BY MINOR TO CUSTODY RELINQUISHMENT
________________________________________, the ___________ (Son/Daughter) of
__________________________________ and _____________________________, being
________________ (__) years of age, consent to the release and relinquishment
by my parents of all rights to the custody and control over me, and all claims
and interest in and to my services and wages.
witness whereof, I have executed this instrument at __________________________ (Place of Execution) on
document was hereby signed in the presence of the following: