This required section contains personal information including the name(s) and address(es) of the parent(s) and of the person(s) to be appointed as caretaker(s). Press [Ctrl+F1] for more information.
This required section states the name(s) of the child(ren) who will be under the care of the caretaker(s). Press [Ctrl+F1] for more information.
This required section states when the grant of temporary authority will become effective and when it will terminate. Press [Ctrl+F1] for more information.
This required section states the specific powers granted to the caretaker(s) in order to care for the child(ren). Press [Ctrl+F1] for more information.
This required section includes signature lines for the parents and provides for a signing date. Press [Ctrl+F1] for more information.
This optional section includes a letter which can be used to explain the authority of the caretaker(s) to care for the minor child(ren). Press [Ctrl+F1] for more information.
Times New Roman
Child Care Authorization
TGUARD
The Child Care Authoization grants some other person (e.g., overnight babysitter) or institution (e.g., school field trip) temporary custody of a child.
!!! !!!!!!!! !!! !!!!! ! ! ! !! ! ! ! !
Enter the name of the first parent who will be granting temporary authority or edit the information as desired. Use the P.I. Manager to select and paste a record. The first and second parent (if there is one) will be referred to in the hints as "the Parents".
Enter the second parent's name or use the P.I. Manager to select and paste a record.
Enter an X to include a second parent's name.
Enter the first child's full name or use the P.I. Manager to select and paste a record. If more than five children need to be listed, a separate document can be used to include the additional names. The "Exhibit" document can be used for this purpose.
Enter the Parents' street address or edit the information as desired.
Enter the Parents' extended address or edit the information as desired.
Enter the Parents' city or edit the information as desired.
Enter the Parents' state/province or edit the information as desired.
Enter the Parents' zip/postal code or edit the information as desired.
Enter the country or edit the information as desired.
Enter an X to include the country in which the Parents reside, if outside the United States.
Enter the first caretaker's full name or use the P.I. Manager to select and paste a record. A caretaker is a person or institution who is responsible for the care of minor children. Press [Ctrl+F1] for more information. The first and second caretaker (if there is one) will be referred to in the hints as "the Caretaker".
Enter the second caretaker's name or use the P.I. Manager to select and paste a record.
Enter an X to include a second caretaker. For example, the spouse of the first caretaker. You are not required to name a second caretaker.
Enter the child's full name or use the P.I. Manager to select and paste a record.
Enter an X to include the name of an additional child.
Using the format MM/DD/YYYY, enter the date on which the grant of temporary authority will become effective or edit the information as desired.
Enter an X to terminate the grant of temporary authority on a specific date.
Enter an X to allow the grant of temporary authority to continue until terminated by one or both of the Parents.
Enter an X if only one parent will be signing the authorization, or to require the agreement of both Parents to terminate the grant of temporary authority.
Enter an X to allow either parent to terminate the grant of temporary authority without the consent of the other.
Using the format MM/DD/YYYY, enter the date that the grant of temporary authority will terminate.
TGD01
! Opening Section (1 of 6)
CHILD CARE AUTHORIZATION
The undersigned parent(s), !
! and !,
!, ! !,
! Country: !,
hereby grant(s) !
! and !,
!, ! !,
! Country: !,
Enter the name of the first parent who will be granting temporary authority or edit the information as desired. Use the P.I. Manager to select and paste a record. The first and second parent (if there is one) will be referred to in the hints as "the Parents".
Enter an X to include a second parent's name.
Enter the second parent's name or use the P.I. Manager to select and paste a record.
Enter the Parents' street address or edit the information as desired.
Enter the Parents' extended address or edit the information as desired.
Enter the Parents' city or edit the information as desired.
Enter the Parents' state/province or edit the information as desired.
Enter the Parents' zip/postal code or edit the information as desired.
Enter an X to include the country in which the Parents reside, if outside the United States.
Enter the country or edit the information as desired.
Enter the first caretaker's full name or use the P.I. Manager to select and paste a record. A caretaker is a person or institution who is responsible for the care of minor children. Press [Ctrl+F1] for more information. The first and second caretaker (if there is one) will be referred to in the hints as "the Caretaker".
Enter an X to include a second caretaker. For example, the spouse of the first caretaker. You are not required to name a second caretaker.
Enter the second caretaker's name or use the P.I. Manager to select and paste a record.
Enter the Caretaker's street address or edit the information as desired. Use the P.I. Manager to select and paste a record. The program assumes that the first and second caretaker have the same address.
Enter the Caretaker's extended street address or edit the information as desired.
Enter the Caretaker's city or edit the information as desired.
Enter the Caretaker's state/province or edit the information as desired.
Enter the Caretaker's zip/postal code or edit the information as desired.
Enter an X to include the country in which the Caretaker resides, if outside the United States.
TGD02
! Children Names Section (2 of 6)
the authority to take temporary care of the following child(ren):
! - !
! - !
! - !
! - !
