Free California Affidavit of Caregiver’s Authorization - PDF Download

Updated on May 16, 2024

The California Caregiver’s Authorization Affidavit is a legal document that allows a caregiver to enroll a minor in school and authorize school-related medical care. This form is particularly useful for non-parental caregivers, such as grandparents, aunts, uncles, or other relatives, to provide necessary care for the minor.

Why Use This California Caregiver’s Authorization Affidavit?

This affidavit is important because it:

  • Empowers caregivers to make educational and medical decisions for the minor.
  • Provides legal documentation of the caregiver’s authority.
  • Ensures that the minor receives timely care and access to education.

How to Write This California Caregiver’s Authorization Affidavit

  1. Minor Information: Fill in the minor’s name and birth date.
  2. Caregiver Information: Provide your name, home address, date of birth, and driver’s license or identification card number.
  3. Relationship to Minor: Indicate your relationship to the minor (e.g., grandparent, aunt, uncle).
  4. Parental Notification: Check the appropriate box to indicate whether you have notified the minor’s parent(s) or if you are unable to contact them.
  5. Signature: Sign and date the affidavit, affirming the truthfulness of the information provided.

Additional Information for Caregivers

There are some additional considerations for caregivers using this affidavit:

  • “Qualified relative” includes a wide range of family members such as grandparents, aunts, uncles, siblings, and others.
  • If you are not a relative or a licensed foster parent, you may need to obtain a foster home license to care for the minor.
  • If the minor stops living with you, you must notify any relevant school or healthcare provider.
  • If you do not have a California driver’s license or ID, you may use another form of identification, such as a social security number or Medi-Cal number.

California Laws

Frequently Asked Questions

Is this affidavit legally binding?

Yes, it provides legal authority for the caregiver to make certain decisions for the minor.

Do I need a notary for this affidavit?

No, notarization is not required, but you must complete it truthfully.

How long is the affidavit valid?

It is valid for one year from the date of execution.

Can a non-relative use this affidavit?

Yes, but non-relatives may need to obtain a foster home license.

What if the parent objects after the affidavit is signed?

The parent’s rights are not affected by this affidavit; they retain legal custody of the minor.


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