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Durable Power of Attorney For Care of Children

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					This Durable Power Of Attorney for Care of Children is intended to provide for the
appointment of 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.
               DURABLE POWER OF ATTORNEY FOR CARE OF CHILDREN

KNOW ALL PERSONS BY THESE PRESENTS:

That pursuant to § ___________ of the ____________________ Revised Statute 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 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.
       c. To grant permission and consent to my 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____ [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: 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____ [Year]




_______________________

Signature of Principal               Witness signature #1 :        ________________________

                                     Name                   :      ________________________

                                     Address                :      ________________________




                                     Witness signature #2 :        ________________________

                                     Name                   :      ________________________

                                     Address                :      ________________________
                                    ACKNOWLEDGEMENT




State of ____________________

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].




                                       
				
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Description: This Durable Power Of Attorney for Care of Children is intended to provide for the appointment of 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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