California Power of Attorney for a Child
This Power of Attorney form is created pursuant to California statutory law allowing parents to designate someone to make decisions on behalf of their child in specific situations.
Parties Involved:
This document is made on the ____ day of ______________, 20____, between:
- Parent or Guardian Name: _______________________________
- Parent or Guardian Address: ____________________________
- City, State, Zip: _______________________________________
- Phone Number: _________________________________________
and
- Agent Name: _____________________________________________
- Agent Address: __________________________________________
- City, State, Zip: _______________________________________
- Phone Number: _________________________________________
The child for whom this Power of Attorney is created is:
- Child's Name: ___________________________________________
- Child's Date of Birth: _________________________________
Grant of Authority:
I, the undersigned Parent or Guardian, hereby appoint the above-named Agent as my true and lawful attorney-in-fact. The Agent shall have full power and authority to make decisions regarding the care, custody, and control of my child, including but not limited to:
- Medical care and treatment.
- Educational decisions and enrollment.
- Legal matters.
- Travel arrangements.
This authority is effective starting on the ____ day of ______________, 20____, and will remain in effect until revoked by me in writing or until the ____ day of ______________, 20____.
Revocation:
I understand that I may revoke this Power of Attorney at any time by providing written notice to the Agent and maintaining a copy of the revocation.
Signatures:
IN WITNESS WHEREOF, I have executed this Power of Attorney on the date first above written.
______________________________
Parent or Guardian Signature
______________________________
Agent Signature
______________________________
Witness Signature (if required)
______________________________
Date
