CONSENT BY MINOR TO CUSTODY RELINQUISHMENT

 

I, ________________________________________, the ___________ (Son/Daughter) of __________________________________ and _____________________________, being ________________ (__) years of age, consent to the release and relinquishment by my parents of all rights to the custody and control over me, and all claims and interest in and to my services and wages.

 

In witness whereof, I have executed this instrument at __________________________ (Place of Execution) on ___________________.

 

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Signature of Minor

 

This document was hereby signed in the presence of the following:

 

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Signature                                                                               Date