El Monte Union High School District

Information coming soon...

Caregiver Authorization Affidavit from The Coalition for Humane Immigrant Rights (CHIRLA)

This form can be signed and kept with other important documents and is written to take effect in the event of a parent's detention. It allows a parent to designate an adult over the age of 18 as a "person in parental relation" and authorizes that person to make health and educational decisions for the child for periods of up to twelve months. It does not require going to court to complete this. It must be signed by the parents and the designated caregiver.

Powers Granted by the Caregiver Authorization Affidavit

• Review school, medical, and other records;
• Enroll the child in school;
• Excuse school absences;
• Consent to participate in school programs and/or school-sponsored activities;
• Consent to medical care related to school;
• Enroll the child in health plans;
• Consent to vaccinations;
• Consent to general medical care;
• Consent to medical procedures;
• Consent to developmental assessments; and/or
• Consent to mental health examination and/or treatment.