Free Temporary Guardianship Form
+ Travel and Medical Consent Forms

Your Free Temporary Guardianship Form makes provision for local travel with a temporary guardian as well as being a parental medical consent form.

Should the child be traveling across borders or even locally for a once-off excursion with a school or organization, you can use the stand-alone free parental travel consent form.

Be sure to read the important information before completing the form lower down on this page.

child waving goodbye




The purpose of the free temporary guardianship form supplied here is for voluntary and temporary use and does not cover petitions for temporary guardianship or court appointed guardians.

In this instance Temporary would mean for a limited time (normally not exceeding 30 days) and Guardian denoting a person lawfully invested with the power to take care of and manage the property and rights of a person (such as a minor).

A temporary guardianship form is ideally used when parents are traveling abroad and are leaving their child in the care of a family member or trusted friend. Another instance may be when the child is going on a field trip or excursion with a school, on a sports trip or on holiday with friends.

Should the trip be across borders it is imperative to issue a parental travel consent form with your temporary guardianship form. Even if the child is traveling with a parent, the legal circumstances may be such that the non-traveling parent may have to sign a parental travel consent form.





At times it may be impossible to get hold of parents in an emergency situation, so your free temporary guardianship form granting permission to authorize medical treatment can prevent serious delays. In the case of the child being looked after by a child minder you can use our separate parental medical consent form.

You can download your Parental Medical Consent Form and Parental Travel Consent Form by clicking on the following links, but do take some time and explore the useful tips and information first.

A Free Guardianship Form, which is available right after the Important Information can be copied into any word program where you can edit it to suit your requirements.

Important Information Re Your Parental Consent Forms

  • If you use our free temporary guardianship template or any other parental consent form supplied here, it adds credibility to have them notarized. If you choose to have them notarized you should not sign them beforehand since the notary public or commissioner of oath must witness your signature. Be sure to take all identification documents along - your own as well as your child's (e.g. birth certificate. Note: if one parent on the birth certificate of the child is deceased you should provide a certified copy of the death certificate);
  • If the child's surname is different from the parent you may need a marriage certificate, name change document, adoption papers etc. to prove the relationship;
  • The organizers of an excursion, field trip or sports tour will usually issue their own forms requesting information as well as indemnifying them against claims. If you do not agree with or understand any particular clause you should take it up with them. If they do not ask for details such as allergies or current medication you should add it as a footnote or as an (attached) addendum. If you know your child's blood group you can add that too;
  • A parent may need a parental travel consent form from the other parent if he / she does not have legal custody or even if they have joint legal custody;
  • If a parent does have sole legal custody, he / she should have a certified copy of the court document when traveling across international borders;
  • To avoid administrative hassles during an emergency you should attach a copy of your Medical Aid or Health insurance to your Temporary Guardianship Form;
  • Make sure you initial wherever wherever alterations are made with full signatures at the end;
  • Witness signatures must be by independent persons and not by anybody listed on the temporary guardianship document.

Copyright Temporary Guardianship Form



Authorization of Temporary Guardianship:

THE PARTIES TO THIS AGREEMENT ARE:

THE PARENT(s) / GUARDIAN(s)

Full Name and Surname:


Identity / Social Security or Other (Specify) number:


Full Name and Surname:


Identity / Social Security or Other (Specify) number:


Physical Address:




Contact Details:




(hereinafter referred to as "the Parent / Guardian")

THE CHILD

Full Name and Surname:


Birth Date / identifying numbers:


(hereinafter referred to as "the Child")

THE TEMPORARY GUARDIAN(s)

Full Name and Surname:


Identity / Social Security or Other (Specify) number:


Full Name and Surname:


Identity / Social Security or Other (Specify) number:


Physical Address:




Contact Details:




(hereinafter referred to as "the Temporary Guardian")

I, the Parent / Guardian of the Child hereby grant temporary guardianship to the Temporary Guardian for the period from the _______ day of ____________________ 20____ and expiring on the

_______ day of _____________________ 20____.

1.    I hereby acknowledge that the Child will reside with the Temporary Guardian and may travel locally with the Temporary Guardian.

2.    I authorize the Temporary Guardian to act on my behalf in making all decisions on a daily basis as to the Child's activities.

3.    I authorize the Temporary Guardian to administer general first aid treatment for minor injuries or illnesses experienced by the Child except where any such first aid treatment is specifically excluded hereunder:




4.    I authorize the Temporary Guardian, in the event that I cannot be contacted or if any urgency dictates, to act in loco parentis for the Child in respect of any circumstances, including any accident or illness, which may necessitate medical treatment, including surgery, and on my behalf to authorize any such treatment or surgery which they, in their sole discretion, (which discretion shall not be unreasonably exercised), may deem necessary. Medical treatment for the Child may also include dental surgery, x-ray, blood transfusion, anesthetic and medication provided any such medical treatment is performed by a duly licensed practitioner. I hereby accept full liability for all costs incurred through such medical treatment for the Child.

5.    Persons responsible should please note the following: (Please state aspects eg. allergies, tendency towards abnormal bleeding, epilepsy, etc.)






       Present prescribed, or other medication that is being administered:




6.    The following information is essential in case of medical treatment or hospitalization:

    6.1.    Name and Address of Employer:




    6.2.    Medical Aid / Insurer:


    6.2.    Policy Number:


7.    I indemnify the Temporary Guardian against any and all claims whatsoever and howsoever arising, save where such claims arise from negligence, gross negligence or willful intent during the specified period of Temporary Guardianship.

8.    I declare that I am the legal custodian of the Child and that I have legal authority to appoint a Temporary Guardian for the Child.

9.    Unless inconsistent with the context, words signifying the singular shall include the plural and vice versa.


Signed at ______________________on this ______day of _________________20____



SIGNATURE _____________________________(Parent / Guardian)

SIGNATURE _____________________________(Parent / Guardian)



WITNESS 1:    _____________________________

WITNESS 2:    _____________________________




Keep a copy of your free Temporary Guardianship Form on hand to issue when you will not be available to make decisions for your child.

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