Birthparent Services

We are so happy you are interested in joining one of our retreats! Please fill out the application to the best of your ability. You will need to complete the "required" sections in order to submit the application. There are no right or wrong answers. If you have questions, please reach out to Vicki or Jennifer.

Please Note: This application should be completed by the prospective attendee. If you are completing this application on behalf of someone else, please indicate at the bottom of this form.

Personal Information

Please note, in order to be eligible to attend a retreat, you must have given birth to and placed a child for adoption.

Retreat Experience

Release of Information

This release does three basic things: 

• Gives us permission to contact the agency/attorney who you worked with
• Allows us to use non-identifying information in our statistical analysis to evaluate the effectiveness of our services and obtain funding to support our programs

• Enables us to collaborate as a team to provide the best possible programs and services.  

  I, name entered below, give permission to On Your Feet to contact references and the adoption agency that provided services to me during pregnancy and placement. I am aware that On Your Feet gathers data for research and funding purposes. I am also aware that signing this release allows my adoption story to be shared in On Your Feet's printed materials and/or website/social media pages without using confidential data or identifying information, such as names and addresses. 

  By signing this release, I understand this allows all pertinent On Your Feet Foundation personnel/staff to collaborate on my behalf as a team, to provide me with the best possible services.