Affidavit Of Voluntary Relinquishment Of Parental Rights - Texas District Court Page 5
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11children for adoption. I therefore designate said agency, to wit: [name of licensed child-placing
agency] to care for the child[ren] or to place the child[ren] for adoption, and to be the managing
conservator of the child[ren].]
“I have been informed that my parental rights, powers, duties, and privileges, are as
follows:
a.
the right to have physical possession, to direct the moral and religious training, and
to establish the legal domicile of the [child[ren];
b.
the duty of care, control, protection, and reasonable discipline of the [child[ren];
c.
the duty to support the [child[ren], including providing the [child[ren] with
clothing, food, shelter, medical and dental care, and education;
d.
the duty to manage the estate of the [child[ren], except when a guardian of the
estate has been appointed, including the right to act as the [child[ren]’s agent of the [child[ren]’s
estate if the [child[ren]’s action is required by a state, the United States, or a foreign government;
e.
the right to the services and earnings of the [child[ren];
f.
the power to consent to marriage, to enlistment in the Armed Forces of the United
States, and to medical, dental, psychiatric, psychological and surgical treatment;
g.
the power to represent the [child[ren] in legal action and to make other decisions of
substantial legal significance concerning the [child[ren];
h.
the power to receive and give receipt for payments for the support of the [child[ren]
and to hold or disburse any funds for the benefit of the [child[ren];
i.
the right to inherit from and through the [child[ren];
j.
the exclusive right to make decisions concerning the [child[ren]'s education; and
k.
any other rights, privileges, duties, and powers existing between a parent
and the [child[ren] by virtue of law.
“I freely and voluntarily surrender, transfer, give and relinquish to the above-named
managing conservator all of my parental rights, powers, duties, and privileges.
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