising, updating, or obtaining new or revised documents.

28.6. Medical and Developmental Risks. Refer to Section 12: Referral and Assignment of Child and Schedule 12 for a description of certain risks associated with the adoption of a child from a foreign country.

28.7. Factors That May Delay or Prevent an Adoption from Being Completed. The Client understands and agrees that CAS does not promise or guarantee placement of children for adoption. Multiple factors may delay, hinder, interrupt, or obstruct the adoption process, such as U.S. and foreign government and court processes, birth family changing their minds, holidays observed in the U.S. and foreign country, inclement weather, political instability and changes in the Client’s situation.

28.7.1. Although it is rare, birth families can change their minds about placing their children for adoption. The Client acknowledges that the Client does not have legal rights to the child until the adoption finalization is complete. If a birth family should change their mind about placing their child for adoption, CAS will place the Client back on the waiting list and make reasonable efforts to provide the Client with another referral of a child. The Client understands that CAS does not guarantee the referral of another child.

28.7.2. In some instances, the referral of a child may be lost or withdrawn prior to placement due to change or decline in the health of the child, death of the child, or adoption of the child by a family in the country of origin. In rare instances, the reason for the withdrawal of the referral by the sending country may never be made clear or known. CAS will make reasonable efforts to provide Client with another child referral

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should this occur. The Client understands that CAS does not guarantee the referral of another child.

28.7.3. If a foreign government decides to change its requirements for client qualifications and the Client no longer meets those requirements, the Client may no longer be eligible for that country’s adoption program, even if the Client paperwork is already in-country. While some countries will “grandfather in” families already in the adoption process, others will not and the Client will have to withdraw from that particular program. A foreign government may also decide to close the program for inter-country adoptions with U.S. citizens, may elect not to work with or stop working with CAS, may not renew its accreditation, or may otherwise no longer be eligible to provide international adoptions. If activities in the foreign country or actions taken by the foreign agency or government prevent placement of a child with the Client or completion of the Client’s adoption process, CAS will make reasonable efforts to transfer the Client to one of CAS’s other adoption programs for which the family may qualify.

28.7.4. Changes in the Client family situation may impact their eligibility to adopt from a particular country and/or may result in their adoption application being placed on hold. The time on hold will be determined by CAS, in its sole discretion, and will vary on a case-by-case basis.

28.7.5. CAS carefully screens and assesses the Client’s eligibility to adopt from a particular country and only approves the Client when CAS feels as confident as possible the Client application will be accepted and approved by CIS and the foreign country. The Client acknowledges, however, that CAS cannot guarantee the Client will be accepted and approved by USCIS or the foreign country for international adoption.

28.8. Inactive Programs. International adoptions are contingent on the cooperation of foreign countries. The Client understands it is possible for a country-program to become backlogged, inactive or close due to variety of reasons, including without limitation changes in the foreign government’s policies on adoption, revision of U.S. or foreign adoption laws, or political instability. Closure or hiatus of programs may be declared by the foreign country or by the United States. The Client acknowledges that hiatus or closure of programs may be indefinite in nature and impossible to predict. The Client acknowledges such risks and understands that CAS reserves the right to suspend or terminate inactive programs, which may result in the termination of the Client’s pending adoption process.

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SCHEDULE 3.1 – Client Policies

Client Policies apply to Carolina Adoption Services and its

subsidiary ABC Adoption Services. All references to CAS shall

also apply to ABC. Please note that some policies are

applicable to international adoption cases only.

ELIGIBILITY

Applicants’ Age: Single applicants must be at least 24 years

old. USCIS has no minimum age requirement for married

couples. CAS follows the age requirements for adoptive parents

as determined by adoption law in each sending country.

Child Abuse/Neglect: Applicants with a substantiated history

as a perpetrator of child abuse or neglect are automatically

disqualified. Applicants who were victims of abuse, neglect,

domestic violence and/or other traumatic events should

demonstrate how they overcame the effects of such behaviors

so that their children will not be negatively impacted by repeat

or resultant behaviors. CAS will likely request a psychological

evaluation.

Applicants who plan to adopt internationally will be required to

provide, for the home study agent, child abuse and criminal

clearances for all states and countries of residence since the

age of 18 years. For domestic adoptions, clearances must go

back 7 years.

Criminal Records: Applicants with a history of arrest or

conviction must disclose this in the application process and be

prepared to discuss this in the home study process. Even

distant, juvenile, or expunged criminal records must be

disclosed. Applicants with a criminal record must provide a copy

of the court disposition of their case. In addition, they need to

write a detailed letter of explanation both of the event and how

rehabilitation has occurred. A letter from rehabilitative services

is obtained if such services were used. This information must

be shared with USCIS in order to obtain approval. A decision is

made on an individual case basis. Some countries will not place

with an applicant who has a criminal record.

Applicants on parole or probation will not be accepted until they

have completed probation and satisfied all requirements of the

court. CAS cannot work with clients who have substantiated

child abuse complaints filed against them or who are having

continuing problems with drugs and/or alcohol. Clients with

histories of felony convictions or multiple criminal charges will

be considered on case-by-case basis during the application

process.

Disruptions; Dissolutions: Applicants with a previous

disrupted adoption should wait two years before reapplying.

They must provide evidence of completed counseling in order to

be considered for placement. Adoption Committee approval,

which approval is within the Adoption Committee’s sole

discretion, is needed before starting either a home study or

adoption process after a disruption or dissolution has occurred.

It is possible that USCIS or the foreign country may not approve

the family for another placement in these types of cases.

Duty to Disclose: In preparation for an adoption, clients are

required to give true and complete information to the home study

preparer. Clients must disclose other relevant information, such

as any history of physical, mental, or emotional health problems;

any arrest, conviction, or other adverse criminal history, whether

in the U.S. or abroad, even if the record of the arrest or

conviction or other adverse criminal history has been expunged,

sealed, pardoned, or the subject of any other amelioration;

disclose any history of substance abuse or sexual abuse, child

abuse, and/or family violence as a victim or perpetrator; and

pending investigations. Clients must notify the home study

preparer and USCIS of any event or information that might

warrant submission of an amended or updated home study.

Health - Physical and Emotional: Applicants need to exhibit

adequate health to parent a child. Minimally, their doctors must

be able to state that clients are in good health, are able to parent

a child, and have normal life expectancies. Applicants with

chronic physical or mental health conditions, or with a life-

threatening illness in their past, must discuss the conditions

before applying and must submit medical letters from their

treating physician. Cases are evaluated individually to assess

the applicant’s ability to function as a parent. Submitted letters

become part of the permanent case record. Country-specific

health policies have precedence over CAS policies.

Applicants undergoing treatment, currently or previously, for

mental health issues shall provide a report from their

psychiatrist, licensed psychologist and/or licensed therapist

noting conditions, treatment, prognosis and recommendations.

When possible, an agency form is used for this purpose, with

prior written releases signed by the applicant. CAS reserves the

right to request psychological testing at the client’s expense; the

results become part of the permanent case record.

Psychotherapy and counseling are positively viewed and are an

asset to individual/marital growth and development. Clients who

experience physical or mental health issues during the adoption

process must report those issues to CAS; the agency and

placing country will evaluate the client’s ability to continue the

process.

Inactivity: In cases where there has been a period of inactivity

for more than 90 days, CAS will close the case. Applicants may

re-open their case without an additional application fee anytime

within the 12 months following the closing of the case.

Internet Usage: Clients should be wary of the reliability of

information posted on adoption bulletin boards and shared in

adoption web forums and blogs. In addition, clients should be

aware that the Internet is accessible to everyone, including

foreign government officials, and should be careful not to post

negative or damaging information. Clients should thoughtfully

consider, when posting on the Internet, what they would want

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their future son or daughter to read someday about their

country, heritage, adoption, etc., and what the clients would

want the officials and citizens in their child’s birth country to

discover about their adoption experience.

CAS requires that clients password-protect their personal

websites and adoption blogs for the sake of personal safety

and privacy. CAS requires that clients restrict information

shared about the child they are referred to non-identifying

information while they are still in the adoption process. The

child’s information is confidential and only intended for the

Clients before the adoption is finalized. CAS recommends the

use of personal journals or scrapbooks rather than internet

blogs or discussion forums.

Marital Status: CAS welcomes both married couples and

single parents, although some countries require that adoptive

parents be married. A prior marriage is not usually a deterrent

to placement. The strength of the current relationship is the

primary concern. Couples must generally be married at least

two years by the time of child placement, allowing adequate time

for individual adjustments to marriage.

Multiple Applications: CAS cannot work with clients who are

seeking adoptive placements through other placing sources.

Non–Discrimination: CAS does not discriminate against any

person on the basis of race, religion, color, gender, sexual

orientation, age, national origin, disability, veteran status, or

any other status or condition protected by law.

Pregnancy: CAS normally does not accept applications from

persons who are actively involved in infertility treatment. Should

a pregnancy occur while in the adoption process, families should

notify their social worker. Such cases may be put on hold and

then reviewed. CAS will not generally place with pregnant

couples. Couples must wait 12 months after the arrival of a child

before another child can be placed in the home. If the case is

later closed, it may be reopened at the family’s request within 12

months without any additional application charge. When an

outcome is pregnancy loss or stillbirth, the social worker and

family will reach a decision on when the family is ready to

proceed with adoption. If agency priorities, policies, guidelines,

or fees have changed while a family has been “on hold,” those

in effect at the time of reactivation will apply. Applicants who

become parents may apply again whenever they meet the

requirements of a country program.

Same Sex Couples: While we rely on information provided to

us by clients regarding their personal circumstances, the placing

country may or may not infer the applicant’s sexual orientation

based on the description of who lives in the household and their

roles and relationships in parenting the child. Some countries do

require that sexual orientation be discussed in the home study

and the client may be required to submit a statement re: their

sexual orientation as part of their dossier. CAS staff may not

knowingly misrepresent information about applicants, their

household or family members, or the roles of household and

family members. CAS helps applicants assess their risks and

probabilities for being accepted for placement by a placing

country. In international and domestic home study, post-

placement, finalization and re-finalization cases, CAS policies

and procedures must adhere to the laws of the local jurisdictions

in clients’ states of residence.

Single Applicants: Single applicants must provide evidence of

a strong support system. Single applicants must provide

information re: opposite sex role models for the child to be

adopted. They must also name married couples as guardians;

singles may be named as long as a married couple is named as

back-up. Single applicants may only adopt one child at a time,

but can adopt additional children sequentially, based on

approved home studies. While many countries allow for single

women to adopt, it may be difficult to find a country permitting

adoption by single men.

Substance Abuse/Domestic Violence: Applicants with a

history of drug/alcohol abuse, or criminal histories related to

alcohol or drug use, must demonstrate that long-term

rehabilitation has occurred. This may be documented through

letters from a therapist or a rehabilitation center. In cases where

no professional treatment was used, the client is required to

have an evaluation done by a certified substance abuse

counselor. Any such documentation shall become part of the

permanent case record. USCIS has requested that any incident

involving substance abuse, domestic violence as well as child or

sexual abuse that has occurred in an applicant’s past be

documented in the home study. If information about an incident

comes to light following submission of a study to USCIS, that

information must be included in an amendment, and the

amendment must be forwarded to USCIS, the foreign country

and becomes part of the study.

