Temporary Guardianship Agreement 

This Temporary Guardianship Agreement (“Agreement”) is entered into on [Effective Date], by and between: 

Parent(s)/Legal Guardian(s): [Full Names], residing at [Address] 

and 

Temporary Guardian: [Full Name], residing at [Address]. 

Child Information: 

• Full Name of Child: [Child’s Name] 

• Date of Birth: [DOB] 

1. Grant of Temporary Guardianship 

The Parent(s)/Legal Guardian(s) hereby voluntarily grant temporary guardianship of the above-named child to the Temporary Guardian. The Temporary Guardian is authorized to make all decisions regarding the care, medical treatment, education, and general welfare of the child. 

2. Duration 

The temporary guardianship granted under this Agreement shall commence on [Start Date] and shall terminate automatically on [End Date], unless terminated earlier by the Parent(s) in writing. 

3. Rights and Responsibilities 

The Temporary Guardian shall have the authority to: 

• Make routine decisions regarding the child’s daily care, education, and activities. 

• Authorize medical or dental care and treatment, including emergency medical decisions. 

• Enroll the child in school or extracurricular activities. 

4. Parental Rights 

This Agreement does not terminate the parental rights of the Parent(s). The Parent(s) retain full legal rights and responsibilities for the child and can terminate this guardianship by providing written notice at any time. 

5. Emergency Contact Information  

Parent’s phone: [Parent’s Phone Number] 

Guardian’s phone: [Guardian’s Phone Number] 

6. Governing Law 

This Agreement shall be governed by the laws of the State of [State]. 

Signatures 

Parent/Legal Guardian: _________________________  Date: ____________ 

Printed Name: ___________________________ 

Temporary Guardian: _________________________ Date: __________ 

Printed Name: ______________________________ 

Notary (if required): _________________________ Date: ___________ 

(Notary Seal)