GPAP Stage I Application Form

MEN HAVING BABIES, INC.

* * *

GAY PARENTING ASSISTANCE PROGRAM

APPLICATION AND TERMS AND CONDITIONS

EFFECTIVE AS OF JULY 1, 2016

* * *

Men Having Babies, Inc. (“MHB”) is a not-for-profit corporation whose primary purpose is to provide educational and practical information to assist gay prospective parents achieve biological parenting and to promote the affordability of surrogacy related services for gay men through financial assistance and the encouragement of transparency and customer feedback. In order to further this purpose, MHB has established the Gay Parenting Assistance Program (the “Program”), the objective of which will be to assist eligible gay prospective parents who cannot afford the full costs of biological parenting by providing grants and access to discounts and pro bono services from in-vitro fertilization clinics, surrogacy agencies, egg donation agencies, providers of reproductive health services, law firms, and other providers of related health, medical, legal and other services (“Service Providers”).

Certain Service Providers have pledged to provide certain participants in the Program with (i) pro bono services and/or products on a free-of-charge basis (“Pro Bono Services”), (ii) supplemental third-party services or products that are donated and underwritten by such Service Providers on a free-of-charge basis (“Supplemental Donated Services”), and/or (iii) services or products on a discounted basis (“Discounted Services” and, collectively, with Pro Bono Services and Supplemental Donated Services, the “Pledged Services”). Only persons that apply to the Program and are determined by MHB to be eligible to participate in the Program may receive Pledged Services. Further, subject to limited exceptions, only those eligible persons that have been nominated by MHB (including, without limitation, any Grant Committee of MHB) may receive Pro Bono Services and/or Supplemental Services. Notwithstanding anything to the contrary herein, the terms and conditions relating to any Pledged Services are set forth in the Charitable Pledge Agreements between MHB and the applicable Service Provider and/or other agreements or instruments that may have been entered into in connection therewith.

Each person applying to the Program (an “Applicant Parent”) shall be required to sign and date the last page hereof and agree to the terms hereof as a condition to being accepted into the Program. There is no guarantee or promise that any Applicant Parent will receive any Pledged Services or other services or products, even if such Applicant Parent is accepted into the Program. MHB makes no representation or warranty, and disclaims all liability with respect to, any Service Provider or Pledged Service or the outcome or success of any Pledged Service. See “Exculpation and Indemnification” in the attached Terms and Conditions for more information.