CHILD RELATED POLICIES

Behavior Management and Child Safety:

Prior to the placement of a child, CAS requires prospective

adoptive parents to familiarize themselves with and agree to

abide by standard behavior management guidelines and child

safety procedures and adhere to any applicable State

regulations regarding the same.

Child Care Plans: The adequacy of child care plans is

evaluated for each family. Generally, in the adoption of one

child, families are requested to abide by the tenets of the Family

Leave Act - that is, enabling one parent to be in the home for up

to the first twelve weeks after placement. When older children,

children with special needs, or sibling groups of two or more

children are placed, parents are expected to stay at home for a

longer period (preferably one year) to accommodate the needs

of each child to adjust to each other as well as to the parents.

The CAS Adoption Committee will consider waivers for child

care plans for sibling placements.

Discipline: Corporal punishment, or the infliction of pain or

discomfort, may not be used by adoptive parents. Prohibited

actions include, but are not limited to, hitting with any part of the

body or with an implement, pinching, pulling, shaking, binding of

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a child, forcing him to assume an uncomfortable position, or

locking the child in a room or closet.

Firearms and Ammunition: Firearms and ammunition in the

home shall be stored separately, and under lock and key. The

keys shall be stored out of the reach of children and separately

from both firearms and ammunition. It is the expectation of the

agency that children do not have access to weapons or other

hazards.

Gender Preference: Families are encouraged to be open to a

child of either gender. Some countries do not allow families to

request a child of a specific gender, except under special

circumstances. While some country programs allow a gender

preference, families should be prepared for a longer wait if they

specify a gender preference. CAS reserves the right to close

applications in particular programs to families open only to the

placement of a specific gender child; this is done if the wait for

children of one gender is becoming too long.

Immunizations: Clients shall follow the immunization schedule

recommended by their pediatrician for the child they adopt.

Number of Children: CAS follows NC foster care guidelines

re: the number of children placed with a family. NC foster care

guidelines limit the number of children in the household to 5.

Exceptions may be made for sibling placements. Families

requesting waivers to this policy should contact their Program

Coordinator or the Director of Social Work Services to request

consideration by the CAS Adoption Committee.

Out-of-Birth-Order Adoptions: CAS generally discourages

families who already have children in the home from adopting

other children out-of-birth-order. If a family wishes to adopt out

of order, they should discuss their desire with the program

coordinator for the country to determine whether such adoption

would be in the best interest of the child and allowed by the

sending country. Additional education will be required for

families adopting out of birth order.

Pets: Pets in the home shall have up-to-date immunizations

and pose no threat to children as verified by a veterinarian.

Reporting of Serious Injury, Death, or Illness: Serious

medical, physical, mental or emotional incidences, and potential

dissolution must be reported to the agency within 24 hours of

the occurrence. These include, but are not limited to, suicide or

suicide attempt, abusive treatment and activity by an adult or

child, critical injuries or death, and placement in out-of-home or

residential treatment facility.

Sibling Placements: A child placed in an adoptive family

should have a minimum of one year difference in age from any

other child present in the family or planned to be in the family,

either through birth or adoption. Families should generally wait

until the finalization of the first adoption before beginning the

process to adopt another child. CAS will not typically refer a child

for placement into a family where there is a pregnancy or

involvement in another adoption program. There must be a one

year period of time between the additions of children to a family

– either through birth or adoption.

Generally, two unrelated children cannot be adopted at one

time. Requests for waivers to this policy may be presented, in

advance of a referral, to the CAS Adoption Committee. In the

past, waivers have been granted only in circumstances for

married couples where one parent will be home with the children

for at least one year following placement. These couples must

also demonstrate an ability to meet the special demands of

multiple child placements and have completed the prescribed

educational process. The home study worker must be able to

recommend the family for such a placement after careful

assessment during the home study process.

Married couples may adopt sibling groups of two or more

children at the same time from some countries, with advance

permission from the CAS Adoption Committee. Married couples

must provide evidence of adequate educational preparation,

childcare arrangements with sufficient financial and emotional

resources. They must have contact with other families who have

adopted siblings, a “buddy” family in place and resources

identified for various needs that can be anticipated. Families

who adopt sibling groups, older children, or children with special

needs must have special preparation/education prior to

placement of the child(ren). They should expect to have one

parent home for at least one year after placement.

AGENCY REQUIREMENTS

Changes in the Family’s Situation: Families must keep CAS

informed of any significant changes in their situation at all times

prior to completion of their adoption. CAS should be informed

of changes such as, but not limited to: health problems, arrests

or convictions, child abuse allegations and investigations,

changes in employment and income, a move, pregnancy,

changes in the numbers of household members, etc. USCIS

also requires that these types of changes be reported to them in

the form of a home study amendment or update. The filing of

additional USCIS documents may also be required. There are

additional fees for the preparation of home study amendments

and updates as well as filing charges for some USCIS

documents, for which Client is solely responsible.

Client/Staff Relations: CAS strives to maintain a highly

professional staff not only possessing appropriate education

and experience, but holding a deep commitment to providing

excellent, courteous service to clients. Our professional Code

of Ethics requires that staff use “accurate and respectful

language in all communications to and about clients.” Similarly,

agency clients are expected to adhere to the same standards.

Clients should interact with staff in an appropriate, respectful

and courteous manner. Instances of derogatory, insulting, or

profane language will be immediately reported to the staff

member’s Supervisor for further action. Termination of services

can result if difficulties are not resolved. In such cases, the

agency fee, as outlined in the Adoption Services Contract, is not

subject to refund.

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Complaints/Grievances: Clients who are not satisfied with

services of CAS have the right to a complaint/grievance

process. Initially, clients should try to resolve the issue with their

case worker. If not satisfied they may contact the Supervisor. If

the issue remains unresolved they should submit in writing to

the Executive Director. Should the complaint involve the

Executive Director the issue should be addressed to the

Chairman of the Board of Directors. Complaints should receive

a response within 30 days. Should the complaint remain

unresolved, the client may contact the Executive Committee of

the Board of Directors and a response will be provided within 30

days. If not satisfied, the client may utilize mediation or

arbitration to resolve the issue. All clients may receive

additional details regarding the complaint or grievance policy

upon request. CAS will never take action to discourage the client

from making or expressing a complaint. CAS does not

discourage the client from providing information in writing,

interviewing, answering questions, or expressing their opinions

about the performance of the agency to an accrediting entity.

Dossier: Families work with their country Program Coordinator

to prepare a group of documents known as a “dossier” as

required by the foreign country to process an adoption. A family

may have a dossier in only one country at a time. Under certain

circumstances, the CAS Adoption Committee may, in its sole

discretion, permit concurrent dossiers to be submitted to two

countries.

Educational Preparation: Clients who intend to adopt

internationally must accrue a minimum of 10 hours of pre-

adoption education prior to completion of the home study and

the recommended 30 hours of adoption preparation prior to

placement of the child. Some countries may have additional or

specific training requirements. CAS offers educational programs

and on-line resources to families. Local service agencies and

support groups also provide educational preparation to families.

Clients must submit verification of education to CAS.

Home Study (Pre-Placement Assessment): A home study

can only be accepted from a licensed child-placing agency.

Some countries require that the home study be completed only

by a Hague-accredited agency. CAS provides guidance to local

service agencies so that all home study reports meet CAS

requirements.

Due to Hague Convention and Universal Accreditation Act

regulations, CAS may accept a home study only from a licensed

agency with whom CAS has a formal, signed inter-agency

agreement. This applies to families who are adopting from a

Hague Convention country. CAS may not accept a home study

from an agency that has been denied Hague Convention

Accreditation, or has had their Hague Convention accreditation

revoked or denied at re-accreditation.

Prospective adoptive parents are required to report any

significant changes in the family situation that occur after

completion of the home study to both the home study and

placing agency. This USCIS-required duty to disclose is on-

going through the adoption process and failure to do so carries

a penalty of perjury. Such changes may include: medical issues,

changes in employment or income, an arrest or conviction,

substance abuse, the addition of a household member, etc. If

there are questions about whether or not a situation should be

reported, please check with the involved agencies.

Inactive Programs: A program may become inactive or close

due to changes in the foreign government’s policies on

adoption, revision of adoption laws, etc. If the situation does

not resolve in a reasonable timeframe, the Board of Directors,

upon recommendation of the Executive Director, may close a

program. Clients currently in-process when a country closes

may choose to switch to another country program or close their

case. CAS will attempt to advocate for pipeline cases and

advise families of all updates received by a foreign government

regarding cases in-process at the time of a closure.

Insurance Coverage: CAS is insured according to licensing

and accreditation regulations and guidelines and meets or

exceeds minimum required coverage amounts.

Medical Evaluation of Referrals: Families are strongly

encouraged to seek professional help in evaluating child

referral information from professionals who specialize in

international adoption.

Post Adoption Reports: Families will be required to complete

post adoption reports as required by CAS, their domestic placing

agency and/or the placing country. The number of reports

required is determined by the placing country, agency or state.

Referrals: Through discussion with the home study worker and

program coordinator, families set expectations for the child to be

placed. If a family declines a referral considered appropriate

based on their parameters, the family’s case may be considered

by the CAS Adoption Committee. If the family appears to have

unrealistic expectations, the family may be asked to consider

other country options. CAS reserves the right to close any case

at any time. The official child referral is only made to families

with an approved home study. Client acceptance of a referral is

considered official upon receipt of the required funds and signed

acceptance agreement. Families should be aware that some

countries may close their case should they decline a referred

child.

Right to Information: Clients may have a copy of their home

study (pre-placement assessment) provided all fees for such

report have been paid to the agency for the services rendered.

Should a home study result in a “non-approval,” a written

explanation of the agency’s decision will be provided to the

family within 5 working days of non-approval decision.

United States Citizenship and Immigration Services

(USCIS): In international adoption cases, clients are

responsible for the filing of their I-600A or I-800A application

materials with USCIS. It is also the client’s responsibility to be

aware of when their USCIS approval and fingerprints expire and

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make sure they are updated upon expiration of such documents.

Families should notify CAS at least 3 months in advance of their

immigration of approval expiration in order to prepare for

renewal.

CAS POLICIES RELATING TO HAGUE CONVENTION

CASES

When using CAS as your international adoption placing agency,

The Hague Convention and Universal Accreditation Act (UAA)

defines CAS as being the “Primary Provider.” As a Hague

Accredited primary provider, CAS has the capacity, when

appropriate, to provide the following 6 Hague Adoption Services:

1. Identifying a child for adoption and arranging an adoption; 2. Securing the necessary consent to termination of parental

rights and to adoption; 3. Performing a home study and reporting on prospective

adoptive parents or a background study and report on a child;

4. Making non-judicial determinations of a child’s best interests and of the appropriateness of an adoptive placement;

5. Monitoring a case after a child has been placed with prospective adoptive parents until final adoption.

6. Assuming custody of a child and providing childcare or any other social service, when necessary, because of a disruption pending alternative placement.

Items number 5 & 6 above apply only in those countries in which

the adoption is not full and final in the country, such as Uganda.

CAS always follows state and regulatory guidelines.

