ALTERNATE CAREGIVER ACKNOWLEDGMENT. To be completed and signed by the alternate caregiver, if you choose one)Si ou chwazi yon lòt moun k ap bay swen, oka premye moun nan pa ta disponib,, ekri non ak adrès moun nan.REKONESANS DEZYÈM MOUN K AP BAY SWEN (Pou dezyèm moun k ap bay swen an ranpli ak siyen, si ou chwazi youn) I, John Smith , am at least 18 years of age and the above child(ren) will reside with me at 1234 Center Street, Boston, MA 01234 .Mwen, , gen omwen 18 lane epiTimoun non li (yo) anwo a pral viv ak mwen . This document shall take effect when the child(ren) is/are residing with me. My attestation of the residence of the child(ren) shall be sufficient evidence of such and presentation of this signed document constitutes my attestation.Moun k ap bay swen an, oka premye moun nan pa ta disponib la, konnen dokiman sa a bay li dwa pou pran desizyon sou lekòl ak swen sante pitit ou yo, lè pitit ou yo ap viv ak li. Li pa ka deside yon bagay li konnen ou pa t ap dakò. Si ou chanje oswa ou anile akò sa a, moun k ap bay swen an ap bay toutmoun kopi.Dokiman sa a ap pran efè lè timoun nan (yo) ap viv ak mwen. Atestasyon mwen pou rezidans timoun nan dwe sifi kòm prèv rezidans li epi depi mwen prezante dokiman sa a ak siyati yo ladan sa reprezante atestasyon mwen.
