Power of Attorney for a Child
This Power of Attorney for a Child document is created in accordance with the laws of the state of [STATE].
By this document, I, [PARENT/GUARDIAN NAME], residing at [ADDRESS], hereby appoint:
[AGENT FULL NAME] residing at [AGENT ADDRESS] as my true and lawful attorney-in-fact for my minor child:
[CHILD'S FULL NAME], born on [CHILD'S DATE OF BIRTH].
This Power of Attorney grants the Agent the authority to make decisions regarding the child’s:
- Healthcare
- Education
- Travel
- Extracurricular activities
This authority is limited to the period beginning on [START DATE] and ending on [END DATE]. In the absence of these dates, the Power of Attorney will remain in effect until revoked.
The following rights are specifically not granted to the Agent:
- Changing the child’s domicile
- Consent to adoption
In signing this document, I affirm that I have the authority to designate the Agent and that such designation is rightful and lawful under the current laws of [STATE].
For the purposes of this Power of Attorney, I confirm the following:
- This document is executed voluntarily.
- I have read and understand the contents of this Power of Attorney.
- I am of sound mind to execute this document.
Signed this [DAY] day of [MONTH], [YEAR].
__________________________
[PARENT/GUARDIAN SIGNATURE]
__________________________
[AGENT SIGNATURE]
__________________________
Witness Signature (if required):
__________________________
Print Name: