CHILD GUARDIANSHIP CONSENT FORM We, John Smith and Mary Smith of xxx, xxx, USA, hereby appoint Larry Smith of USA, xxx, USA, as the legal guardian of the person of our children, John-Boy, Jim-Bob. The guardian shall have all powers normally bestowed upon a legal guardian of the person of USA, including, among other powers, the right to allow or deny medical treatments, the right to define and arrange for child care of our children when appropriate, and the right to feed, clothe and otherwise determine our children's normal daily care. Executed this ________ day of ______________, __________, at ________________________, USA. _______________________ John Smith _______________________ Mary Smith