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Other Names: Authorization for Childcare Child Care Authorization
Child Care Authorization Form document preview

What is a Child Care Authorization Form?

A Child Care Authorization is a form that allows someone to temporarily care for or make decisions about your child, such as allowing your nanny to pick up your child from daycare. Child Care Authorizations help document that you are entrusting your children to a childcare provider and gives them limited powers to make decisions in regards to your children.

Create a Child Care Authorization to define the terms when another person can make decisions about your child. 
 
If you want to grant legal authority to make major decisions, create a Power of Attorney for Child instead.

When to use a Child Care Authorization:

  • You would like to authorize your child's school to release your child to another individual.
  • You would like to give authorization for another individual to make decisions regarding your child in your unexpected absence.

Sample Child Care Authorization Form

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CHILD CARE AUTHORIZATION

 

 

I, the undersigned parent or guardian, , of , ,  , We, the undersigned parents or guardians, and , of , ,  , , of , ,   and , of , ,  , hereby grant , of , ,  , hereby grant and , of , ,  , the authority to take temporary care of the below described minor(s): . This grant of temporary authority shall begin on , and shall remain effective through .until terminated by either of the undersigned.

 

The above named Caretaker(s) shall have 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
- authorize medical treatment or medical procedures in an emergency situation
- make appropriate decisions regarding clothing, bodily nourishment, and shelter
- explain absences from school
- pick child(ren) up from school
- sign release forms for sports
- sign release forms for field trips
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By:   Date:  

 

By:   Date:  

 

OPTIONAL NOTARY 

 

_________________________________

 

 

_________________________________

 

 

,  

 

,  

 

Dear :To Whom It May Concern:

 

The purpose of this letter is to advise you of the authority given to over over and over .

 

This grant of temporary authority shall begin on and shall remain effective through .until terminated by either of the undersigned.

 

The above Caretaker(s) shall have the authority 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
- authorize medical treatment or medical procedures in an emergency situation
- make appropriate decisions regarding clothing, bodily nourishment, and shelter
- 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.

 

Sincerely,

 

 

____________________________________ Date: ____________

 

____________________________________ Date: ____________

 

Child Care Authorization Checklist

 

 

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___Sign this document. This document needs to be signed by:

 

 

The Authorization can be signed online. It becomes effective as of the date specified in the document. You may choose to sign your document in front of a notary public. It becomes effective as of the date signed.

 

___Everyone gets a copy. Anyone named in the document should receive a copy of the signed document. If you sign this agreement online a copy will be securely stored in your account. You can share your document from your account.

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