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Letter of Guardianship

BEFORE ME, the undersigned authority, personally came and appeared: who did say

(Parent Name)

that they are the parent of

(Child's Name)

who is a minor. They do

hereby give permission to

(Guardian Name)

commencing on

and ending

(Beginning Date) (Ending Date)

to have full rights of guardianship, including such matters as to authorize medical treatment of any necessary nature, sign documents of any type, obtain lodging and do all things that I as a parent and/or legal guardian may do.

Parent Signature

STATE OF: COUNTY OF: Before me, a Notary Public, in and for said County and State, personally appeared who acknowledged the execution of the foregoing, and who, having been duly sworn, stated that the representations therein contained are true. day of 20 . Witness my hand and Notarial Seal this

Signature Printed My Commission Expires

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