Referrals of Children Available for Adoption in Inter-

Country cases: (Hague Regulation 96.49(k)): Carolina

Adoption Services shares all available medical, developmental,

and psychosocial information regarding available children, and

the biological family, with prospective adoptive parents prior to

placement. It is totally the decision of the client to accept or not

accept a particular referral. Agency staff offers ongoing support

as the client takes as much time as necessary to decide whether

or not to accept the referral. CAS will not withdraw a referral until

the prospective adoptive parent(s) have had two weeks (unless

extenuating circumstances involving the child’s best interests

require a more expedited decision) to consider the needs of the

child and their ability to meet those needs, and to obtain

physician review of medical information and other descriptive

information, including videotapes of the child if available. As

available, CAS will obtain and include in the case file of the

adoptive family information regarding the prospective adoptee

and siblings.

Provision of Medical and Social Information in Incoming Cases: When Carolina Adoption Services provides information on a child available for adoption to an adoptive family for consideration, the information shall be subject to the following: Minimum of Two Weeks’ Notice of Referral Information:

Carolina Adoption Services shall provide to prospective

adoptive parents a copy of the child’s medical records

(including, to the fullest extent practicable, a correct and

complete English-language translation of such records) as early

as possible, but no later than two weeks before either:

a. the adoption or placement for adoption, or

b. the date on which the prospective adoptive parent(s)

travel to the foreign country to complete all procedures

in such country relating to the adoption or placement for

adoption, whichever is earlier.

Copy of Original Record (Not Only Summary): Where any

medical record is provided a summary or compilation of other

medical records, CAS will include those underlying medical

records in the medical records provided pursuant to paragraph

(a) if they are available.

Translations: CAS will make every effort to provide the

prospective adoptive parent(s) with any un-translated medical

reports or videotapes or other reports and provide an

opportunity for the client(s) to arrange for their own translation

of the records, including a translation into a language other than

English, if needed.

Reasonable Efforts to Obtain Specific Additional

Information: CAS will make reasonable efforts, or require its

supervised provider in the child’s country of origin who is

responsible for obtaining medical information about the child, to

use reasonable efforts, to obtain additional available

information, including in particular:

a. The date that the foreign country or other child welfare authority assumed custody of the child and the child’s condition at that time;

b. History of any significant illnesses, hospitalizations, special needs, and changes in the child’s condition since the foreign country or other child welfare authority assumed custody of the child;

c. Growth data, including prenatal and birth history, and developmental status over time and current developmental data at the time of the child’s referral for adoption; and

d. Specific information on the known health risks in the specific region or country where the child resides.

Medical Reports from Non-Government Officials (Hague

Regulation 96.49(e)): If CAS or its supervised provider, or other

person, provides medical information other than the information

provided by public foreign authorities, to the prospective

adoptive parent(s) from an examination by a physician or from

an observation of the child by someone who is not a physician,

CAS shall use reasonable efforts to include the following:

a. Doctor’s Information - The name and credentials of the

physician who performed the examination or the

individual who observed the child;

b. Date - The date of the examination or observation; how

the report’s information was retained and verified; and

if anyone directly responsible for the child’s care has

reviewed the report;

c. ID of Medical Professionals - If the medical information includes references, descriptions, or observations

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made by any individual other than the physician who performed the examination or the individual who performed the observation, the identity of that individual, the individual’s training, and information on what data and perceptions the individual used to draw his or her conclusions;

d. Health History - A review of hospitalizations, significant

illnesses, and other significant medical events, and

the reasons for them;

e. Test History - Information about the full range of any

tests performed on the child, including tests addressing

known risk factors in the child’s country of origin; and

f. Current health information.

Reasonable Efforts for Additional Information: CAS shall

use reasonable efforts, or require its supervised providers in the

child’s country of origin who is responsible for obtaining social

information about the child on behalf of CAS or person to use

reasonable efforts, to obtain available information, including in

particular:

a. Birth Family - Information about the child’s birth family

and prenatal history and cultural, racial, religious,

ethnic, and linguistic background.

b. Placement History - Information about all of the child’s

past and current placements prior to adoption,

including, but not limited to, any social work or court

reports on the child and any information on who

assumed custody and provided care for the child; and

c. Siblings - Information about any birth siblings whose existence is known to CAS or person, or its supervised provider, including information about such siblings’ whereabouts.

Documentation of Reasonable Efforts: Where any of the

information listed in paragraphs (d) and (f) of this section cannot

be obtained, CAS or person documents in the adoption record

the efforts made to obtain the information and why it was not

obtainable. CAS or person continues to use reasonable efforts

to secure those medical or social records that could not be

obtained up until the adoption is finalized.

Doctor Contact Information: Where available, CAS will

provide information for contacting the examining physician or

the individual who made the observations to any physician

engaged by the prospective adoptive parent(s), upon request.

Photos and Videos: During the adoption process and to the

extent there are photographs and video of the child referred,

CAS will take reasonable efforts to ensure that videotapes and

photographs of the child are identified by the date on which the

videotape or photograph was recorded or taken and that they

were made in compliance with the laws in the country where

recorded or taken.

Full Disclosure: CAS will not withhold from or misrepresent to

the prospective adoptive parent(s) any available medical, social,

or other pertinent information concerning the child(ren).

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SCHEDULE 3.10 – Educational Agreement

Understanding that adoption is a life-long process and that

continuing education is a requisite to successful placements, I

agree to assume responsibility for my continuing education

regarding and related to adoption. I will work in partnership

with Carolina Adoption Services to obtain the required 10

educational hours/12 hours for China and recommended 30

hours of education prior to placement, by completing the Heart

of the Matter program, Because they Waited. I will avail myself

to education through support groups, current

books/magazines, and webinars related to adoption. Prior to

international adoption, I will prepare myself with knowledge

including but not limited to, the following areas:

The inter-country adoption process.

The general characteristics and needs of children awaiting adoption and the in-country conditions that affect children in the country from which the prospective adoptive parents plan to adopt.

The effects on children of malnutrition, relevant environmental toxins, maternal substance abuse, and other known genetic, health, emotional, and developmental risk factors associated with children from the country of origin.

Information about the impact on a child of leaving familiar ties and surroundings, as appropriate to the expected age of the child, and the conditions surrounding referred child.

Data on institutionalized children and the impact of institutionalization.

Information on attachment disorders and other emotional problems that institutionalized or traumatized children, or children with multiple caregivers, may experience.

Information on the laws and adoption process of the expected country of origin.

Multicultural issues for adoptive families.

Reporting requirements of the country of origin.

The known health risks in the country of origin.

Short and long term developmental delays in physical, emotional and psychological development.

Separation and loss issues during adjustment and later

How children grieve and experience loss, initially and long term

Possibility of rejection during attachment process

No perfect parents/no perfect children

Importance of a positive attitude towards child’s culture and heritage. A family plan to help child gain knowledge and an appreciation for their child’s heritage.

Parents understand they are unable to specify skin tone or color

A life book and the importance of preparing one for their child

The possible effects of prenatal alcohol use including Fetal Alcohol Syndrome (FAS) and the realization that prenatal alcohol usage may not be identified before adoption

Awareness that social/medical information may be scarce and inaccurate.

SCHEDULE 4.1 – Client Rights

Client Rights apply to Carolina Adoption Services and its

subsidiary ABC Adoption Services. All references to CAS shall

also apply to ABC.

Carolina Adoption Services does not discriminate against any

person on the basis of race, religion, color, gender, sexual

orientation, age, national origin, disability, veteran status, or

any other status or condition protected by law.

All clients of the Adoption Program shall be afforded the

following rights:

1. The right to participate in the development of the plan of services to be offered by this agency and to be informed of the expectations of all parties involved in the implementation of the plan.

2. The right to the least restrictive or least intrusive process available and appropriate to the client’s case, utilizing sound clinical social work practices.

3. The right to confidentiality of all client records. Client consent is required prior to the release of any confidential information provided to CAS.

4. The right to access public and private records about yourself, but not information that is defined as confidential by law, or information from another source that requires a written release. Access may take a few days and an appointment is necessary.

5. The right to not be subject to any research activities outside of the routine plan of services, without the client’s written consent.

6. The right to not be filmed or taped without written consent. 7. The right to treatment in a fair and equitable manner. 8. The right of access to a complaint and grievance

procedure. 9. The right to statistical information regarding the number of

applications, placements, intact placements, disruptions and dissolved placements for the last three years. Information on waiting children is also available.

10. The right to add a statement to your case record about the services being provided to you or services you wish to receive. If personnel insert a statement in response, such statements are inserted with your knowledge and you are given the opportunity to review such a response. Copies of any response to this statement by CAS must be provided to you.

To initiate the grievance procedure (Schedule 11) please contact: Angela Jackson, Interim Executive Director, at 301 North Elm Street, Suite 201, Greensboro, NC 27401 or by calling (336) 275-9660. In the event the grievance concerns the Executive Director, please contact: Chairperson, Board of Directors, at the above address. Refund requests must be made in writing to the Executive Director.

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SCHEDULE 10.1 – Explanation of Fees and Services

Carolina Adoption Services, Inc. and its subsidiary strive to provide a transparent and accurate representation of anticipated adoption expenses. Below is a chart detailing expected fees and estimated fees paid to third parties as well as a chart detailing fees charged by the agency for other services provided or special circumstances which are generic to most programs. The Client understands that CAS has no control over any fees and costs which the Client is obliged to pay to third party providers or the Sending Country in order to complete their adoption. The fees to third party providers referenced in this document are estimates only and are for the purpose of assisting the Client to develop a budget for their adoption. The Client further understands that CAS has outlined the expected total fees for the adoption process to the best of its ability. However, there is a possibility that there could be additional unexpected expenses during the adoption process and while traveling in the foreign country. It is further understood that once the service has been rendered, the fees are non-refundable. Fees are only refundable as outlined in the refund policy in this Agreement. All fees are due as services are rendered, or earlier, with the final balance due prior to traveling to receive the child or prior to child placement with the Client. ALL FEES ARE BASED ON THE ADOPTION OF ONE CHILD. Additional fees will apply when adopting siblings or two or more children at the same time. We have provided a chart on the pages that follow for each country outlining the expected fees and estimated expenses for adopting a child through CAS. The charts describe the fees, when the fees are due, to whom they are paid, and an estimation of possible expenses. Refer to “Forms” section of http://www.uscis.gov for the most current USCIS related fees.

International Adoption Expenses Paid to Third-Parties

Service Fee When due

USCIS fees, I-600A/I-800A $720 Upon filing of I-600A/I-800A (paid directly to USCIS)

USCIS fees, fingerprints $85/adult household member

Upon filing of I-600A/I-800A (paid directly to USCIS)

USCIS Fees, I-824 (Non-Hague – 2nd or subsequent change of country)

$405 Upon filing of I-824 (paid directly to USCIS)

USCIS Supplement 3 Hague Fees, $360

Used for Hague Countries only for: A 2nd extension of I800A approval, change in residence, financial status, criminal status, change of country, change of placing agency, siblings, age, special need

US Embassy Fees, DS-260 $230 Varies, depending on country. May be paid to CAS at time of referral or prior to travel or paid during first trip to country in programs which have multiple trips.

Hague Required criminal record clearances & Child Abuse Registry checks

$10-$100/document

Paid by Client directly to Home Study agency or to appropriate entity conducting the search.

