Temporary Guardianship Form

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Dear Parents and Guardians,

For the safety and well-being of your child(ren), we kindly ask that you complete this form if you will be traveling and leaving your child(ren) in the care of another trusted adult. By providing the necessary contact details of the temporary guardian, you help us ensure that we are informed and able to support your child during your absence.

Thank you for your support.

Student's full name *

Current Grade Attending *

Guardia's Full Name *

Legal Guardian's Phone Number and Email Address *

Acting Guardian's Full Name *

Acting Guardian's Phone Number and Email Address *

Dates of Absence *

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