South Carolina Durable Power of Attorney for Care of Children


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                             This Durable Power Of Attorney for Care of Children is used by individuals located in South
                             Carolina to appoint an Attorney-in-Fact to take care of the principal's children and to make
                             decisions regarding the children's education and health care. This form grants the
                             Attorney-in-Fact the right to participate in decisions regarding the children's education and
                             health care and to sign documents regarding such matters. The power of attorney
                             becomes effective when the document is executed and remains in effect in event of the
                             principal's incapacity. This document contains some of the standard powers typically
                             included in a power of attorney for care of children, but can be customized to fit the specific
                             needs of the principal.

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That pursuant to the South Carolina Code I, _______________________________ [Instruction: Insert the
name      of     the    principal]     (hereinafter    referred    to    as   “Principal”),    residing    at
______________________________________ [Instruction: Insert the address of principal] execute this
Durable      Power      of    Attorney     and      do    hereby      make,   constitute,   and      appoint:
___________________________________ [Instruction: Insert the name of agent] (hereinafter referred to
as “Attorney-in-Fact”), residing at __________________________ [Instruction: Insert the address of
agent], 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 child(ren), his/her/their education, including attending
          conferences with his/her/their teachers or any other educational authorities, granting permission
          for his/her/their participation in school trips and other activities, and making any other decisions
          and executing any documents pertinent to his/her/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.

       c. To grant permission and consent to my child(ren) 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 child(ren), including making decisions regarding
          his/her/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 child(ren) and to examine his/her/their medical records and to consent to the
          disclosure of such records in circumstances 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 child(ren) is/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

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           be responsible for payment for any such care or treatment consented to by my Attorney-in-Fact
           that 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____. [Year] [Instruction: Insert the expiration date]

3. Period: This Power of Attorney shall remain in full force and effect until the date stated in Paragraph 2,
   and any party dealing with my 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.

4. Disability/Incapacitation/Incompetence: This Power of Attorney will continue to be effective even if I
   become disabled, incapacitated, or incompetent.

5. 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.

6. Compensation: 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 Attorney-in-Fact named herein.

IN WITNESS WHEREOF, I hereunto set our hands and seals on                 ____ [Month] ____ [Date], 20____


Signature of principal


Signature of agent

                                       Witness signature #1 :         ________________________

                                       Name                    :      ________________________

                                       Address                 :      ________________________

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                                       Witness signature #2 :         ________________________

                                       Name                    :      ________________________

                                       Address                 :      ________________________

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State of South Carolina

County of __________________ [Instruction: Insert county]

I, the undersigned, a Notary Public, in and for said County, in said State, hereby certify that
__________________________ [Instruction: Insert name of principal], 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 this the ________ [Date] day of ________ [Month], ____ [Year].


                                                       Notary Public

                                                       My commission expires: _______________


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