USCIS fees, N-600, proof of citizenship $550 Upon filing of N-600 after child’s arrival (paid directly to USCIS) (If applicable)

USCIS fees, N-565, replacement of naturalization document

$345 Upon filing of N-565 after child’s arrival (paid directly to USCIS) (If applicable)

Miscellaneous (physical exams, background checks, adoption education, etc.)

$200-$1,000 Paid directly to service providers throughout adoption process

U.S. Passports per person $125 Paid directly to service providers

Photos for passports, country dossier and other $10-20 Paid directly to service providers

General Agency Professional Fees and Special Circumstance Fees

International Home Study Fee $2,000 Fee for completion of international home study

Home Study Update $400-$1,700 Range depends on type of update & extent of changes

Home Study Amendment $50-$1,700 For several changes to Home Study

Coordination Fee $200-$500 For Home Study Clients working with another placement agency

Home Study Review $450

Review of Home Study done by other agency (Placement Only Clients)

Home Study Review Fee for subsequent Home Study reviews

$225 Review of subsequent home studies or updates done by other agency (Placement Only Clients)

Program Change fee* $1,000 Fee when Client changes countries before completing adoption

Professional Service fee for Program Change

$1,000 Fee for additional professional services provided when family changes to a subsequent country including assistance with dossier preparation

23

Professional Fee for additional sibling/relative* ^

No charge No additional agency professional fee charged for adoption of sibling group

Professional Fee for additional unrelated child* ^

Varies by case Only allowed with approval of CAS Adoption Committee.

Professional Service Annual Program Maintenance Fee $500/year

Annual fee for professional services provided when the adoption is not completed within the second anniversary of execution of this Agreement; fees will be assessed annually until the adoption is completed.

Aid & Development when changing country Varies

Varies depending on whether the Aid & Development fees from 1st country were expended.

Additional Professional Services $150/hour

Including but not limited to additional social worker visits-consultation when unusual circumstances present

Record Retrieval fee $100/hour Retrieval of closed or stored inactive files

Wire Fee $30 Fee to send International funds by wire

Translation Fees Varies Additional translation fees could be required in special circumstances when additional documents translation for the adoption are required

*see Description of Fees on following pages ^ Additional international fees will be applied by the foreign country when adopting more than one child. Contact your program

coordinator. Description of Fees:

The following description of services is provided to help Clients gain a better understanding of terminology used in international adoption. This is a general overview of the types of services available to Clients. Due to the unique process of each country, the descriptions provided should not to be considered an itemization of the fee for the stated service. The services may include, as applicable, but are not limited to the following: (* see below, refer to chart of “General Agency Professional Fees and Special Circumstance Fees)

Additional Professional Services: Requests for special services outside the normal scope of the adoption services provided are billed at the stated hourly rate.

Agency Coordination Fee: A coordination fee is charged to provide the necessary coordination of services between agencies when a family is utilizing another agency to do the placement portion of the adoption process. In the event a Client transfers from Carolina Adoption Services to another agency and requests the transfer of documents this fee will apply.

Aid & Development: Consists of costs incurred for developing and maintaining overseas programs, including agency accreditation, government approval and humanitarian support.

Aid & Development when changing country: When families change from one country to another, the Aid & Development fee for the 2nd country must be paid.

Airfare: The estimated airfare is listed for one person and one trip. Total cost of Airfare significantly varies due to the season, economy, number of trips & people etc.

Child Abuse & Criminal Record Checks: Families completing an intercountry adoption are required to have child abuse and criminal record checks completed in every state/country the Client has lived in since the age of 18.

Child’s Medical Exam & Visa: Any individual who is immigrating to the United States is required to undergo a physical examination with a specified panel physician, indicating that they are legally permitted to enter the U.S.

Country Reports: Each country has requirements for social worker generated reports and/or family generated reports at specific intervals. Refer to charts on the following pages for information specific to each country.

Country Report Administration: Covers the costs associated with the collection and processing of country reports required by the sending country.

Country Report Deposit: Country report deposits (if applicable) are returned upon the timely and thorough completion of all required country reports.

*Concurrent Adoption Fee: Concurrent adoptions (pursuing two adoptions in separate programs simultaneously) are only permitted by special exception upon approval from the CAS Adoption Committee. Taking into consideration the requirement that the arrival of children is no less than one year apart; the age difference of the children is no less than 1 year; if another agency is working with the family, they agree in writing with the concurrent adoption plan. Additional Professional Services Fee may apply.

Dossier Authentication: All countries require some type of authentication of the dossier documents ranging from having the documents notarized to having the foreign Embassy seal the documents. Having a document authenticated with an apostil or State Seal means that the Secretary of the State the document was notarized or certified in is attesting that the notary is indeed a notary in good standing.

Education:

Pre-adoption counseling and training prior to adopting a child.

Explores issues relevant to adoption including: attachment, grief and loss, impact of institutionalization and environment on child development, becoming a multiracial family, keeping children connected to their cultural heritage, dealing with community and family reactions, coping with the wait time, and talking to your child about adoption.

All families are required to complete the 10 hour Because They Waited on-line program by Heart of the Matter

24

Seminars prior to completion of the Home Study. Families adopting from China must complete 12 hours. Families are strongly encouraged to continue education by completing the recommended 30 hours.

Family & Children’s Agency (FCA) Program Enrollment Fees: These fees only apply to the South Korea program offered by Family & Children’s Agency (FCA). The fees include the FCA Application fee, Enrollment Fee, & International Service Fee.

Home Study Fee: Families who reside in Virginia, South Carolina and North Carolina and are Home Study Clients of CAS will be charged a fee for Home Study Services.

Home Study Review Fee:

A Home Study review fee will be charged to families using agencies other than CAS to complete their Home Study assessment. The placing agency is responsible for ensuring that the Home Study format and information is in adherence with CAS’s and the country’s requirements.

Client should select a Home Study agency which is fully licensed in their state of residence and has a written agreement with CAS prior to contracting for their service.

Once the Home Study is in complete draft form, CAS will review, make corrections or suggestions as needed and return to the Home Study agency for finalization.

Once the changes have been made and an original has been received, CAS will send the family a letter of acceptance.

If a Home Study update is necessary, a Home Study review fee for placement-only families will be charged to the family.

Home Study Update Fee: A Home Study update is required anytime the validity period of the original Home Study is near its expiration and placement has not occurred, if USCIS approval is expiring; examples of other update reasons include: any significant changes to the family during the adoption process such as moved to a new house, job change, addition of another household member, family member moves from the home, change in country from where adopting, change in number of children adopting, change in criminal history, change in type of child desired. Families in need of a Home Study update to extend their immigration approval should contact the involved agency(ies) at least 3 months before the immigration approval expires.

In-Country Expenses: Estimates of in-country expenses may include, but are not limited to: hotel(s), in-country travel, transportation, and if applicable a driver and translator.

International Fee:

International services are provided by the contracted supervised provider, as well as agency staff by: Regular professional contact with the central authority and other government officials to ensure the family and agency are well represented.

Participation in government meetings to ensure a clear understanding of adoption law.

Maintain the agency accreditation in good standing.

Submission of dossier on behalf of family.

Obtain available medical and social information on the child, provide pictures as appropriate.

Represent the agency and the adoptive family in all adoption activities. (Excludes US Embassy process as facilitators are typically not allowed to enter the Embassy).

Travels to outlying areas as needed, meets with social workers and local government officials as needed.

Submits all country reports to government authorities as needed.

Represents the agency and the family in legal proceedings, provides advice and seeks legal consultation as needed.

Works to maintain appropriate ethical and operational standards.

Pension, taxes and salaries required for the in-country representative.

Ensures legal translation of all documents for court proceedings and prepares all post court documents (if appropriate).

Secures all appointments on behalf of the adoptive family including visit(s) with the child, court proceedings, meetings with officials, etc.

Guides the family through the process while in country.

Foreign office overhead, utilities, etc.

Office and operating expenses for staff

Communication with in-country representatives

Expenses associated with the care of the child may also be included.

Orphanage Donation:

Orphanage Donations are customary and necessary for the health and welfare of the orphaned, abandoned and vulnerable children. Adoptive families should be advised that if they make the donation directly to a third party, such as the orphanage, CAS is unable to provide a charitable contribution record for tax purposes for any such cash donations made in-country. Please obtain receipts for any donations made while you are in-country. If the donation comes directly from CAS, then documentation for income tax purposes may be provided.

The orphanage donation may be a required donation in some countries, as the donation is used for care provided to the children in the orphanage they reside.

Care of the child may also be included in the donation. Expenses such as, but not limited to; costs for food, clothing, shelter & medical care; foster care services; orphanage care; and any other services provided directly to the child.

Professional Services Fee:

Acceptance of adoptive parent(s) into the program and entering into a written agreement with the Home Study agency (if other than CAS)

General adoption agency overhead expenses including personnel cost, administrative overhead, operational cost and communications

Communication with the family via email, fax and telephone

Case management support

Counseling on the USCIS process

Guidance in dossier preparation, review for correctness and submission to the foreign country.

Facilitating the family’s adoption process between agency and government officials both in the U.S. and the foreign country

25

Presentation of referred child information including a translated medical, social history and all other information available.

Confirmation of USCIS approval at the foreign Embassy

Preparation for travel

Consultation while in country

Coordination with the foreign team for ease of travel and processing through the foreign procedures

*Professional Fee for Sibling/Relative: Adoption of more than one child at a time requires special approval from the CAS Adoption Committee. Families adopting a sibling at the same time are not charged an additional Professional Fee by the agency. However, the country may charge additional International fees. USCIS fees are based on a per child basis. See individual country-fee charts on following pages.

*Professional Fee for additional unrelated child: Adoption of more than one child at a time requires special approval from the CAS Adoption Committee. Additional Professional Service Fees will apply with the adoption of an additional unrelated child at the same time. In addition, there will most likely be additional costs in country of origin. USCIS fees are based on a per child basis. See individual country-fee charts on following pages.

Professional Fee for Concurrent Adoption: Families approved for a concurrent adoption must prepare a new dossier for the additional country. The fee covers professional services needed to assist the family with the subsequent dossier preparation and instructions.

* Professional Fee for waiting child with special needs: Families’ adoption of a child with special needs may be eligible for an adoption grant to reduce the Professional Agency Fee. The reduction is assessed on a case-by-case basis depending on family’s circumstances, child’s circumstances and amount of funds available.

Professional Service Annual Program Maintenance Fee: If a family’s adoption is not completed before the second anniversary of the execution of this Agreement, additional annual professional service fees will apply. Such fees cover professional services provided during the extended term of the adoption process and will be assessed annually until the adoption process is completed. These fees do not apply to Clients whose adoption is completed within the first two years of the execution of this Agreement.

Professional Service fee for Program Change: Fee for additional professional services for assistance with dossier preparation when family changes to a different country.

*Program Change Fee: Families changing from one country program to another within the agency are subject to a fee depending on the nature and reason for the change. The change fee may be waived for families transferring from a regular program to a Waiting Child/Special Needs program.

Post-Adoption Reports: CAS requires all families have 3 post-placement/post-adoption supervised visits and reports completed by their social worker at 1 month, 3 months, and 6 months after arriving home. Supervision reports conducted by CAS, which coincide with a Country Required Reports result in one visit being used for both purposes.

