Article Structure
The Agreement Nonparent Relative Caregiver form is a vital document designed to facilitate the temporary care of a child by a relative or a voluntary caregiver when the parents are unable to provide direct supervision. This form, in accordance with Texas Family Code Chapter 34, allows a parent to authorize a designated individual—such as a grandparent, adult sibling, or aunt or uncle—to make important decisions regarding the child's welfare. Key responsibilities granted to the caregiver include authorizing medical treatment, enrolling the child in educational programs, and applying for public benefits. The form also emphasizes the necessity for both the parent and the caregiver to communicate any changes in contact information promptly. Importantly, it clarifies that while the caregiver can make certain decisions, they do not gain the full rights of a legal guardian. The agreement is structured to ensure that parental rights are respected, allowing parents to revoke the authorization at any time. Additionally, specific mailing requirements are outlined to ensure that both parents are informed of the arrangement, reinforcing the importance of transparency and communication in these sensitive situations.
Form Sample
AUTHORIZATION AGREEMENT
FOR NONPARENT RELATIVE OR
VOLUNTARY CAREGIVER
August 2011
Page 1 of 4
This authorization agreement is made in conformance with Chapter 34 of the Texas
Family Code concerning the following Child:
Child's Full Name:
Date of Birth:
Parent completing this form:
Full Name:
Physical Address:
Telephone Number:
Other contact information:
Child's other parent:
Full Name:
Physical Address:
Telephone Number:
Other contact information:
Parent voluntarily authorizes the following relative or Parental Child Safety Placement
voluntary caregiver to make certain decisions regarding the child, as listed on the next
page of this authorization agreement.
Name:
Relationship to Child (check one):
Child's Grandparent
Child's Adult Sibling Child's Aunt or Uncle
Parental Child Safety Placement Voluntary Caregiver in accordance with Child Protective Services
Physical Address:
Telephone Number:
Other contact information:
PARENT AND RELATIVE OR VOLUNTARY CAREGIVER UNDERSTAND THAT THEY ARE
REQUIRED BY LAW TO IMMEDIATELY PROVIDE EACH OTHER WITH INFORMATION
REGARDING ANY CHANGE IN THE OTHER PARTY'S ADDRESS OR CONTACT
INFORMATION.
AUTHORIZATION AGREEMENT
FOR NONPARENT RELATIVE OR
VOLUNTARY CAREGIVER
August 2011
Page 2 of 4
Parent authorizes the above named relative or voluntary caregiver to perform the following acts in
regard to the child and the relative or voluntary caregiver assumes the responsibility of
performing these functions:
(1) To authorize medical, dental, psychological, surgical treatment, and immunization of the child,
including executing any consents or authorizations for the release of information as required by law
relating to the treatment or immunization;
(2) To obtain and maintain health insurance coverage for the child and automobile insurance coverage
for the child, if appropriate;
(3) To enroll the child in a day-care program or public or private preschool, primary or secondary school;
(4) To authorize the child to participate in age-appropriate extracurricular, civic, social, or recreational
activities, including athletic activities;
(5) To authorize the child to obtain a learner's permit, driver's license, or state-issued identification card;
(6) To authorize employment of the child; and
(7) To apply for and receive public benefits on behalf of the child.
(8) This authorization agreement does not confer on the relative or voluntary caregiver of the child the
right to authorize the performance of an abortion on the child or the administration of emergency
contraception to the child
To the best of the parent's and the relative's or voluntary caregiver's knowledge (check if applicable):
This child is not the subject of a current (pre-existing) valid authorization agreement, and no
parent, guardian, custodian, licensed child-placing agency or other agency makes any claim to
actual physical possession or care, custody or control of the child that is inconsistent with this
authorization agreement.
To the best of the parent's and the relative's or voluntary caregiver's knowledge (choose one from below):
THERE IS NO COURT INVOLVEMENT WITH THIS CHILD
All of the following statements must apply:
• There is no court order or pending suit affecting the parent-child relationship concerning the child.
• There is no pending litigation in any court concerning custody, possession, or placement of the
child or access to or visitation with the child.
• The court does not have continuing jurisdiction concerning the child.
THIS CHILD HAS BEEN THE SUBJECT OF A COURT ACTION
The court with continuing jurisdiction concerning the child has given written approval for the execution of
the authorization agreement accompanied by the following information:
• The county in which the court is located;
• The number of the court; and
• The cause number in which the order was issued or the litigation is pending.
Please staple a copy of the court's order to this agreement.
