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Temporary Guardianship Agreement

I, _____________________________________________, of ___________________________________________

(print your full name)(street )

________________________________________________________, as the custodial parent of:

(city, state, zip)

List the full names of each child

List each child’s birth date

Do hereby grant temporary guardianship of the above listed children to:

List the full names of the individual (s) to whom you are List each person’s relationship to the child(ren) granting temporary custody

Contact information of temporary guardians listed above:

Address: _____________________________________________________________________________________

Phone numbers: ________________________________________________________________________________

Statement of Consent: (To be signed in the presence of a legalized notary public.)

I, _____________________________________, hereby grant temporary guardianship of the above children, whom

I have legal custody of to ________________________________________________________________________:

□From ________________________________to ___________________________________

(mm/dd/yyyy)

(mm/dd/yyyy)

□For as long as necessary, beginning on __________________________________________

(mm/dd/yyyy)

In addition, in the event of an emergency or non-emergency situation requiring medical treatment, I hereby grant permission for any and all medical and/or dental attention to be administered to my child/children, in the event of an accidental injury or illness. This permission includes, but is not limited to, the administration of first aid, and the use of an ambulance, and the administration of anesthesia and/or surgery, under the recommendation of qualified medical personnel. I also grant permission for the guardian(s) named above to make educational decisions for my child/children.

Signature: ______________________________________________________________ Date: _________________

Signature: ______________________________________________________________ Date: _________________

Notarization:

On this _______________day of _______________, _________, ________________________________________

(date)

(month)

(year)

(name of parent)

 

personally appeared before me in ___________________________, _______________and, in my presence,

 

(city)

 

(state)

 

has/have satisfactorily identified him/her/themselves as the signer(s) of

this Temporary Guardianship Form.

 

 

 

 

Affix Notary

Name of Notary Official: ________________________________________________________

Seal Here

Signature: _____________________________________________________Commission Expires: ______________

⇓ Temporary Custody PDF

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Similar forms

  • Child Custody Agreement: This document outlines the terms of custody between parents or guardians. It specifies who will have physical and legal custody of the child, similar to the Temporary Custody form, which also addresses custody arrangements.
  • Visitation Agreement: A Visitation Agreement establishes the schedule for when a non-custodial parent can spend time with the child. Like the Temporary Custody form, it is designed to ensure the child's best interests are prioritized.
  • Power of Attorney for Minor Child: This document allows a parent or guardian to grant another adult the authority to make decisions on behalf of the child. Similar to the Temporary Custody form, it addresses the delegation of care and responsibilities for the child.
  • Guardianship Petition: A Guardianship Petition is filed to establish a legal guardian for a child when parents are unable to care for them. It shares similarities with the Temporary Custody form in that both seek to provide a stable environment for the child.

  • Self-Proving Affidavit: To simplify the probate process, consider using the necessary Self-Proving Affidavit documentation that confirms the legitimacy of a will without the need for witnesses in court.

  • Child Support Agreement: This document details the financial responsibilities of each parent towards the child. While it focuses on financial support, it complements the Temporary Custody form by ensuring that the child's needs are met.
  • Emergency Custody Order: An Emergency Custody Order is issued in urgent situations where a child may be at risk. Like the Temporary Custody form, it is a legal mechanism to protect the child’s welfare and ensure their safety.