The Parent Acknowledgement Form is a essential legal document widely used across various institutions in Indonesia that interact with minors. It serves as a formal record of parental consent and understanding, required under Indonesian law, particularly Law No. 35 of 2014 on Child Protection and the Indonesian Civil Code. This document should be used whenever an organization needs to obtain formal parental consent for activities, services, or programs involving children. The form typically includes parent and child identification details, specific acknowledgements, consent statements, and may incorporate additional elements such as medical authorizations or media releases depending on the context. It provides legal protection for both the institution and the parents while ensuring clear communication of rights, responsibilities, and permissions.
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1. Parent/Guardian Information: Full legal name, ID number (KTP), relationship to child, contact details, and address of the parent or legal guardian
2. Child Information: Full legal name, date of birth, and any relevant identification numbers of the child
3. Institution Information: Name, address, and registration details of the institution requesting acknowledgement
4. Acknowledgement Statements: Clear, numbered list of specific items being acknowledged by the parent/guardian
5. Declaration of Understanding: Statement confirming that the parent/guardian has read, understood, and agrees to all terms
6. Signature Block: Space for parent/guardian signature, date, and witness signature if required
1. Medical Authorization: Optional section for authorizing emergency medical treatment, to be included when the form relates to activities or programs where medical emergencies might occur
2. Media Release: Optional section for obtaining permission to use child's photos/videos, to be included when the institution may need to document activities
3. Transportation Consent: Optional section for transportation permission, to be included when activities involve travel or field trips
4. Financial Responsibility: Optional section outlining financial obligations, to be included when the acknowledgement relates to programs or activities with associated costs
1. Schedule A - Program Details: Detailed description of the program, activity, or circumstances being acknowledged (if applicable)
2. Schedule B - Medical Information Form: Separate form for detailed medical information including allergies, conditions, and emergency contacts (if medical authorization is included)
3. Schedule C - Rules and Regulations: Complete list of relevant rules, policies, or guidelines being acknowledged
4. Appendix 1 - Emergency Contact List: List of emergency contacts and their relationship to the child
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