Adoptive Parents Forms - The Cradle

2049 Ridge Avenue, Evanston, IL 60201 847-475-5800
Other Relevant Information (if adopted person or birth parent is deceased, please provide information, i.e. date of death, cause of death, etc.):
_________________________________________________________________________ ______
_______________________________________________________________________________
Signature: ___________________________________________
Date: _____________________________
Parental Permission (if applicable):
I/We are aware that an adopted person under 21 years of age must have the written consent of the adoptive
parent(s) in order to receive non-identifying information. I/We do hereby give my/our permission for
__________________________, who is 18-20 years of age, to receive non-identifying information. Attached is a
copy of my/our photo ID(s).
Signature:
Date:
I would like to receive
General Cradle Newsletter □ Yes □ No
Cradle e-newsletter □ Yes □ No
12/11 x:/Materials/Post Adoption/Forms/Client Identification.doc