"Parent/Legal Guardian Permission" - City of San Diego, California

Parent/Legal Guardian Permission is a legal document that was released by the Public Library - City of San Diego, California - a government authority operating within California. The form may be used strictly within City of San Diego.

Form Details:

  • Released on November 18, 2019;
  • The latest edition currently provided by the Public Library - City of San Diego, California;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Public Library - City of San Diego, California.

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Parent/Legal Guardian Permission
Child/Minor’s Name:* _________________________________________________________________________
Child/Minor’s Date of Birth (MM/DD/YYYY):* __________________/__________________/_________________
Parent/Legal Guardian Name:* __________________________________________________________________
Child/Minor’s Address:*
___________________________________________________________________________________________
Street #, Name, Apt/Unit/Space # City State Zip Code
Parent/Legal Guardian’s address (if different from Child/Minor’s):*
___________________________________________________________________________________________
Street #, Name, Apt/Unit/Space # City State Zip Code
Phone/Email: _______________________________________________________________________
Parent/Legal Guardian Responsibility
A minor child (registrants under 18 years of age) must have a parent or legal guardian’s signature before a card can
be issued. An identification number (drivers' license #, passport #, ID #, etc.) is required for a full borrower card.
No identification number is needed for a two item card. The Parent/Legal Guardian of a minor child accepts
responsibility for all materials borrowed on this card and for all overdue fines, fees, lost, or damaged materials.
Theft or damage of library materials may result in criminal charges being brought against the card holder.
Supervision of a minor child’s access to all books and media is the parent/legal guardian’s responsibility. The
library does not restrict access to any materials of an adult nature. A replacement fee is charged for a lost,
damaged, or stolen library card.
Parent/Legal Guardian Signature:*________________________________________________________________
Parent/Legal Guardian Identification
Type of ID (Driver’s License):__________________________________________________________________
Number on ID (A1234567):___________________________________________________________________
*Required
For Staff Use Only
New:
JVMEDIA
J_NO_ID
NON-RESJV
Address Change
Renewal
Lost Card
Rules/Fee Schedule given to patron
Revised 11/18/2019
Parent/Legal Guardian Permission
Child/Minor’s Name:* _________________________________________________________________________
Child/Minor’s Date of Birth (MM/DD/YYYY):* __________________/__________________/_________________
Parent/Legal Guardian Name:* __________________________________________________________________
Child/Minor’s Address:*
___________________________________________________________________________________________
Street #, Name, Apt/Unit/Space # City State Zip Code
Parent/Legal Guardian’s address (if different from Child/Minor’s):*
___________________________________________________________________________________________
Street #, Name, Apt/Unit/Space # City State Zip Code
Phone/Email: _______________________________________________________________________
Parent/Legal Guardian Responsibility
A minor child (registrants under 18 years of age) must have a parent or legal guardian’s signature before a card can
be issued. An identification number (drivers' license #, passport #, ID #, etc.) is required for a full borrower card.
No identification number is needed for a two item card. The Parent/Legal Guardian of a minor child accepts
responsibility for all materials borrowed on this card and for all overdue fines, fees, lost, or damaged materials.
Theft or damage of library materials may result in criminal charges being brought against the card holder.
Supervision of a minor child’s access to all books and media is the parent/legal guardian’s responsibility. The
library does not restrict access to any materials of an adult nature. A replacement fee is charged for a lost,
damaged, or stolen library card.
Parent/Legal Guardian Signature:*________________________________________________________________
Parent/Legal Guardian Identification
Type of ID (Driver’s License):__________________________________________________________________
Number on ID (A1234567):___________________________________________________________________
*Required
For Staff Use Only
New:
JVMEDIA
J_NO_ID
NON-RESJV
Address Change
Renewal
Lost Card
Rules/Fee Schedule given to patron
Revised 11/18/2019