For anyone under the age of 18 that will be attending GPF we need a Temporary Guardianship form filled out and Notarized for us to keep.  This will allow the adult accompanying the minor to sign our liability waivers for said minor. Please feel free to copy and paste the text below where you can simply fill in the blanks and sign before a public notary.  Thanks.


 

TEMPORARY GUARDIANSHIP OF MINOR CHILD

 

I  ______________________________ FATHER AND/OR SOLE GUARDIAN 

PRINT NAME (CIRCLE ONE)

 

I  _____________________________MOTHER AND/OR SOLE GUARDIAN  

PRINT NAME (CIRCLE ONE) 

 

OF MINOR CHILD___________________________d.o.b.___/___/___ GRANT TEMPORARY GUARDIANSHIP OF SAID MINOR CHILD FOR PURPOSES OF PRACTICE, RACING AND MEDICAL TREATMENT TO __________________________________ PRINT ADULT GUARDIAN NAME 

 

  FOR THE PERIOD OF ___/____/20___  THROUGH ____/____/20____.

 

FOR PURPOSES OF PRACTICE, RACING,  OTHER ACTIVITIES AND MEDICAL TREATMENT.

 

________________________________                          ___/___/____ FATHERS SIGNATURE DATE

 

________________________________ ___/___ /____

MOTHERS SIGNATURE

 

NOTARY

SIGNED BEFORE ME ON THIS DATE OF:  ____/____/20___

NOTARY SIGNATURE_________________________________

COUNTY OF: ____________________STATE OF:___________

MY COMMISSION EXPIRES:___________________________

 

SEAL:

 

 

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