Common use of Custodial Statement Clause in Contracts

Custodial Statement. Are there any custodial arrangements concerning your child? If YES, please give details of any custodial arrangements or court orders (a copy of any court order is required) Person/s who cannot pick up your child: Name: Name: Name: Name:

Custodial Statement. Are there any custodial arrangements concerning your child? If YES, please give details of any custodial arrangements or court orders (a copy of any court order is required) Person/s who cannot pick up your child: Name: Name: Name: Name:

Custodial Statement. Are there any custodial arrangements concerning your child? If YES, please give details of any custodial arrangements or court orders (a copy of any court order is required) Person/s who cannot pick up your child: Name: Name: Name: Name: Name: Name:

Custodial Statement. Are there any custodial arrangements concerning your child?  Yes  No If YES, please give details of any custodial arrangements or court orders (a orders. A copy of any court order is required. Names of any person(s) Person/s who cannot pick up your child: Name: Name: Name: Name:

Custodial Statement. Are there any custodial arrangements concerning your child? If YES, please give details of any custodial arrangements or court orders (a copy of any court order is required) * Information about acceptable identity verification documents is available online at Person/s who cannot pick up your child: Name: Name: Name: Name:

Custodial Statement. Are there any custodial arrangements concerning your child? If YES, please give details of any custodial arrangements or court orders (a copy of any court order is required) Person/s who cannot pick up your child: Name: Name: Relationship to child: Relationship to child: Name: Name: Relationship to child: Relationship to child: Address: Address: Post Code: Post Code: Phone (Home): Phone (Home): Phone (Work): Phone (Work): Phone (Mobile): Phone (Mobile): Relationship to child: Relationship to child:

Custodial Statement. Are there any custodial arrangements concerning your child? If YES, please give details of any custodial arrangements or court orders (a copy of any court order is required) Any changes to this form must be signed and dated by the parent/guardian. Person/s who cannot pick up your child: Name: Name: Name: Name:

Custodial Statement. Are there any custodial arrangements concerning your child? O Yes O No If YES, please give details of any custodial arrangements or court orders (a orders. A copy of any court order is required. Names of any person(s) Person/s who cannot pick up your child: Name: Name: Name: Name:

Custodial Statement. Are there any custodial arrangements concerning your child? If YES, please give details of any custodial arrangements or court orders (a copy of any court order is required) Person/s who cannot pick up your child: Name: Name: Name: Name:: Any changes to this form must be signed and dated by the parent/guardian.

Custodial Statement. Are there any custodial arrangements concerning your child? If YES, please give details of any custodial arrangements or court orders (a copy of any court order is required) Person/s who cannot pick up your child: Name: Name: Name: Name:

Custodial Statement. Are there any custodial arrangements concerning your child? If YES, please give details of any custodial arrangements or court orders (a copy of any court order is required) Person/s who cannot pick up your child: Name: Name: Name: Name:: Mother only Father only Both parents together Other

Custodial Statement. Are there any custodial arrangements concerning your child? If YES, please give details of any custodial arrangements or court orders (a copy of any court order is required) Person/s who cannot pick up your child: Name: Name: Name: Name:: Additional Emergency Contacts (also able to pick up child):

Custodial Statement. Are there any custodial arrangements concerning your child? □ Yes □ No If YES, please give details of any custodial arrangements or court orders (a copy of any court order is required) Person/s who cannot pick up your child: Name: Name: Name: Name:)