AUTHORIZATION AGREEMENT
FOR NONPARENT RELATIVE OR
VOLUNTARY CAREGIVER
August 2011
Page 3 of 4
WARNINGS AND DISCLOSURES
This authorization agreement is an important legal document. The parent and the relative or voluntary
caregiver must read all of the warnings and disclosures before signing this authorization agreement.
The parent and relative are not required to consult an attorney but are advised to do so.
A parent's rights as a parent may be adversely affected by placing or leaving the parent's child with
another person.
This authorization agreement does not confer on the relative or voluntary caregiver the rights of a
managing or possessory conservator or legal guardian.
A parent who is a party to this authorization agreement may terminate the authorization agreement and
resume custody, possession, care, and control of the child on demand and at any time the parent may
request the return of the child.
Failure by the relative or voluntary caregiver to return the child to the parent immediately on request may
have criminal and civil consequences.
Under other applicable law, the relative or voluntary caregiver may be liable for certain expenses relating
to the child in the relative's or voluntary caregiver's care, but the parent still retains the parental obligation
to support the child.
In certain circumstances, this authorization agreement may not be entered into without written permission
of the court. Examples of when court permission must be granted include when a court has entered a
previous order granting custody or establishing a child support obligation.
This authorization agreement may be terminated by certain court orders affecting the child.
This authorization agreement does not supersede, invalidate, or terminate any prior authorization
agreement regarding the child.
This authorization agreement is void if a prior authorization agreement regarding the child is in effect and
has not expired or been terminated.
MAILING REQUIREMENTS:
When both parents do not sign the parent authorization agreement, a copy of the agreement MUST be
mailed to the non-signing parent, unless that parent is deceased or has had his or her parental rights
terminated. This authorization agreement is void unless:
1. The parties mail a copy of this agreement to a non-signing parent not later than the 10th day
after the date the authorization agreement is signed, by certified or international registered
mail, as applicable, return receipt requested.
2. If the parties do not receive a response from the non-signing parent before the 20th day after the
date the copy of the agreement is mailed, the parties must mail a second copy of the agreement
by first class mail or international first class mail, as applicable, to the parent not later than
the 45th day after the date the authorization agreement is signed.
EXCEPTION TO MAILING REQUIREMENTS:
If a parent who did not sign the authorization agreement does not have court-ordered possession of
or access to the child who is the subject of the agreement, the parent who is a party to the
agreement does not have to mail a copy of the agreement to the non-signing parent if either of the
following circumstances applies:
1. A protective order has been issued against the non-signing parent as provided under Chapter
85 of the Texas Family Code or under a similar law of another state for committing an act of
family violence (as defined by Section 71.004 of the Texas Family Code) against the parent
AUTHORIZATION AGREEMENT
FOR NONPARENT RELATIVE OR
VOLUNTARY CAREGIVER
August 2011
Page 4 of 4
who signed the agreement or any child of the parent who signed the agreement; or
2. The non-signing parent has been convicted of any of the following criminal offenses against
the parent who signed the agreement or any child of the parent who signed the agreement:
o any offense under Title 5 of the Texas Penal Code (including murder, homicide,
kidnapping, assault and sexual assault); or
o any other criminal offense in Texas or any other state if the offense involves a violent act
or prohibited sexual conduct.
This authorization agreement (select one of the following two):
Expires on this date: OR
Is valid until revoked in writing by either party
In addition, check here if you want the agreement to continue in effect after your death or during any
period of incapacity.
Execution of a subsequent authorization agreement does not by itself supersede, invalidate, or terminate
a prior authorization agreement.
By signing below, parent and the relative or voluntary caregiver acknowledge that they have each read
this authorization agreement carefully, are entering into the authorization agreement voluntarily, and have
read and understand all of the Warnings and Disclosures included in this authorization agreement.
_____________________________________
PARENT
Printed name:
SUBSCRIBED AND ACKNOWLEDGED BEFORE ME on this ____ day of _________________, 20____.
_____________________________________
Notary Public in and for the State of TEXAS
_____________________________________
PARENT**
Printed name:
SUBSCRIBED AND ACKNOWLEDGED BEFORE ME on this ____ day of _________________, 20____.
_____________________________________
Notary Public in and for the State of TEXAS
_____________________________________
RELATIVE OR VOLUNTARY CAREGIVER
Printed name:
SUBSCRIBED AND ACKNOWLEDGED BEFORE ME on this ____ day of _________________, 20____.
