This Legal Guardianship Agreement is an agreement whereby the legal guardian of a
child or children grants temporary guardianship to another for a certain period of time.
The agreement grants all of the rights and powers of the legal guardian such as the
power to obtain medical services and make decisions regarding the child's general
welfare. This document contains numerous standard provisions and may be tailored to
fit the specific needs of the parties. This should be used by the legal and temporary
guardian of a minor child when appointing temporary guardianship.
LEGAL GUARDIANSHIP AGREEMENT
WHEREAS, ___________________ (the “Legal Guardian”) is the Legal Guardian of the
minor child/children namely ______________________ and __________________ (the “Minor
Children” or the “Minor Child”) born ___________________ and ____________________;
AND WHEREAS, the Legal Guardian desires to appoint _____________________ (the
“Temporary Guardian”) as the Temporary Guardian of the Minor Children/Minor Child;
AND WHEREAS, Temporary Guardian desires to accept such appointment from the
Legal Guardian for the Minor Children/Minor Child.
NOW THEREFORE, THE LEGAL GUARDIAN HEREBY DECLARES AS
(i) That the Legal Guardian is of sound mind and has not been declared incompetent
and is executing this agreement of his/her own free will; and
(ii) That the Legal Guardian has the legal custody of the Minor Children/Minor Child.
1. The Legal Guardian hereby appoints _______________________ as the Temporary
Guardian of the Minor Children/Minor Child, and such Temporary Guardian shall have
temporary custody and control over the Minor Children/Minor Child and shall be responsible for
the health care decisions and general and personal welfare of the Minor Children/Minor Child
while under this appointment. The Temporary Guardian shall have the full authorization make
any and all decisions related to the Minor Children/Minor Child’s educational or recreational
2. The Legal Guardian hereby further authorizes the Temporary Guardian to obtain any
medical or dental assistance that may be required for the Minor Children/Minor Child. In the
event the Minor Children/Minor Child is in need of any emergency treatment, I further authorize
the Temporary Guardian to obtain any and all required emergency personnel to attend, transport
and treat the Minor Children/Minor Child and to issue any consents required for any medical
procedure, including but not limited to, x-rays, medication or blood transfusion.
3. The appointment of the Temporary Guardian by the Legal Guardian shall commence on
the _____ day of _______________, 2_______ and shall end on the _____ day of
_____________, 2_____. [Instruction: The term may terminate on a specific date or upon the
occurrence of a specific event.]
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4. If a court-appointed guardian is required for the Minor Children/Minor Child, this
document shall additionally serve as a nomination of the above listed Temporary Guardian under
Probate Code Section 1502 et seq., who I believe will act in the best interest of the Minor
Children/Minor Child. If these nominations are inconsistent with any will I have executed, it is
my intention that these documents be read together if possible and otherwise that this document
control unless it has terminated prior to my death. Until such legal guardianship is established,
this Temporary Guardianship and power of attorney is intended to be of the individual of the
Minor Children/Minor Child only, not of their estate(s). It is my express intention that the Minor
Children/Minor Child not be taken into government child protective custody or foster care,
unless all other temporary guardian(s) are exhausted and even then I prefer that other relatives
assume custody of the Minor Children/Minor Child.
5. It is my intention that this document also qualify as a caregiver authorization affidavit
under Section 6550 et seq. of the California Family Code, unless I have also attached or
simultaneously executed a statutory Caregiver’s Authorization Affidavit, in which case
that/those document(s) shall instead control with regard to caregiver authorization issues and the
documents shall be read together as a harmonious whole wherever possible.
1. This Legal Guardianship Agreement shall be governed in accordance with the laws of the
State of _____________________.
DATED this ______ day of _____________________, 2_____.
Witness: LEGAL GUARDIAN
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CONSENT OF TEMPORARY GUARDIAN
I, ______________________, hereby consent to being appointed as the Temporary
Guardian for the Minor Children/Minor Child named above, hereby acknowledges and agrees to
be bound to the terms, conditions and appointment set out