Kentucky Power of Attorney for a Child
This Power of Attorney document is created in accordance with the laws of the Commonwealth of Kentucky. It allows a parent or legal guardian to designate another individual to make decisions regarding the care and welfare of their child.
Principal Information:
- Full Name of Parent/Guardian: ___________________________
- Address: ___________________________
- City, State, Zip Code: ___________________________
- Phone Number: ___________________________
Agent Information:
- Full Name of Agent: ___________________________
- Address: ___________________________
- City, State, Zip Code: ___________________________
- Phone Number: ___________________________
Child Information:
- Full Name of Child: ___________________________
- Date of Birth: ___________________________
Authority Granted:
The Principal grants the Agent the authority to make decisions on behalf of the child, including but not limited to:
- Medical decisions, including consent for treatment.
- Educational decisions, including enrollment in school.
- Travel arrangements and permissions.
Effective Date: This Power of Attorney shall become effective on the date signed and shall remain in effect until revoked by the Principal in writing.
Signatures:
By signing below, the Principal confirms that they are the legal parent or guardian of the child and that they understand the authority granted to the Agent.
Principal's Signature: ___________________________
Date: ___________________________
Witness Signature: ___________________________
Date: ___________________________
Notary Public:
State of Kentucky
County of ______________________
Subscribed and sworn before me this ____ day of __________, 20__.
Notary Public Signature: ___________________________
My Commission Expires: ___________________________