Record Retrieval Fee: This fee covers cost of retrieving a closed or stored file when Clients need information that requires access to the closed file by staff.

Re-Finalization: Cost associated with providing documents, assistance & required court report. Re-finalization with resident state is highly encouraged and recommended within 12 months of the international placement.

Travel Visas: Some countries require entrance, or travel visas, in order to legally enter the country. Please refer to Department of State website for current requirements before travel.

Program Fees and Estimated Expenses

Expenses vary based upon the country the Adoptive Parents are adopting from and the expected program fees and expenses are outlined in the charts on the following pages. Fees listed are based on the adoption of One Child. Additional fees will apply

if a second child is being adopted, and based upon whether or not the children are siblings or not, contact CAS for additional information. The expected fees and estimated expenses provided in the following charts do not include optional sightseeing expense, food, souvenirs, or the cost associated with a U.S. based attorney to finalize or re-finalize the adoption.

Families living in some states may be required to hire an attorney to assist in finalization within their state of residence.

INSTRUCTIONS: The charts provided on the following pages outline expected program fees and estimated expenses for each program in which CAS operates. If CAS/ABC is doing both your Home Study and your placement, you follow the column labeled, “Full Service” under “CAS Fees”. If your Home Study is being done by another agency, CAS/ABC is therefore your Placing Agency. In this case, please follow the column labeled “Placement Only”. By signing this Agreement, you are acknowledging that you have read and understood the fees presented in this Agreement.

THE CHARTS ALSO SERVE AS YOUR PAYMENT SCHEDULE. Please note, the “Payment Due” and “Payable To” columns which indicate when each payment will be required. Payments are typically due at the following intervals: At Application; Upon Submission of Contracts; Upon Approval or Acceptance of Home Study; Upon Dossier Submission; Upon Acceptance of Referral; Prior to Travel; and During Travel. Payment at the appropriate time must be received prior to moving forward with the next step of the adoption process.

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ARMENIA (Hague Convention Country)

Description CAS Fees

Estimated Third-Party Expenses

Payment Due Payable

To

Total Paid to

CAS

Office Use Only

Full Service Placement-only

Application Fee $300 N/A At Application CAS $300

Home study $2,000 Report cost

determined by HS Agency

N/A With Home

Study Agreement

CAS or other HS Agency

$2,000

Or $0

Education N/A $150 to $200 Time of service Provider N/A

Home study Review N/A $450 N/A Submission of

Contracts CAS

$3,500

or

Professional Services Fee Part A $3,500 N/A Submission of

Contracts CAS $3,950

Professional Services Fee Part B $3,500 N/A Approval or

Acceptance of HS

CAS $3,500

Dossier Authentication N/A $250 N/A Provider N/A

International Fee - 1st Installment * See Chart Below N/A Submission of

Dossier CAS

$9,530 to $16,530

Aid & Development $500 N/A Submission of

Dossier CAS

Wire Fee (1@30.00) $30 N/A Submission of

Dossier CAS

International Fee – 2nd Installment* See Chart Below N/A Acceptance of

Referral CAS

Post-Adoption Reports (3 social worker reports required generated at 1, 3 & 6 months @ $300

each) $900

TBD by HS agency

N/A Acceptance of

Referral

CAS or other HS Agency

$6,930 to $13,930

Country Report Deposit (REFUNDABLE) $1,000 N/A Acceptance of

Referral CAS

Country Reports (5 reports. All reports are completed by a social worker 1, 2, 3, 4 & 5 years

@ $300 each.) $1,500

TBD by HS agency

N/A Acceptance of

Referral

CAS or other HS Agency

Country Report Administration Fee (5 reports @ $100 each)

$500 N/A Acceptance of

Referral CAS

Wire Fee (1@30.00) $30 N/A Acceptance of

Referral CAS

International Fee – 3rd Installment* $4,150 N/A Prior Final Trip CAS

$4,180

Wire Fee (1@30.00) $30 N/A Prior Final Trip CAS

TOTAL (Including $1,000 refundable deposit)

Estimated Cost (based on 2 people) Paid to CAS Est. 3rd Party Fees Total Fees & Estimated Expenses

Full Service $29,910

to $43,910

$400

to $450

$30,310 to $44,360

Placement-only

$25,960 $26,360 to

$40,410 to

$39,960

Travel Related Estimated Expenses (two trip required)

DESCRIPTION ESTIMATED EXPENSE WHEN DUE PAYABLE TO

Airfare for Adoptive Family(approximate) $1,000 - $1,750 per person per trip Travel Chosen Provider

Airfare for child(approximate) $100 - $900 Travel Chosen Provider

Approximate In-country Expenses (2 people)+ $5,000 - $8,000 Travel Chosen Provider

+ In-Country expenses can vary significantly due to specific needs and family preferences.

*INTERNATIONAL FEES DUE:

1st Installment 2nd Installment

$12,000 for Downs Syndrome 9,000 3,000

$14,000 for Special Needs 10,000 4,000

$20,000 for children age 10+ 13,000 7,000

$24,000 for children age 5-10 15,000 9,000

$26,000 for children age 0-5 16,000 10,000

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BULGARIA (Hague Convention Country)

Description CAS Fees

Estimated Third-Party Expenses

Payment Due Payable To Total Paid to

CAS Office Use

Only Full Service Placement-only

Application Fee $300 N/A At Application CAS $300

Home study $2,000 Report cost determined by

HS Agency N/A With Home study

Agreement CAS or other HS

Agency

$2,000

Or $0

Education N/A $150 $200 Time of service Provider N/A

Home study Review N/A $450 N/A Submission of

Contracts CAS

$3,500

or

Professional Services Fee Part A $3,500 N/A Submission of

Contract CAS $3,950

Professional Services Fee Part B $3,500 N/A Approval or

acceptance of HS CAS $3,500

Dossier Authentication N/A $250 N/A Provider N/A

International Fee - 1st Installment* $1,500 to $2,950 N/A Submission of

Dossier CAS

$2,500

to

Aid & Development $1,000 N/A Submission of

Dossier CAS $3,950

International Fee - 2nd Installment* $4,500 to $7,270 N/A Acceptance of

Referral CAS $5,900

Post-Adoption Reports (3 social worker reports required generated at 1, 3 & 6 months @ $300

each) $900 TBD by HS agency N/A

Acceptance of Referral

CAS or other HS Agency

to

$8,670

Country Report Deposit** (REFUNDABLE) $1,000 N/A Acceptance of

Referral CAS or

Country Reports ** (4 reports. 1st report combined with CAS 6 month agency required visit. All reports are completed by a social worker at 6, 12, 18 & 24

months @ $300 each.)

$900 TBD by HS agency N/A Acceptance of

Referral CAS or other HS

Agency

$7,700

to

Country Report Administration Fee (4 reports @ $100 each)

$400 N/A Acceptance of

Referral CAS $10,470

Child’s Medical US Visa N/A $325 Hand-carried US Embassy &

approved provider N/A

During Trip

Child’s Medical Exam N/A $12 to $120

Hand-carried During Trip

US Embassy & approved provide

N/A

Contribution Bulgaria does not require a contribution/donation to the orphanage

TOTAL (Including $1,000 refundable deposit)

Estimated Cost (based on 2 people) Paid to CAS Est. 3rd Party

Fees Total Fees & Estimated Expenses

Full Service $19,500 to $23,720 $737 $20,237 to $20,395

Placement-only $16,150 to $20,370 to $895 $16,887 to $21,265

* Fee will change by exchange rate ** The Bulgarian Government will monetarily fine families for failure to comply with the required Country Reports. Families sign an acknowledgement and agreement as part of their dossier, and will forfeit Country Report Deposit if reporting is not completed within time requirements of due dates.

Bulgaria does not require a contribution/ donation to the orphanage

Travel Related Estimated Expenses (two trips required)

DESCRIPTION ESTIMATED EXPENSE WHEN DUE PAYABLE TO

Travel Visa N/A for US Citizens N/A N/A

Airfare for Adoptive Family(approximate) $800 - $1,600 per person per trip Travel Chosen Provider

Airfare for child(approximate) $100 - $900 Travel Chosen Provider

Approximate In-country Expenses (2 people) $3,500 - $4,000 Travel Chosen Provider

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CHINA (Hague Convention Country)

Description

CAS Fees Estimated Third-Party Expenses

Payment Due Payable To Total

Paid to CAS

Office Use Only

Full Service Placement-

only

Application Fee $300 N/A At Application CAS $300

Home study $2,000

Report cost determined

by HS Agency

N/A With Home study Agreement CAS or other HS Agency

$2,000

Education N/A $150 $200 Time of Service Provider N/A

Home study Review N/A $450 N/A Submission of Contracts CAS $3,000

or

Professional Services Fee Part A $3,000 N/A Submission of Contracts CAS $3,450

Professional Services Fee Part B $3,000 N/A Approval or Acceptance of HS CAS $3,000

Dossier Authentication (approximate) N/A $500-$700 N/A Provider N/A

International Facilitator Fee $2,400 N/A Submission of Dossier CAS

$4,910

Aid & Development $1,000 N/A Submission of Dossier CAS

Int’l Fee: Dossier Registration $1,100 N/A Submission of Dossier CAS

Int’l Wire Fee (4@$30) $120 N/A Submission of Dossier CAS

Int’l Fee: Dossier Translation $350 N/A Submission of Dossier BLAS

Int’l: Required Orphanage Donation+ $5,830 N/A LOA (Letter of Approval) CAS

Int’l: Provincial Gov’t fee $1,900 N/A LOA (Letter of Approval) CAS

Post-Adoption Reports (3 social worker reports required generated at 1, 3 & 6 months @ $300 each)

$900 TBD by HS

agency N/A LOA (Letter of Approval)

CAS or other HS agency

Country Report Deposit (REFUNDABLE)

$1,000 N/A LOA (Letter of Approval) CAS $10,300

Country Reports (6 reports. The 6 month report is combined with CAS agency required visits. Reports are completed by a social worker at 6, 12 months and 2 years @ $300 each.) *

$600 TBD by HS

agency N/A LOA (Letter of Approval)

CAS or other HS agency

Or

Country Report Administration Fee (6 reports @ $100 each)

$600 N/A LOA (Letter of Approval) CAS $11,800

Country Report Translation Fee (6 reports @ $60 each)

$360 N/A LOA (Letter of Approval) CAS

Wire Fee (6 wires @ $30) $180 N/A LOA (Letter of Approval) CAS

Child’s US Visa & Processing Fee $430 N/A LOA (Letter of Approval CAS

Child’s Medical Exam~ N/A $300 Hand-carried US Embassy

& approved provider

N/A During Trip

TOTAL (Including $1,000 refundable deposit)

Estimated Cost (based on 2 people) Paid to CAS Est.3rd Party Expenses Estimated Cost (based on 2 people)

Full Service $25,070 $950 to $1,200

$26,020 to $26,270

Placement-only $22,020 $22,970 to $23,220

+ Expenses associated with care of the child are provided by the orphanage. ~ Does not include TB test/Chest X-ray, extra immunization fees or immunization waiver fees.

* Family generated reports @ 3, 4, and 5 years.