_____________________________________
Notary Public in and for the State of TEXAS
Document Specifications
| Fact Name | Details |
|---|---|
| Governing Law | This form is governed by Chapter 34 of the Texas Family Code. |
| Purpose | The form allows a parent to authorize a nonparent relative or voluntary caregiver to make decisions for a child. |
| Eligible Caregivers | Eligible caregivers include grandparents, adult siblings, aunts, uncles, and voluntary caregivers. |
| Medical Decisions | The caregiver can authorize medical, dental, and psychological treatment for the child. |
| Education Authorization | The caregiver may enroll the child in daycare, preschool, or school. |
| Extracurricular Activities | The caregiver has the authority to allow the child to participate in recreational and athletic activities. |
| Termination of Agreement | A parent can terminate the agreement and regain custody of the child at any time. |
| Mailing Requirements | If both parents do not sign, a copy must be mailed to the non-signing parent within 10 days. |
| Exceptions to Mailing | No mailing is required if a protective order exists against the non-signing parent. |
| Expiration | The agreement can either have a specific expiration date or remain valid until revoked in writing. |
Steps to Filling Out Agreement Nonparent Relative Caregiver
Completing the Agreement Nonparent Relative Caregiver form is a crucial step in ensuring that a relative or voluntary caregiver can make important decisions regarding a child’s welfare. After filling out the form, you will need to ensure that both parents are informed and that any necessary court documentation is attached, if applicable. Follow these steps carefully to complete the form accurately.
- Begin by entering the child's full name and date of birth at the top of the form.
- Fill in the full name, physical address, telephone number, and other contact information of the parent completing the form.
- Provide the same details for the child's other parent, including their full name, physical address, telephone number, and other contact information.
- Identify the relative or voluntary caregiver by entering their name and selecting their relationship to the child from the provided options (e.g., grandparent, aunt, uncle, etc.).
- Complete the caregiver's physical address, telephone number, and other contact information.
- Check the applicable box to confirm that the child is not subject to any existing authorization agreements or custody claims that conflict with this agreement.
- Select one of the options regarding court involvement with the child. If the child has been involved in court actions, provide the required court details, including county, court number, and cause number. Be sure to attach a copy of any relevant court order.
- Read the warnings and disclosures section carefully. It is essential to understand the implications of this agreement.
- Decide on the expiration of the agreement by selecting either a specific expiration date or the option for it to remain valid until revoked in writing.
- Sign the form where indicated as the parent. Make sure to have your signature notarized.
- If applicable, have the relative or voluntary caregiver sign the form and ensure their signature is also notarized.
- If both parents do not sign the agreement, mail a copy to the non-signing parent within the required timeframe.
Once the form is filled out, remember to keep copies for your records and follow through with any mailing requirements to ensure compliance with legal obligations. This process is vital for the child's safety and well-being.
More About Agreement Nonparent Relative Caregiver
What is the Agreement Nonparent Relative Caregiver form?
The Agreement Nonparent Relative Caregiver form is a legal document that allows a parent to authorize a relative or voluntary caregiver to make certain decisions on behalf of their child. This agreement is designed to ensure that the child receives necessary care and support while also protecting the rights of the parent.
Who can be designated as a caregiver in this agreement?
The form allows parents to designate specific relatives as caregivers. Eligible relatives include grandparents, adult siblings, aunts, uncles, or a voluntary caregiver approved by Child Protective Services. This ensures that the child is cared for by someone who is familiar and trusted.
What decisions can the caregiver make on behalf of the child?
The caregiver can make various important decisions, including authorizing medical and dental treatments, enrolling the child in school or daycare, and permitting participation in extracurricular activities. They also have the authority to apply for public benefits on the child’s behalf.
What are the responsibilities of the parent after signing this agreement?
After signing the agreement, the parent must keep the caregiver informed of any changes in their contact information. Additionally, the parent retains the right to terminate the agreement at any time and request the return of the child, ensuring that parental rights are upheld.
Does this agreement affect the parent's legal rights?
Yes, the agreement can affect the parent's legal rights. While it allows the caregiver to make certain decisions, it does not grant them the rights of a legal guardian or conservator. The parent still holds the ultimate responsibility and can revoke the agreement whenever necessary.
What should be done if both parents do not sign the agreement?
If both parents do not sign the agreement, the signing parent must mail a copy of the agreement to the non-signing parent within ten days. This is crucial to ensure that the agreement remains valid and legally recognized.
What happens if there is court involvement regarding the child?
