Get Imm 5464

CUSTODIANSHIP DECLARATION PARENTS/GUARDIANS STUDENT Information Student s full name Citizenship Date of birth dd/mm/yyyy Sex K Male K Female Name and address of school in Canada Address where student will reside in Canada PARENTS/GUARDIANS Information Preferably from both parents/guardians Full name Parent/Guardian 1 Home address Telephone number CUSTODIAN Information Current residential address Status in Canada K Canadian citizen or K Permanent resident My/our child will reside K with the appointed custodian K in the school dormitory or K with another person please provide name and indicate relationship. I/We and names of parents/guardians the parents/guardians of the said student name of student hereby grant full custodianship to name of custodian during the student s stay in Canada while he/she is under the age of majority in the province in which he/she resides. I have made the necessary arrangements for the care and support of the said student such that the custodian should act in the place of me/us the parents. By signing this custodian agreement I/we affirm that I am/we are satisfied the above appointed custodian resides within a reasonable distance of my/our child s intended residence and school and will be able to fulfil his/her obligations as a custodian in the event of an emergency. Signature of parent/guardian 1 Sworn before me at city in the province of province/territory This day of month year Signature of notary Date Official seal of Notary Public. I/We and names of parents/guardians the parents/guardians of the said student name of student hereby grant full custodianship to name of custodian during the student s stay in Canada while he/she is under the age of majority in the province in which he/she resides. I have made the necessary arrangements for the care and support of the said student such that the custodian should act in the place of me/us the parents. I have made the necessary arrangements for the care and support of the said student such that the custodian should act in the place of me/us the parents. By signing this custodian agreement I/we affirm that I am/we are satisfied the above appointed custodian resides within a reasonable distance of my/our child s intended residence and school and will be able to fulfil his/her obligations as a custodian in the event of an emergency. By signing this custodian agreement I/we affirm that I am/we are satisfied the above appointed custodian resides within a reasonable distance of my/our child s intended residence and school and will be able to fulfil his/her obligations as a custodian in the event of an emergency. Signature of parent/guardian 1 Sworn before me at city in the province of province/territory This day of month year Signature of notary Date Official seal of Notary Public. I/We and names of parents/guardians the parents/guardians of the said student name of student hereby grant full custodianship to name of custodian during the student s stay in Canada while he/she is under the age of majority in the province in which he/she resides. I have made the necessary arrangements for the care and support of the said student such that the custodian should act in the place of me/us the parents. By signing this custodian agreement I/we affirm that I am/we are satisfied the above appointed custodian resides within a reasonable distance of my/our child s intended residence and school and will be able to fulfil his/her obligations as a custodian in the event of an emergency.