Travel Related Estimated Expenses (One trip required) Estimated Cost (based on 2 people)

DESCRIPTION ESTIMATED EXPENSE WHEN DUE & PAYABLE TO

Guide $39/per day Due to CAS prior to travel

Chinese Entrance Tax (“head tax”) $75/person Due to CAS prior to travel

Travel Visa $130 per person At time of service to chosen provider

Int’l Airfare for Adoptive Family(approximate) $1,200 - $1,900 per person per trip At time of service to chosen provider

Airfare for child(approximate) $350 - $1,200 At time of service to chosen provider

Approximate In-country Expenses (2 people) Approx. $4,000 - $5,000 Varies by province, some paid to CAS prior to travel, some

paid during trip

Optional 2-day Beijing Tour prior to adoption Approx. $1,660 per 2 people Varies

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HAITI (Hague Convention Country)

Description

CAS Fees Estimated Third-Party

Expenses Payment Due Payable To

Total Paid to

CAS

Office Use Only Full Service Placement

Application Fee $300 N/A At Application CAS $300

Home study $2,000 TBD by HS

Agency N/A

With Home study Agreement

CAS or other HS Agency

$2,000

Or $0

Education N/A $150 to $200 Time of Services Chosen Provider N/A

Home study Review N/A $450 N/A Submission of Contracts CAS $3,500

Or

Professional Services Fee Part A $3,500 N/A Submission of Contract CAS $3,950

Professional Services Fee Part B $3,500 N/A Approval or acceptance of HS CAS $3,500

Dossier Authentication &Translation N/A $1,500 to $1,800 At time of service Chosen Provider N/A

International Facilitator Fee ^ $1,100 N/A Upon Submission of

Dossier CAS

$8,235

International -Legalization of Dossier at IBESR+Copies

$520 N/A Upon Submission of

Dossier CAS

International Fee - Installment^ $5,525 N/A Upon Submission of

Dossier CAS

Wire (3@$30) $90 N/A Upon Submission of

Dossier CAS

Aid & Development $1,000 N/A Upon Submission of

Dossier CAS

International Fee -Orphanage Service Fee+^

$6,100 to $10,000 N/A Acceptance of Referral CAS

International Translation Fee- Translation of referral docs/acceptance letter court adoption paperwork (One Child)

$600 N/A Acceptance of Referral CAS

Wire (2@30) $60 N/A Acceptance of Referral CAS $60

Post-Adoption Reports (3 social worker reports required generated at 1, 3 & 6 months @ $300 each)

$900 TBD by

HS agency

N/A Acceptance of Referral CAS or other HS Agency

$10,200 Or $14,100

Country Report Deposit (REFUNDABLE) $500 N/A Acceptance of Referral CAS

Country Reports (9 reports. The first 3 report is completed by social worker at 6,12,24 months. 1st report combined/CAS 6 mo agency required visit. CR Fee :$300 ea. Last 6 reports are family generated 3,4,5,6,7,8 years)

$600 TBD by HS

agency N/A Acceptance of Referral

CAS or other HS Agency

$8,700

Country Report Administration Fee (9 reports @ $100 each)

$900 N/A Acceptance of Referral CAS To

Translation Fee translation of 9 Country Reports $540 N/A Acceptance of Referral CAS $12,600

Child’s Medical Exam & US Visa N/A $625 Hand-carried During Trip US Embassy &

approved provider

N/A

TOTAL (Including $500 refundable deposit)

Estimated Cost (based on 2 people) Paid to CAS Est. 3rd Party Fees Total Fees & Estimated Expenses

Full Service $27,585 to $31,485 $2,275 to $2,625

$29,860 to $34,110

Placement-only $24,535 to $28,435 $26,810 to $31,060

+ Expenses associated with care of the child are provided by the orphanage * Additional for second child ^

Travel Related Estimated Expenses (One or two trips required)

DESCRIPTION ESTIMATED EXPENSE WHEN DUE PAYABLE TO

Travel Visa N/A for US Citizens N/A N/A

Airfare for Adoptive Family(approximate) $400 - $800 per person per trip Travel Chosen Provider

Airfare for child(approximate) $100 - $500 Travel Chosen Provider

Approximate In-country Expenses (2 people) $1,500 - $2,500 Travel Chosen Provider

30

MEXICO (Hague Convention Country)

Description

CAS Fees Estimated Third-Party Expenses

Payment Due Payable

To Total Paid

to CAS

Office USE Only

Full Service

Placement- Only

Application Fee $300 N/A At Application CAS $300

Home study $2,000 TBD by HS

Agency N/A

With Home study Agreement

CAS or other HS Agency

$2,000

$0

Education n/a $150 to $200 Time of Service Provider N/A N/A

Home study Review N/A $450 N/A Submission of Contracts CAS $3,500

Or

Professional Services Fee Part A $3,500 N/A Submission of Contract CAS $3,950

Professional Services Fee Part B $3,500 N/A Approval or acceptance

of HS CAS $3,500

Dossier Authentication N/A $250 At time of service Provider N/A N/A

Psychological Evaluation (submitted as part of dossier)

N/A $500 to $1,000 Time of service/prior to

dossier submission Provider N/A N/A

International Fee – installment-Legal Fee

$2,500 N/A Submission of Dossier CAS

$4,930

International Fee – Installment-Dossier Translation

$930 N/A Submission of Dossier CAS

Aid & Development $1,500 N/A Submission of Dossier CAS

International Fee-Installment $6,325 N/A Upon Approval of

Dossier DIF CAS $6,325

International Fee-Installment $5,000 N/A Acceptance of Referral CAS

Post-Adoption Reports 3 social worker reports required generated at 1, 3 & 6 months @ $300 each

$900 TBD by HS

agency N/A Acceptance of Referral

CAS or other HS Agency

$5,500

Country Report Deposit (REFUNDABLE) $500 N/A Acceptance of Referral CAS Or

Country Reports ** (Varies according to age of child. Every 6 months for 3 yrs then annually until child is 16 @ $300 each)

**Varies TBD by HS

agency N/A Acceptance of Referral

CAS or other HS Agency

$6,400

Country Report Administration Fee (4 reports @ $100 each) **

**Varies- minimum 10 reports

N/A Acceptance of Referral CAS

Child’s Medical Exam & US Visa N/A $325 Hand-carried During Trip US Embassy & approved

provider N/A

TOTAL (Including $500 refundable deposit)

Estimated Cost (based on 2 people) Paid to CAS Est. 3rd Party Fees Total Fees & Estimated Expenses

Full Service $26,955 $1,225 to $1,775

$28,180 to $28,730

Placement-only $24,505 $25,730 to $26,280

**One report every 6 months for first 3 years and then one report every year till child turns 16 years old.

Travel Related Estimated Expenses (One or two trips required)

DESCRIPTION ESTIMATED EXPENSE WHEN DUE PAYABLE TO

Adoption Visas $200 Travel Mexico Consulate

Airfare for Adoptive Family(approximate) $700 per person per trip Travel Chosen Provider

Airfare for child(approximate) $400 Travel Chosen Provider

In-country guide/translator $85 per day approximately 12 days Travel Guide

Approximate In-country Expenses (2 people) $1,900 - $5,300 Travel Chosen Provider

31

SOUTH KOREA (PARTNERSHIP PROGRAM WITH FAMILY AND CHILDREN’S AGENCY [FCA])

Description CAS Fees Estimated

Third-Party Expenses

Payment Due Payable to

SWS Total Paid

to CAS Office Use

Only Full Service

Application Fee $300 N/A At Application CAS $300

Home study $2,000 N/A With Home study

Agreement CAS $2,000

FCA –Program Enrollment Fee N/A $4,700 Submitted w/ return of

FCA appl.

Remitted to FCA, payable

to FCA N/A

Education N/A $150 $200 Time of Service

Provider

CAS-Professional Services Fee Part A $2,750 N/A Submission of CAS

Contract CAS

$3,250

Aid & Development $500 N/A Submission of CAS

Contract CAS

CAS-Professional Services Fee Part B $2,750 N/A Approval of HS CAS $2,750

Dossier Authentication N/A N/A—No Dossier

N/A N/A N/A

FCA –Acceptance of Referral Fee N/A $4,000 Acceptance of Referral Remitted and

Payable to FCA

N/A

Korean International Service Fee to

Social Welfare Society (SWS) + N/A $20,040 Acceptance of Referral

Payable to SWS

N/A

Post-Adoption Reports (6 reports. All reports are completed by a social worker at 2 weeks, 2, 3, 6, 9 & 12 months @ $300 each.)

$1,800 N/A Acceptance of Referral CAS $1,800

Child’s Medical Exam & US Visa N/A

Included in Korean Int’l Serv. Fee to

SWS

N/A N/A N/A

TOTAL

Estimated Cost (based on 2 people) Paid to CAS Est. 3rd Party Fees Total Fees & Estimated Expenses

Full Service $10,100 $28,890 $38,990 to $39,040

Placement-only N/A must be HS Client to $28,940 N/A

+Expenses associated with care of the child are provided by the orphanage/government. There is no additional contribution/donation required.

Travel Related Estimated Expenses (Two trips required)

DESCRIPTION ESTIMATED EXPENSE WHEN DUE PAYABLE TO

Travel Visas N/A for US Citizens N/A N/A

Airfare for Adoptive Family(approximate) $1,500 - $2,000per person Travel Chosen Provider

Airfare for child(approximate) ~10% of one adult fare ($150-$200) Travel Chosen Provider

Approximate In-country Expenses (2 people)

$1,600 - $6,000 Travel Chosen Provider

32

UGANDA

Description

CAS Fees Estimated Third-Party Expenses

Payment Due Payable To Total Paid

to CAS Office Use Only Full

Service Placement-

only

Application Fee $300 N/A At Application CAS $300

Home study $2,000 TBD by HS

agency N/A

With Home study Agreement

CAS or other HS Agency

$2,000

Or $0

Education N/A $150 to $200 Time of Service Provider N/A

Home study Review N/A $450 N/A Submission of Contracts CAS $3,500

Or

Professional Services Fee Part A $3,500 N/A Submission of Contract CAS $3,950

Professional Services Fee Part B $3,500 N/A Approval or acceptance

of HS CAS $3,500

Dossier Documents N/A $100 to $200 As gathering documents Provider N/A

Int’l Attorney Fee – 1st Installment $3,315 N/A Submission of Dossier CAS

$7,625 Int’l Service Fee – 1st Installment $3,250 N/A Submission of Dossier CAS

Aid & Development $1,000 N/A Submission of Dossier CAS

Wire Fee (2@$30) $60 N/A Submission of Dossier CAS

Int’l Attorney Fee- Final installment $3,065 N/A Acceptance of Referral CAS

Int’l Service Fee - Final Installment $3,250 N/A Acceptance of Referral CAS

Wire Fee (2@$30)

$60 N/A Acceptance of Referral CAS

Post-Placement Reports 3 social worker reports

required generated at 1, 3 & 6 months @ $300 each $900

TBD by HS agency

N/A Acceptance of Referral CAS or

other HS Agency

Country Report Deposit (REFUNDABLE) $500 N/A Acceptance of Referral CAS $9,185

Orphanage Reports (3 reports. The 3 & 6 month reports

are combined with CAS agency required visits. All reports are to be completed by a social worker at 3, 6 & 12 months @ $300 each.)**

$300 TBD by HS

agency N/A Acceptance of Referral

CAS or other HS Agency

0r

Country Reports (to be determined by the courts

ruling @$300 each)*** ***Varies

TBD by HS agency

N/A Acceptance of Referral CAS or

other HS Agency

$7,235

Orphanage Report Administration Fee (3 reports @ $100 each)***

$300 N/A Acceptance of Referral CAS

Country Report Administration Fee (to be determined by the courts ruling @ $100 each)**/***

***Varies N/A Acceptance of Referral CAS

Adoption Finalization Deposit (REFUNDABLE)~

$500 N/A Acceptance of Referral CAS

Finalization $250 TBD by HS

agency N/A Acceptance of Referral CAS

Child’s Medical Exam & US Visa N/A $475 Hand-carried During

Trip

US Embassy & approved provider

N/A

TOTAL ( Including $1,000 refundable deposits total)

Estimated Cost (based on 2 people) Paid to CAS Est. 3rd Party Fees Total Fees & Estimated Expenses

Full Service $26,050 $725 to $875

$26,775 to $26,875

Placement-only $22,550 $23,275 to $23,425

**Families will be required to complete biannual self-generated reports for submission to Uganda until child turns 18 years old. ***Varies – dependent upon court ruling as to number and interval of country reports due after placement. +The orphanage service fee covers all expenses associated with care of the child while in orphanage. Orphanages typically receive little to no financial support from the Ugandan government and rely solely on donations to provide care for the orphans. ~ This is refunded when CAS is provided a copy of Certificate of Citizenship.

