HTML Preview Temporary Guardianship Form page number 1.
Authorization of Temporary Guardianship:
I, ________________________________ (parent’s name) the Parent of _______________________________
(child’s name) hereby grant temporary guardianship to ________________________________
(guardian’s name) for the period from the _______ day of ____________________ 20____ and expiring
on the _______ day of _____________________ 20____.
I also approve of my Child participating in the ____________________________ (event name) on
______________ (date). I authorize the Temporary Guardian to act on my behalf in making all
decisions on a daily basis as to the Child's activities.
SIGNATURE _____________________________ DATE ______________________
Please attach copy of PARENT ID with signature:
PARENT INFORMATION TEMPORARY GUARDIAN
Full Name: _____________________________ Full Name: _____________________________
Phone: _____________________________ Phone: _____________________________
Email: _____________________________ Email: _____________________________
CHILD INFORMATION
Full Name: _____________________________
Example of ID w/ Signature.
Can be included in separate
document.