Power Of Attorney For Minor

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Power of Attorney for Minor
Effective Date
____/____/______
I, do hereby
[Legal Name], AKA [Name]
A resident of
[City][State]
Located at
[Address]
[City], [State] [Zip Code]
Being the natural mother/ father of [Legal Name of Child]
Do Hereby Appoint [Legal Name]
A resident of
[City][State]
Located at
[Address]
[City], [State] [Zip Code]
As my true and lawful attorney-in-fact, for me and in my name, place and in my behalf, and to
do and perform all of the following responsibilities and to have all the rights in connection with
the following:
1. To perform and act as and for me in a parental capacity to the above mentioned child;
2. Give consent and permission for any kind of medical care and treatment, and to sign any
papers that are needed to have the above mentioned child admitted to a hospital for
such purpose, or as may be required to maintain the health of the above mentioned
child.
3. Give consent and permission for enrollment in and admission to school and to resolve
any problems that may arise from school attendance, and to sign any papers that are
necessary for such purpose or sign other documents relating to the child’s welfare at
school.
4. Perform any act that is necessary to obtain relief or aid that may benefit the above
mentioned child.
5. Perform any other acts for support, health, and general care of the above mentioned
child as may be required or necessary.
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