监护人声明中英文.doc

委托监护人声明-父母/监护人学生信息学生姓名XXX国籍中国出生日08/10/1993性别男在加拿大的学校名称和地址：学生在加拿大住址：希尔顿家庭住宿服务系统安排的接待家庭父母/监护人信息（最好父母两人的信息）：父母/监护人1父母/监护人2姓名全称XXXXXX生日20/11/196211/5/1968家庭住址北京市丰台区70号院4单元402室北京市丰台区70号院4单元402室电话管理人信息姓名全称：柯里斯廷W. 佛埃在加拿大状况：加拿大公民 或永久居留生日：05/09/59现住址：电话：我们的孩子将与另一人接待户家庭（请提供姓名并说明关系）我们，XXX和XXX是学生XXX的父母/监护人，在此授XXXXXXX.XXXXX全权管理上述学生在加拿大住宿的省份未达到成年之前的管理。我们已做好上述学生的各项照顾和生活安排，管理人应该代表我们父母进行处理。我们签署此声明，确认指定的管理人居住地与我们孩子将要选择的居住地以及学校之间的距离适当，能够确保管理人在紧急情况下执行管理人职责。父母/监护人（1）签字：日期：父母/监护人（2）签字：日期：于-年-月-日，在-国家-省市，在我面前，作出上述声明。公证员签字：-公证处盖章CUSTODIANSHIP DECLARATION-PARENTS/GUARDIANSSTUDENT InformationStudents full NameXXXCitizenshipChineseDate of Birth08/10/1993SexMaleFemaleName and address of school in CanadaAddress where student will reside in CanadaHost family arranged by Halton Homestay ServicePARENTS/GUARDIANS Information (Preferably from both parents/guardians)Parent/guardian 1Parent/guardian 2Full NameXXXXXXDate of birth20/11/196211/5/1968Home addressphoneCUSTODIAN InformationFull NameStatus in CanadaCanadian citizen orPermanent residentDate of birth05/09/59Crrent residential addressphoneMy/our child will reside:With appointed custodianin the school dormitoryorwith another personI/We -and -(name of the parents or guardians, the parents/guardians of the said student-(name of student), hereby grant full custodianship to -(name of custodian),during the students 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 childs 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):Date:Signature of parent/guardian (2):Date:Sworn before me at:-(city), in the province of -(pr