Power of Attorney for a Child
This document serves as a Power of Attorney for a Child, effective under the laws of [State]. It allows the designated agent to make decisions on behalf of the minor child when the parents or guardians are unavailable.
1. Parent/Guardian Information:
- Full Name: ________________
- Address: ________________
- Phone Number: ________________
- Email Address: ________________
2. Child's Information:
- Full Name: ________________
- Date of Birth: ________________
3. Agent Information:
- Full Name: ________________
- Address: ________________
- Phone Number: ________________
4. Authority Granted:
The Agent shall have the authority to:
- Make medical decisions pertaining to the child’s care.
- Enroll the child in educational programs or institutions.
- Make decisions regarding the child's extracurricular activities.
- Authorize any necessary treatments in case of an emergency.
5. Duration of Power of Attorney:
This Power of Attorney shall commence on [Start Date] and shall remain in effect until [End Date], unless revoked in writing by the parent/guardian.
6. Revocation of Power of Attorney:
The parent/guardian may revoke this Power of Attorney at any time by providing written notice to the Agent and keeping a record of the revocation.
7. Signatures:
The parties agree to the terms of this Power of Attorney.
Parent/Guardian Signature: ______________________
Date: ________________
Agent Signature: ______________________
Date: ________________