Parental/custodial Acknowledgment Form & Affidavit printable pdf download

Parental/Custodial Acknowledgment Form & Affidavit

The Runaway Warrant or Complaint issued for your child only gives Law Enforcement the legal authority to search for and

apprehend your child, not to place him/her into Marietta Youth Detention Center, (Y.D.C.). However, your child will be

required to answer to the Court for his/her actions.

When you child is located, he/she WILL NOT be taken to Y.D.C., unless he/she commits a Delinquent Offense and or the

circumstances warrant contacting the "On Call" Probation Officer for final decision on admission to Y.D.C.. This procedure

conforms to Georgia Law 15-11-19 (1), Release of minors to Parent, and the policy established by the Georgia

Department of Children and Youth Services, and Cobb County Juvenile Court. You are expected and obligated to assume

custody and control of your child immediately upon being notified. If our agency, Cobb County Sheriff's Office,

apprehends your child, we will deliver him/her to you at home or a convenient location, (Georgia Law 15-11-19 (1). If you

are not available or cannot be located, we will deliver your child to the adult you designate on this form, within Cobb

County.

If another agency, inside or outside of Cobb County, or outside of Georgia apprehends your child, you will be required to

pick him/her up immediately at that agencies designated location. In certain instances, we may transport them back to

Cobb County from within Georgia.

If you refuse to pick up your child, your child will be placed into Foster Care with Cobb County Family and Children

Services, You will be subject to arrest under Criminal Code of Georgia 16-12-1 (3). Contributing to the Deprivation of a

Minor.

Please read each item listed below, and initial each box.

A. [ ] I am the legal custodian of said child and the child is a resident of Cobb County.

B. [ ] I will assume custody and control of my child immediately, when he/she is apprehended.

C. [ ] If I am not available or cannot be reached, the following listed adults are authorized to assume custody and control

of my child.

Name____________________________________________

Phone# (______) ________________________

Address______________________________________________________ Relationship __________________

Name____________________________________________

Phone# (______) ________________________

Address______________________________________________________ Relationship __________________

[ ] I have provided the Juvenile Court with phone numbers where I can be reached at home, business, pager, cellular,

etc.. These will be held in confidence by your agency.

I fully understand the information in this form and will comply with Georgia law 15-11-19. (1). Release of Child to Parent.

I will immediately notify each of the adults i have listed, of my request for them to assume temporary custody and control

of my child if I am unavailable when he/she is apprehended. I will not hold these adults, Cobb County, or State of

Georgia, or any employee(s) of Cobb County or the State of Georgia Civilly or Criminally liable for the transfer of this

custody or assuming temporary custody and control.

____________________________________________

______ /______ / _______

Signature

Sworn to and subscribed before me this ______ day of _____________________ 20___

___________________________

Notary Public

Parental/custodial Acknowledgment Form & Affidavit