J. Baby

Date of Birth*

Email Address*

Confirm Email Address*

Create Password*

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Confirm Password*

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Do you have any current or past medical issues?*

Yes

No

Do you smoke or use illegal drugs?*

Yes

No

I understand that J.BABY will publish my profile (without my last name) and any photographs submitted by me on their website and in any other medium J.BABY deems appropriate.
I understand that J.BABY, potential Intended Parents and other professionals will rely upon the information contained in my application and I agree to answer each question completely and truthfully. I understand that failure to comply at any point in this process could result in significant financial and emotional distress for the intended parents.
I understand that if at any time I have questions or I am unsure about any aspect of this process, I will promptly communicate such concerns and/or questions to J.BABY.
I agree to release J.BABY and hold it harmless from any and all responsibility or liability with respect to any and all risks associated with the legal, medical, genetic, and/or psychological aspects of the surrogacy process.

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