Chicago Leadership

Declaration of No Sex or Intimacy: I _________________________________ declare to meet the special needs of Maureen Uche by donating sperm with no sex or romance or intimacy.   

Declaration of Professionalism:  I_____________________________________declare I will professionally provide the best insemination help to Maureen Uche in this donation process. 

Declaration to provide Fresh Sperm: I______________________________declare that I know that it is my responsibility to provide fresh sperm at all times for insemination.  I declare that I am willing to provide sperm as many times as needed by Recipient in this process.

Declaration of No Parental Rights:  I _________________________________________declare that I am NOT willing to be a parent of any of recipient’s children. I also declare that I am  NOT willing to meet the expectant child at any age even at the age of 18 years.

Declaration of No Romantic Involvement With Maureen Uche  I_________________________________declare that I will never seek a romantic relationship with recipient.  

Health Declaration:  I _________________________________________ declare that I am healthy and clean and that I do not have any sexually transmittable diseases.  I declare that I have no symptoms that may be recognized as a sexually transmitted diseases such as HSV, Syphilis, herpes etc

Declaration of Payment Received:  I___________________________declare that I am willing to receive $1 after a ten  day insemination process.  I acknowledge that this $1 includes travel feeding and all other donor expenses. 

I certify that the information that I provided to the Sperm Recipient is correct and I authorize this sperm Recipient to use it. 

Donor Signature:_________________________________ Date:_________________