Travel Related Estimated Expenses (One trip required)

DESCRIPTION ESTIMATED EXPENSE WHEN DUE PAYABLE TO

Travel Visa $100 per person Travel Ugandan Immigration

Airfare for Adoptive Family(approximate) $1,200 - $1,700 per person Travel Chosen Provider

Airfare for child(approximate) $350 - $1,200 Travel Chosen Provider

Driver $40 - $100/day/family - As needed During trip Driver

Approximate In-country Expenses (2 people) $2,000 - $5,000 Travel Provider

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SCHEDULE 11 – Complaint and Grievance Policy

The Client understands that CAS will make every effort to work with the Client toward a mutually beneficial solution. In the event of a complaint, the Client agrees to:

11.1. The Client will first discuss the complaint with their assigned Program Coordinator. In the instance that a Program Coordinator has not been assigned or the Client wishes to voice a complaint regarding a Program Coordinator, the Program Coordinator’s supervisor should be contacted.

11.2. If this effort is unsuccessful, the Client shall submit the complaint in the form of a written description of the basis for complaint to CAS’s Executive Director. Should the complaint concern the Executive Director the complaint should be addressed to the Chairperson of the Board of Directors. CAS (or the Board of Directors in the event the complaint is against the Executive Director) will immediately investigate the facts of the complaint and respond to each complaint in writing within 60 days of receipt of such complaint. If the Client requests expedited consideration, expedition of the complaint process shall be made in the sole discretion of CAS or its Board of Directors, as applicable.

11.3. Should the complainant be dissatisfied with the response, they may request reconsideration by writing to the Chairperson of the Board of Directors of CAS. The Executive Committee of the Board of Directors will meet and attempt to resolve the complaint within 60 days and respond in writing. If the complainant is not satisfied with the resolution with the Executive Committee of the Board of Directors at CAS the Client shall next utilize mediation or arbitration process described below.

11.4. Mediation and Arbitration. Subject to the exceptions set forth in subsection 11.5 below, CAS and the Client agree that in case of any dispute, controversy or claim arising under this Agreement or in any way connected with CAS's services to the Client and not otherwise resolved through the CAS complaint process provided in the preceding paragraphs, the parties will, at the request of either party, attempt to settle such controversy without litigation through mediation consistent with the North Carolina "Rules Implementing Statewide Mediated Settlement Conferences in Superior Court Civil Actions," (the “Mediation Rules”). Notwithstanding anything to the contrary contained in the Mediation Rules or otherwise, the Client hereby waives their right to trial by judge or jury in any action, suit or proceeding arising under or related to this Agreement, or relating to the services provided under this Agreement. In the event that mediation is waived by both parties or is not successful, then any dispute, controversy, or claim arising under this Agreement or in any way connected with CAS's services to the Client will, at the request of either party be resolved by binding arbitration as provided herein and subject to the exceptions contained herein. The arbitration shall be conducted by an arbitrator who shall be appointed pursuant to the rules of the American Arbitration Association ("AAA"). The arbitration shall be held in

Greensboro, North Carolina, and shall be conducted in accordance with the commercial arbitration rules of the AAA, except that the rules set forth herein shall govern such arbitration to the extent they conflict with the rules of the AAA. Upon written notice by a party to the other of a request for arbitration hereunder, the parties shall use their best efforts to cause the arbitration to be conducted in an expeditious manner. All other procedural matters shall be within the discretion of the arbitrator. In the event a party fails to comply with the procedures in any arbitration in a manner deemed material by the arbitrator, the arbitrator shall fix a reasonable time for compliance and, if the party does not comply within such period, a remedy deemed just by the arbitrator, including an award of default, may be imposed. The determination of the arbitrator shall be final and binding on the parties. Judgment upon the award rendered by the arbitrator may be entered and enforced in any court having jurisdiction. The parties shall each be responsible for their own expenses in connection with any mediation or arbitration, including without limitation legal fees and fees of experts provided; however, the parties shall share equally in the expense of the mediator or arbitrator and of the AAA.

11.5. Exceptions to Mediation and Arbitration. The following are the sole exceptions to subsection 11.4 above:

11.5.1. To the extent the Client fails to comply with any obligations contained in this Agreement, including without limitation any post-placement or post-adoption obligations, CAS, may in its sole discretion, pursue all legal action necessary to force compliance with such requirements, including without limitation, an action for specific performance or injunctive relief in the state or federal courts of North Carolina, or any other appropriate court as deemed necessary by CAS.

11.5.2. Matters in dispute with a value of $10,000 or less may be heard by the Small Claims Court division of Guilford County, North Carolina, at the sole discretion of CAS.

11.6. If the complaint cannot be resolved through the CAS complaint processes, including mediation or arbitration, or if the complaint was resolved by an agreement to take action but CAS or the agency or person providing the service (if different) failed to take such action within thirty (30) days of agreeing to do so, or as otherwise set out in such agreement, the complaint may then be filed with the U.S. Department of State on-line Complaint Registry in accordance with § 96.70 and using the procedure establish by the Department of State for reporting of such complaints.

11.7 Complaint Process for Hague Convention Cases: Complaints against CAS in specific Hague Convention adoption cases and relating to that case must first be submitted by the complainant in writing to the primary provider and to the agency or person providing adoption services, if different from the primary provider. If the

34

complaint cannot be resolved through the CAS complaint processes, including arbitration, or if the complaint was resolved by an agreement to take action but CAS or the agency or person providing the service (if different) failed to take such action within thirty days of agreeing to do so, or as otherwise set out in such agreement, the complaint may then be filed with the Complaint Registry in accordance with § 96.70 and using the procedure established by the Department of State for reporting of such complaints. The U.S. Department of State website is www.travel.state.gov.

The Hague Convention on Intercountry Adoption Complaint Registry can be accessed at the following link: https://adoptionusca.state.gov/HCRWeb/WelcomeForm.aspx

CAS agrees not to take action to discourage the Client from making or expressing a complaint. Nor will CAS discourage the Client from providing information in writing, interviewing, answering questions, or expressing their opinions about the performance of the agency to an accrediting entity or the Secretary of State.

SCHEDULE 12 – Risks of Unknown Physical, Emotional and Developmental Conditions

The Client acknowledges and agrees that the Client has been fully informed about the risks inherent in intercountry adoption due to lack of information regarding birth parents and background information; information may be limited, incomplete, and/ or erroneous.

12.1 CAS makes every effort to fully inform the Client about the risks inherent in intercountry adoption. The Client acknowledges and agrees that CAS provides the Client with as complete and accurate medical, social and background information as reasonably possible about the child so the Client can make an informed decision about the appropriateness of a particular child’s placement with their family.

12.2 The Client acknowledges and agrees that CAS will disclose all information about the child obtained from the Foreign Entity or foreign government adoption authorities to the Client, including without limitation all background information and medical diagnoses obtained by CAS.

12.3 The Client acknowledges and agrees that if the Client requests additional information about the child, CAS will work diligently to obtain as much information as can reasonably be gathered.

12.4 The Client acknowledges and agrees that CAS does not withhold or misrepresent any medical, social or other pertinent information regarding the child.

12.5 The Client acknowledges and agrees that CAS would not knowingly place a child having medical, emotional or mental problems with a family requesting a child as healthy as possible; however, CAS cannot guarantee the child will not have undiagnosed or undisclosed medical, emotional or mental problems.

12.6 The Client acknowledges and agrees that, although CAS will exercise reasonable efforts to obtain and furnish the Client with a record of the medical, developmental and social status of any referred child, CAS can neither guarantee the completeness nor the accuracy of the information it receives from the facilitator and/or foreign placing entity; the Client is aware that medical testing and diagnosis from another country can be unreliable and, therefore, it is possible that a child placed with the Client may have one or more undiagnosed or

undisclosed physical, emotional, mental and/or developmental conditions which may not be discovered until Client's adoption has been completed. This could result in the Client adopting a child in need of expensive treatment, therapy, or other special care for which the Client may not have a third-party source of payment. CAS will inform the Client promptly about any new information on a child referred or under consideration for referral to the Clients, including information about physical, emotional, mental and/or developmental conditions received from the facilitator and/or foreign placing entity or any other circumstances that may affect the process or the Client's ability or desire to continue or conclude the adoption. The Client should keep in mind that orphanage children will likely have developmental delays.

Conditions to which children adopted from foreign countries may be subject to include, but are not limited to:

Hepatitis A, B and C Premature Birth Complications HIV Physical Abuse Salmonella Pneumonia Tuberculosis Sexual Abuse Depression Attachment Disorder (RAD) Chronic Infections Internal Parasites Developmental Delays Vitamin Deficiency Lice Learning Disabilities Malnutrition Skin Rashes Mental Retardation Chronic Ear/Sinus Infection Scabies Undiagnosed Genetic Problems Vision/Hearing Problems Mental Illness Syphilis Fetal Alcohol Syndrome Orthopedic Problems Hernia Tooth Decay Undiagnosed cleft palate

12.7 The Client acknowledges and agrees that CAS staff do not act as medical experts or interpret medical information. CAS strongly advises, and in some instances requires, the Client consult with a physician, experienced in international adoptions, prior to making a decision about accepting or declining the referral of a child. The Client acknowledges that it reserves the right and has the opportunity to consult with a physician and/or

35

mental health professional of their choosing and at their expense to discuss medical, emotional, and psychological risks which may need to be considered with a particular child. A list of international adoption clinics and doctors are available to the Client upon request.

12.8 The Client acknowledges and agrees that CAS allows the Client at least two weeks to consider the needs of the particular child, assess their ability to meet the child’s needs, and obtain an independent physician review of the child’s medical records and other information, including videos and photos of the child, if available. CAS reserves the right to shorten the timeframe upon written notice to the Client if there are extenuating circumstances involving the child’s best interests which require a more expeditious decision.

