Garfield Re-2 Policies

JF-E2

Delegation of Custodial Power by Parent or Guardian

The undersigned, being the parent or guardian of ______________________ , a minor child residing within the boundaries of ____________________________________ SCHOOL DISTRICT ___________________, pursuant to Colorado Revised Statutes, Section 15-14-105, does hereby designate and appoint , whose address is ___________________________, as his true and lawful attorney-in-fact for a period not exceeding nine months from the date hereof, and conferring upon said attorney-in-fact powers limited to the following:

Any and all power the undersigned may have regarding the care, custody, or property of said minor child or ward, except the undersigned’s power to consent to marriage or adoption of said minor child or ward, specifically including but not by way of limitation of this power the authority to make all decisions, consents, approvals, and authorizations as may be required, appropriate or convenient in connection with said minor child's education in the public schools operated by ___________________________SCHOOL DISTRICT ____.

                          Dated this _______ day of _________, 20 ___.

_________________________________________

Parent or guardian

SUBSCRIBED AND SWORN to before me this ________ day of __________, 20___, by _____________________________ .

Witness my hand and official seal.

My commission expires: _________________________________________

                                        _____________________________________

Notary public

Issued:  October 22, 2002

Reviewed: June 4, 2019

Garfield School District No. Re-2, Rifle, Colorado