If there is ongoing court involvement, the agreement requires written approval from the court. The parent must provide details about the court, including the county, court number, and cause number. This ensures that the agreement does not conflict with existing court orders.
Are there any exceptions to mailing requirements?
Yes, exceptions exist. If a protective order has been issued against the non-signing parent or if they have been convicted of certain violent offenses, the signing parent is not required to mail a copy of the agreement. This helps protect the safety of the child and the signing parent.
How long does the agreement last?
The agreement can either have a specific expiration date or remain valid until revoked in writing by either party. Additionally, it can continue to be effective even after the death or incapacity of the signing parent, if indicated in the agreement.
What should both parties do before signing the agreement?
Both parties should read the agreement carefully, including all warnings and disclosures. While it is not mandatory to consult an attorney, it is highly advisable to ensure that both parties fully understand their rights and responsibilities before proceeding.
Common mistakes
-
Incomplete Information: Failing to provide all required details about the child, parents, and caregiver can lead to delays or rejection of the form.
-
Incorrect Signatures: Not ensuring that all parties sign the form can invalidate the agreement. Each parent and the caregiver must sign where indicated.
-
Missing Contact Updates: Not immediately informing each other of any changes in address or contact information is a common oversight that can cause legal complications.
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Ignoring Court Involvement: If there is ongoing court action regarding the child, failing to disclose this can invalidate the agreement.
-
Not Following Mailing Requirements: Not mailing a copy of the agreement to the non-signing parent within the specified timeframe can render the authorization void.
-
Neglecting to Check for Prior Agreements: Overlooking existing authorization agreements can lead to conflicts and legal issues.
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Failure to Understand Warnings: Not reading or understanding the warnings and disclosures included in the agreement can lead to unintended consequences.
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Ignoring Expiration Terms: Not indicating whether the agreement expires or continues after death or incapacity can create confusion about its validity.
Documents used along the form
The Agreement Nonparent Relative Caregiver form is an essential document for families navigating custody and caregiving arrangements. Alongside this agreement, several other forms and documents may be required to ensure all legal bases are covered. Below is a list of these documents, each serving a specific purpose in the caregiving process.
- Power of Attorney for Minor Child: This document allows a parent to grant another individual the authority to make decisions on behalf of their child, particularly in situations where the parent cannot be present.
- Child Custody Agreement: This agreement outlines the terms of custody and visitation rights between parents or guardians, ensuring clarity on where the child will live and how often they will see each parent.
- Medical Authorization Form: This form grants a caregiver the authority to make medical decisions for a child, including consent for treatment and access to medical records.
- School Enrollment Form: This document is necessary for enrolling a child in school and may require proof of residency and guardianship.
- Emergency Contact Form: This form provides vital information about whom to contact in case of an emergency involving the child, ensuring that caregivers have the necessary support.
- Child Support Agreement: If applicable, this document outlines the financial responsibilities of each parent regarding the child's upbringing, including education and healthcare costs.
- Background Check Consent Form: This form allows for a background check on the caregiver, ensuring the child's safety by verifying the caregiver's history.
- Affidavit of Relationship: This document can be used to establish the relationship between the child and the caregiver, which may be necessary for legal or educational purposes.
- Termination of Authorization Agreement: If a parent wishes to revoke the caregiver's authority, this document formalizes the termination of the previous agreement.
These documents collectively help protect the rights and welfare of the child while ensuring that caregivers have the necessary authority to act in the child's best interest. Understanding these forms can facilitate smoother transitions in caregiving arrangements and support the child's needs effectively.
Similar forms
The Authorization Agreement for Nonparent Relative Caregiver is similar to a Power of Attorney document, particularly a Durable Power of Attorney for Minor Children. Both documents allow someone other than the parent to make important decisions regarding a child's welfare. In the case of the Power of Attorney, it grants authority to a designated individual to act on behalf of the parent in various matters, including healthcare and education. This ensures that the child’s needs are met even when the parent is unable to fulfill those responsibilities, whether due to absence or incapacity.
Another document that shares similarities is the Temporary Custody Agreement. This agreement is often used when a child needs to stay with a relative or friend for a short period. Like the Authorization Agreement for Nonparent Relative Caregiver, it allows the caregiver to make decisions on behalf of the child. However, the Temporary Custody Agreement is typically more focused on establishing a temporary living arrangement and may include specific terms regarding the duration of custody and the responsibilities of the caregiver.