Enter the first child's full name or use the P.I. Manager to select and paste a record. If more than five children need to be listed, a separate document can be used to include the additional names. The "Exhibit" document can be used for this purpose.
Enter an X to include the name of an additional child.
Enter the child's full name or use the P.I. Manager to select and paste a record.
TGD03
! Effective Date Section (3 of 6)
This grant of temporary authority shall begin on !, and shall remain effective
! through !.
! until terminated by
! the undersigned.
! either of the undersigned.
Using the format MM/DD/YYYY, enter the date on which the grant of temporary authority will become effective or edit the information as desired.
Enter an X to terminate the grant of temporary authority on a specific date.
Using the format MM/DD/YYYY, enter the date that the grant of temporary authority will terminate.
Enter an X to allow the grant of temporary authority to continue until terminated by one or both of the Parents.
Enter an X if only one parent will be signing the authorization, or to require the agreement of both Parents to terminate the grant of temporary authority.
Enter an X to allow either parent to terminate the grant of temporary authority without the consent of the other.
TGD04
! Caretaker Powers Section (4 of 6)
The above named caretaker(s) shall have the following powers:
! The power to seek appropriate medical treatment or attention on behalf of the child(ren) as may be required by the circumstances, including but not limited to, medical doctor and/or hospital visits.
! The power to authorize medical treatment or medical procedures in an emergency situation.
! The power to make appropriate decisions regarding clothing, bodily nourishment, and shelter.
! The power to
Press the space bar if the Caretaker will NOT have the power to authorize general medical treatment.
Press the space bar if the Caretaker will NOT have the power to authorize EMERGENCY medical treatment or procedures.
Press the space bar if the Caretaker will NOT have the power to make decisions regarding clothing, nourishment and shelter.
Enter an X to grant additional powers to the Caretaker.
Enter the additional powers granted to the Caretaker. For example, the power to make decisions regarding education.
TGD05
! Signature Section (5 of 6)
Dated: !
________________________________________
! ________________________________________
Using the format MM/DD/YYYY, enter the date that this document will be signed or edit the information as desired. This date may be left blank and be completed when the document is signed.
The program completes the checkbox if a second parent was named in the Opening Section. You may modify the information only by returning to that section.
TGD06
Sincerely,
! Optional Letter to School Section (6 of 6)
[FROM:]
!, ! !
! Country: !
[TO:]
!, ! !
! Country: !
The purpose of this letter is to advise you of the authority given to
! and !
while taking care of:
! - !
! - !
! - !
! - !
! - !
This grant of temporary authority shall begin on ! and shall remain effective
! through !.
! until terminated by
! the undersigned.
! either of the undersigned.
The above caretaker(s) shall have the authority to:
! - Make emergency health care decisions
! - Explain absences from school
! - Pick child(ren) up from school
! - Sign release forms for sports
! - Sign release forms for field trips
! - !
! - !
! - !
! - !
! - !
! - !
Thank you for your cooperation in this matter.
This optional section provides a letter that can be used to explain that someone other than the Parents has been given temporary authority to care for the children. Press [Ctrl+F1] for more information.
The program completes this field by transferring the information from a previous section. You may modify the information only by returning to that section.
Using the format MM/DD/YYYY, enter the date of the letter or edit the information as desired.
If known, enter the personal title and name of the contact person at the children's school (for example, "Ms. Jane Smith"). Use the P.I. Manager to select and paste a record.
If known, enter the contact person's employment title (for example, "Principal").
Enter the name of the children's school.
Enter the school's street address or edit the information as desired.
Enter the school's extended street address or edit the information as desired.
Enter the city in which the school is located or edit the information as desired.
Enter the state/province in which the school is located or edit the information as desired.
Enter the school's zip/postal code or edit the information as desired.
Enter an X to include the country in which the school is located, if outside the United States.
Enter the country or edit the information as desired.
Enter a salutation or edit the information as desired. Add a colon or comma after the salutation if appropriate. NOTE: If this field or the following name field is left blank, they will not be printed; this feature allows you to customize the name and greeting.
The program completes the personal title and name of the contact person by transferring the information from a previous section. This information may be modified without affecting earlier data. Add a colon or comma after the name if appropriate.
The program completes this field by transferring the information from an earlier section. If you do not wish to include this child in the Letter to School, press the space bar to deselect the X from this box. Only the children with an X before their names will be printed in the letter.
Enter an X if the Caretaker will have the authority to make emergency health care decisions.
Enter an X if the Caretaker will have the authority to explain absences from school. For example, for a dental appointment or an illness.
Enter an X if the Caretaker will have the authority to pick up the children from school.
Enter an X if the Caretaker will have the authority to sign release forms for sports.
Enter an X if the Caretaker will have the authority to sign release forms for field trips.
Enter an X to list an additional authority granted to the Caretaker that might be helpful or necessary for the school to know.
Use this space to list an additional authority granted to the Caretaker.
Enter a closing or edit the information as desired.
The program completes the checkbox if a second parent was named in the Opening Section. You may modify the information only by returning to that section.
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