12.9 In the event the Client travels to the foreign country and finds the child has a medical condition, not previously known, that is deemed to be serious by both the Client and CAS, the Client may decline the referral.

12.10 CAS provides copies of originals of all medical and social information received on the child to the Client as early as possible. CAS also provides English translations if provided by the Foreign Entity. The Client acknowledges and agrees that the English translations are correct and complete to the best of CAS’s knowledge. CAS provides all translated and un-translated documentation available to the Client, including reports, medical tests, photographs and videos. The Client understands that they reserve the right to have any and all documents or videos in a language other than English to be translated by a certified translator of their choosing and at their expense.

12.11 Age Preferences and Other Specifications as to Children. The Client may specify the Client's age preference of children desired. (Note: Infant generally refers to babies from birth to eighteen (18) months.) CAS will ask the

facilitator and/or foreign placing entity to refer a child of the preferred age. The Client acknowledges and agrees, however, that a foreign placing entity may refer a child older or younger than specified, or, if the foreign adoption process takes longer than expected, the child may become older than the specified age by the time the Client is asked to accept the child. A Client's refusal to accept a referred child based on age or skin tone may have an adverse effect on that child's being accepted by another family and on the Client's obtaining a future referral from the same source. In many countries, the amount paid to the foreign government or other foreign placing entity (and the amount of the International Fee) is based upon the child's age at the time of referral. The Client acknowledges and agrees that CAS does not guarantee that a child referred to the Client will meet the Client’s age preference or other preferences requested.

12.12 The Client agrees to hold CAS harmless from any and all responsibility for any type of injury, harm, damage, or loss in any way relating to or arising out of the physical, psychological, or emotional condition of any child assigned to, placed with, or adopted by the Client regardless of when such injury, harm, damage or loss is known or discovered. The Client further agrees not hold CAS responsible for any translation error or omission that occurs on the child’s referral information or related documents.

12.13 The client understands and agrees that the signing of this Agreement, the performance of services by CAS, or the payment of fees by the Client does not guarantee, express or implied, Client’s approval for adoption, the adoptive placement of a child with Client, or successful completion of adoption of a child by Client. The parties further acknowledge that adoptions are subject to legal, political, and social factors not under the control of CAS or the Client and which may change from time to time.

36

SCHEDULE 13 – Fed-Ex Account Agreement

Families are required to set up and maintain a personal Federal Express account throughout their adoption and post-adoption

period. Each family must provide their Federal Express account number to CAS. CAS may ship envelopes or packages related

to your adoption case in one of two ways:

a. Individual family shipment- Package contains only documents related to your adoption case. CAS will ship using your

personal FedEx Account number.

b. Multiple families’ documents in one shipment- Whenever possible, CAS will consolidate shipments to foreign entities. These

packages will be shipped using the CAS FedEx Account. The charges will be split and billed accordingly to each family,

reducing the overall cost per client. Families will receive an invoice from CAS for shipping fees.

INSTRUCTIONS:

Please go to www.fedex.com and select “New Customer Center” on the left side of the window to set up a personal account

with Federal Express. Or you may call Federal Express at 1-800-GO-FEDEX and a service representative will guide you

through the process.

Please remember that you will need to keep this account current and up to date with all relevant personal information and

billing information. If your credit card changes or expires, you will need to update your Fed Ex account.

AUTHORIZATION TO USE FEDERAL EXPRESS ACCOUNT NUMBER

I/We, authorize Carolina Adoption Services

PRINT NAME(S) OF ADOPTIVE CLIENT FAMILY

to use my/our Federal Express account number, , in processing my/our documents for our Adoption. I/We understand that any domestic or international shipment of documents sent by Carolina Adoption Services on my/our behalf in relation to our adoption, will be charged to this Federal Express account, unless the shipment of our documents are combined and sent with other documents, in which case our CAS Accounts Receivables account will be billed according to cost share of the shipment. _______________________________ ____________________________ _______________

Prospective Adoptive Parent Signature Printed Name Date

_______________________________ ____________________________ _______________

Prospective Adoptive Parent Signature Printed Name Date

37

SCHEDULE 14 – Release and Receipt of Information & Release to Disclose and Receive

Health Information

AUTHORIZATION FOR RELEASE AND RECEIPT OF INFORMATION

I/We ______________________________________________________ hereby authorize Carolina Adoption Services, Inc. to

release a copy of my/our home study and related documents, application materials and pertinent verbal and written information

to:

a) Any licensed agency or authorized resource in the U.S. or foreign country/countries for the purpose of providing services in connection with my adoption process.

b) Any authority needed to be contacted in order to obtain required clearances.

c) Any governmental entity of U.S. or foreign country for the purpose of certification and/or authentication of documents;

d) Translator(s) of documents from/to English;

e) The U.S. Citizenship and Immigration Services, the U. S. Department of State; and the U. S. Department of Homeland Security for the purpose of processing child/children’s visa for entry into the US;

f) Any government entity of the United States or foreign country for the purposes associated with my adoption process;

g) The provider of medical and/or therapeutic services for the purpose of determining suitability of client/s to parent a child adopted from another country.

_______________________________ ____________________________ _______________

Prospective Adoptive Parent Signature Printed Name Date

_______________________________ ____________________________ _______________

Prospective Adoptive Parent Signature Printed Name Date

RELEASE TO DISCLOSE AND RECEIVE HEALTH INFORMATION

Preface: Carolina Adoption Services, Inc. (“CAS”) will be obtaining, using and disclosing Protected Health Information (“PHI”)

about me and minor dependents as related to the Health Insurance Portability and Accountability Act’s regulations related to

privacy (HIPAA Privacy) in my adoption process. In order to continue the ability to provide support and services throughout the

adoption process, there will be instances where it is necessary for CAS to disclose certain PHI to third parties in an official capacity

or to obtain such PHI. This authorization and release is designed to accomplish that requirement for the work during, and after

finalization of my adoption process.

This document is intended for the sole purpose of authorizing CAS and/or its employees, contractors, affiliates and/or third parties

as needed, to receive, obtain, disclose and otherwise possess PHI about me and/or my minor dependents as described below.

_____ _____ I understand the work involved during and after the completion of my adoption process could require disclosure to CAS, its employees, contractors, affiliates and/or other third parties, as needed, of PHI concerning me and my minor dependents (if any) as related to HIPPA Privacy, and authorize such disclosure. _____ _____I understand that CAS, is prohibited under relevant law, from improperly using my PHI for any improper purpose or disclosing my PHI to any unauthorized third party unrelated to the work during and after the adoption process. _____ _____I authorize CAS, its employees, contractors, affiliates and/or other third parties, to obtain, use and disclose all PHI concerning me and my minor dependents (if any) in connection with my adoption process, including post-adoption activities occurring after the finalization of the adoption process.

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I have read and understand the information contained in this authorization and with my signature below authorize the receipt, use

and disclosure of the information described in this document for the limited purposes identified herein, legal or otherwise, arising

from the possession of PHI about me. No promises or representations have been made to me to induce me to sign this form.

_______________________________ ____________________________ _______________

Prospective Adoptive Parent Signature Printed Name Date

_______________________________ ____________________________ _______________

Prospective Adoptive Parent Signature Printed Name Date

_______________________________ ____________________________ _______________

Witness Signature Printed Name Date

GENERAL COVENANTS AND DISCLOSURES RELATED TO AUTHORIZATION

1. Persons Authorized to Make Disclosures. Persons authorized to make the requested uses and disclosures of the information identified herein: Your Adoption Agency, adoption agents or facilitators or any other person or entity performing functions on behalf of your Adoption Agency, the adoption process, providers who are assisting you as you work through the adoption process.

2. Persons to Whom Disclosures May be Made. The information identified herein will be disclosed only to the following persons for the purposes identified herein:

a. Adoption Agency staff, other adoption agents and facilitators that provide or administer the adoption process or services or that your agency may request provide PHI information for the work during and after the completion of your adoption.

b. Any other person or entity performing functions on behalf of your adoption process.

3. Expiration Date and Revocation. This authorization shall survive the completion of your adoption process as permission for your agency to have access to and disclose this information and survives the completion of your adoption process accordingly.

4. Consequences of Refusal to Sign or Subsequent Revocation. I understand that I may refuse to sign this authorization or revoke this authorization in writing and that my refusal to sign or revocation will affect my ability to complete the adoption process.

However if you have voluntarily provided to your Agency certain PHI about yourself or dependents, your voluntary

disclosure and subsequently refuse to sign an authorization or revoke this authorization, such disclosed PHI does not

constitute possession of PHI for the purpose of HIPAA privacy compliance as directed under HIPPA privacy. I understand

that revocation is not effective to the extent that any person or entity has already acted in reliance on my authorization.

5. Reuse and Redisclosure of Information. Information disclosed under this authorization is subject to redisclosure by the recipient, however any information disclosed to your Adoption Agency, adoption agents or facilitators or any other person or entity performing functions on behalf of you and/or your dependents., will continue to be protected and not be reused or redisclosed other than as authorized by you or permitted by law.

6. Scope of Disclosure. I understand that if my medical record contains information relating to HIV infection, AIDS, or AIDS-related conditions, alcohol abuse, drug abuse, psychological or psychiatric conditions, or genetic testing, this authorization will include disclosure of that information.

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Signature Page of Adoption Services Contract and Acknowledgement of

Schedules

THE UNDERSIGNED HAVE READ EACH INDIVIDUAL PAGE OF THIS AGREEMENT, INCLUDING WITHOUT LIMITATION THE FOLLOWING SCHEDULES HERETO:

SCHEDULE 3.1 …….. CLIENT POLICIES

SCHEDULE 3.10 …… EDUCATIONAL AGREEMENT

SCHEDULE 4.1 ……. CLIENT RIGHTS

SCHEDULE 10.1 …... EXPLANATION OF FEES AND SERVICES

SCHEDULE 11 ……… COMPLAINT AND GRIEVANCE POLICY

SCHEDULE 12 …….. RISKS OF UNKNOWN PHYSICAL, EMOTIONAL AND DEVELOPMENTAL CONDITIONS

SCHEDULE 13 …….. FEDEX ACCOUNT AGREEMENT

SCHEDULE 14 …….. RELEASE OF INFORMATION & RELEASE TO DISCLOSE AND RECEIVE HEALTH INFORMATION

WE/I HAVE HAD THE OPPORTUNITY TO ASK QUESTIONS ABOUT THE AGREEMENT. WE/I FULLY UNDERSTAND THIS ADOPTION SERVICES CONTRACT AND WILL FULLY COMPLY WITH THE POLICIES AND GUIDELINES SET FORTH HEREIN. WE/I HAVE BEEN GIVEN THE OPPORTUNITY TO SEEK LEGAL COUNSEL CONCERNING THE ADOPTION PROCESS AND THIS AGREEMENT, AND ENTER INTO THE SAME, EFFECTIVE UPON THE DATE LAST WRITTEN BELOW.

_______________________________ ____________________________ _______________ Prospective Adoptive Parent Signature Printed Name Date

_______________________________ ____________________________ _______________ Prospective Adoptive Parent Signature Printed Name Date

_______________________________ ____________________________ _______________ CAS Representative Signature Printed Name Date