Name

County Attorney

Address

City, State, Zip

Telephone Number

Attorney for Plaintiff

MONTANA JUDICIAL DISTRICT COURT, COUNTY

*

FOR YOUTH UNDER THE AGE * CAUSE NO.

*

OF 12 YEARS. * JUDGE

*

(Parents & Youth Agree) * WAIVER OF RIGHT

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* * * * * * * * * * * * * * * *

I. FOR YOUTH UNDER THE AGE OF 12 YEARS

The undersigned, and , being the (parents/mother/father) of , a Youth under the age of twelve (12) years, do hereby acknowledge that we have been advised and understand our Constitutional rights and our rights under the Montana Youth Court Act.

We have discussed this and (do/do not) wish to have an attorney present and hereby (do/do not) waive such rights.

DATED this day of , 19 .

Witness Father

Witness Mother

Youth