The Child Care Authorization form is also comparable. This form is used by parents to grant permission for a caregiver to take care of their child, which may include authorizing medical treatment and educational decisions. While both documents empower caregivers to make decisions, the Child Care Authorization is often used for short-term arrangements, such as during a parent’s work hours, whereas the Authorization Agreement for Nonparent Relative Caregiver is designed for longer-term care situations.
Additionally, the Foster Care Placement Agreement bears similarities to the Authorization Agreement. In both cases, a child is placed in the care of someone other than their biological parents. The Foster Care Placement Agreement is often more formal and involves a state agency, focusing on the legal responsibilities and rights of the foster parent. Conversely, the Authorization Agreement is typically a private arrangement between family members or close friends, emphasizing the parent's voluntary decision to allow a relative to care for their child.
Finally, the Guardianship Agreement is another document that aligns closely with the Authorization Agreement for Nonparent Relative Caregiver. Both documents establish a legal relationship where a non-parent is granted authority over a child's care. However, a Guardianship Agreement usually involves a more permanent arrangement, often requiring court approval, while the Authorization Agreement is generally more flexible and can be revoked by the parent at any time. This distinction is crucial for understanding the level of commitment and legal standing each document provides.
Dos and Don'ts
When filling out the Agreement Nonparent Relative Caregiver form, there are several important guidelines to follow. Here is a list of what you should and shouldn't do:
- Do read the entire form carefully before starting to fill it out.
- Do provide accurate and complete information about the child and all parents involved.
- Do ensure that both parents sign the form, if applicable.
- Do keep a copy of the completed form for your records.
- Do mail a copy of the agreement to the non-signing parent within the specified timeframe.
- Don't leave any sections of the form blank unless instructed to do so.
- Don't sign the form without understanding the implications of the authorization agreement.
- Don't assume that the agreement is valid if a prior agreement is still in effect.
- Don't forget to check for any required court orders if there has been previous court involvement.
- Don't delay in mailing the agreement if both parents do not sign it.
Following these guidelines will help ensure that the process goes smoothly and that all parties involved are adequately informed and protected.
Misconceptions
Misconceptions about the Agreement Nonparent Relative Caregiver Form
- This form gives all parental rights to the caregiver. Many believe that signing this form transfers all parental rights to the relative or caregiver. In reality, it does not grant them the rights of a managing conservator or legal guardian.
- Only one parent needs to sign the form. Some think that if one parent agrees, the form is valid. However, both parents must sign unless specific conditions apply, such as one parent being deceased or having their rights terminated.
- The caregiver can make decisions without parental input. There is a misconception that caregivers can act independently. The agreement requires communication between the parent and caregiver about any changes in contact information and decisions made regarding the child.
- This form is permanent and cannot be revoked. Many assume that once the form is signed, it cannot be changed. In fact, a parent can terminate the agreement at any time and regain custody of the child.
- Mailing the agreement to the non-signing parent is optional. Some believe that mailing a copy to the non-signing parent is not necessary. However, if both parents do not sign, the law requires that a copy be sent within a specific timeframe.
Key takeaways
Filling out the Agreement Nonparent Relative Caregiver form is an important step for parents who wish to authorize a relative or caregiver to make decisions on behalf of their child. Here are some key takeaways to consider when completing and using this form:
- Understand the Purpose: This form allows a parent to grant specific rights to a nonparent relative or voluntary caregiver regarding the child's care and decision-making.
- Identify the Child: Clearly provide the child's full name and date of birth at the beginning of the form to ensure accurate identification.
- Provide Accurate Information: Include correct contact details for both parents and the caregiver. This is crucial for maintaining communication and fulfilling legal obligations.
- List Authorized Actions: The form outlines specific decisions that the caregiver is authorized to make, such as medical treatment and educational enrollment. Review these carefully.
- Legal Awareness: Be aware that this agreement does not grant the caregiver legal custody or guardianship. Parents retain their rights and can terminate the agreement at any time.
- Mailing Requirements: If both parents do not sign, a copy must be mailed to the non-signing parent within a specified timeframe. This is essential to ensure the agreement is valid.
- Exceptions to Mailing: Understand the circumstances under which mailing to the non-signing parent is not required, such as protective orders or certain criminal convictions.
- Read Warnings and Disclosures: Before signing, both parties should read the warnings and disclosures section carefully. This section outlines the implications of the agreement and the responsibilities involved.
By keeping these key points in mind, parents and caregivers can navigate the process of completing the Agreement Nonparent Relative Caregiver form with greater confidence and understanding.