Durable Power of Attorney
for Care of Children
This Durable Power Of Attorney for Care Of Children is intended to provide for the
appointment of an Attorney-in-Fact for the purposes of taking care of children and making
ocstoc Legal Agreements
decisions regarding their education and medical care.
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Attorney Drafted
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DURABLE POWER OF ATTORNEY FOR CARE OF CHILDREN
KNOW ALL PERSONS BY THESE PRESENTS:
That pursuant to ___________________________ [Instruction: Insert the name of state code],
I, _______________________________ [Instruction: Insert the name of the principal]
residing at ______________________________________ [Instruction: Insert the address of
principal],(hereinafter referred to as “Principal”), execute this Durable Power of Attorney and
do hereby make, constitute and appoint: ___________________________________
[Instruction: Insert the name of agent], __________________________ [Instruction: Insert
the address of agent], (hereinafter referred to as "Attorney-in-Fact"), as my Attorney-in-Fact
TO ACT IN MY NAME, PLACE AND STEAD in any lawful way with respect to the care and
custody of my child (ren): [Instruction: Insert the name of child(ren)]
a. _______________________________
b. _______________________________
c. _______________________________
d. _______________________________
1. Effectiveness of Power of Attorney: This instrument is to be construed and interpreted as a
General Durable Power of Attorney for the following purposes:
a. To participate in decisions regarding my children, their education including attending
conferences with their teachers or any other educational authorities, granting permission
for their participation in school trips and other activities, and making any other decisions
and executing any documents pertinent to their education.
b. To endorse and execute any document necessary for the performance of the powers
granted by this document, including, but not limited to, consent forms, releases, waivers,
insurance documents, claims, agreements, contracts and legal documents.
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c. To grant permission and consent to our children participating in any activity sponsored
by any group, association or organization which activity my Attorney-in-Fact may deem
appropriate.
d. To make health care decisions on behalf of my children, including making decisions
regarding their medical or dental care, whether routine or emergency in nature, including
admissions to hospitals or other institutions; to consent to, to refuse to consent to, or to
withdraw consent to the provision of any care, tests, treatment, surgery, service or
procedure to maintain, diagnose or treat a physical or mental condition, as well as the
right to sign such medical forms as may be necessary to carry out such decisions; to talk
with health care personnel who may be treating my children and to examine their
medical records and to consent to the disclosure of such records in circumstances the
Attorney-in-Fact may deem appropriate; to file claims for medical insurance and to
obtain information from any insurance company with respect to any policy of health or
medical insurance under which my children are insured; provided however, that my
Attorney-in-Fact shall not be required to execute any documents which would involve
incurring any personal liability for any such treatment and care, and I affirm that I will
be responsible for payment for any such care or treatment consented to by my Attorney-
in-Fact which is not covered by insurance.
e. Request, ask, demand, sue and take any or all legal steps necessary on behalf of my
child (ren)
2. Effective Date: This Power of Attorney shall become effective when I sign and execute it
below. Unless sooner revoked or terminated by me, this Power of Attorney shall become null
and void on this ____ [Month] ____ [Date], 20____ [Instruction: Insert the expiration date]
3. Period: This Power of Attorney shall remain in full force and effect until the date stated in
Paragraph 0above, and any party dealing with our Attorney-in-Fact during such time shall be
fully protected and is hereby discharged, released and indemnified from so doing in respect of
any matter relating hereto unless such particular party shall have received prior notice in writing
of the revocation of this Power of Attorney.
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1. Disability/Incapacitation/Incompetence: This Power of Attorney will continue to be
effective even if I become disabled, incapacitated, or incompetent.
2. Severability: If any part of this document is held to be invalid, illegal or unenforceable under
applicable laws, then the remaining parts of the document shall still remain in full force and
effect and not be affected by any partial invalidity.
3. Compensation: The Attorney –in-Fact shall be entitled to reimbursement of all reasonable
expenses incurred as a result of carrying out any provision of this Power of Attorney.
By signing here, I indicate that I am fully informed as to the content of this document and
understand the full import of this grant of power to the Attorney-in-Fact named herein.
IN WITNESS WHEREOF, I hereunto set our hands and seals on ____ [Month] ____ [Date],
20____
_______________________
Signature of principal
Witness signature #1 : ________________________
Name : ________________________
Address : ________________________
Witness signature #2 : ________________________
Name : ________________________
Address : ________________________
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ACKNOWLEDGEMENT
STATE OF NEW MEXICO
COUNTY OF ______________________
I, the undersigned, a Notary Public, in and for said County, in said State, hereby certify that
__________________________ whose name is signed to the foregoing Power of Attorney and
who is known to me, acknowledged before me on this day, that, being fully informed of the
contents of the foregoing instrument, he executed the same voluntarily on the day the same bears
date.
Given under my hand and official seal on this _____ day of___________, 20 _____.
____________________________________
Notary Public
My commission expires: _______________
(NOTARIAL SEAL)
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Note: Carefully read and follow the Instructions and Comments contained in this document for
your customization to suit your specific circumstances and requirements. You will want to
delete the Instructions and Comments from open bracket (“[“) to close bracket (“]”) after
reading and following them. You (or your attorney) may want to make additional modifications
to meet your specific needs and the laws of your state
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information or number should be, you might want to verify this, including by consulting with your own attorney
practicing in your state, and be reasonable.
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(http://www.docstoc.com/popterm.aspx?page_id=15), as well as our disclaimer that Legal information is not
legal advice, and the important content available here: Read More
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of statutes within this document may not be
100% correct as they may be partially or wholly out of date and some relevant ones may have been omitted or
misinterpreted. You may wish to consult with your own attorney practicing in your state to confirm the
accuracy of statutory references."
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