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Form 201S (Rev. 10/10) The Family Court of the State of Delaware In and For New Castle Kent Sussex County STANDBY GUARDIANSHIP AFFIDAVIT OF CONSENT OF CHILD 14 YEARS OF AGE OR OLDER Petitioner Respondent Name Name File Number Street Address Street Address P.O. Box Number P.O. Box Number Petition Number City/State/Zip Code State Zip Code City/State/Zip Code Date of BirthDate Date of Birth 2nd Petitioner (if any) 2nd Respondent (if any) Name Name Street Address Street Address P.O. Box Number P.O. Box Number City/State/Zip Code City/State/Zip Code Date of Birth Date of Birth BE IT REMEMBERED, that on this date, , (“Child”), who, being duly sworn by me according to the law personally appeared before me, a Notary Public for the State and County declared above, did depose and say: 1) I hereby agree that shall be my standby guardian(s) 2) I understand that as my standby guardian(s), shall protect, manage and care for me as a parent would and they shall make decisions regarding my care upon the occurrence of my parent(s)/ guardian(s) death, incapacity, or debilitation.SWORN TO AND SUBSCRIBEDbefore me this date, Affiant Notary Public/Clerk of Court