New York Power of Attorney for a Child
This Power of Attorney for a Child document is prepared in accordance with the laws of the State of New York. It is designed to temporarily grant certain parental or guardian rights to an identified individual, for the purpose of care and decision-making on behalf of the minor child.
This document entrusts the named individual with the authority to make decisions regarding the child's education, healthcare, and general welfare, in the absence or unavailability of the child's parent(s) or legal guardian(s).
Please enter the required information in the designated blanks to complete this document effectively.
Section 1: Parent(s) or Legal Guardian(s) Information
Full Name of Parent(s) or Legal Guardian(s): __________________________
Address: __________________________
City, State, Zip: __________________________
Phone Number: __________________________
Email Address: __________________________
Section 2: Child's Information
Child's Full Name: __________________________
Date of Birth: __________________________
Address (if different from above): __________________________
City, State, Zip: __________________________
Section 3: Temporary Guardian's Information
Full Name of Temporary Guardian: __________________________
Relation to Child: __________________________
Address: __________________________
City, State, Zip: __________________________
Phone Number: __________________________
Email Address: __________________________
Section 4: Term
The term of this Power of Attorney shall commence on ________________ and shall remain in effect until ________________, unless earlier revoked in writing by the child's parent(s) or legal guardian(s).
Section 5: Powers Granted
The temporary guardian is hereby granted the following powers in relation to the care of the named child:
- Decision-making authority related to the child's education, including but not limited to enrollment in school and participation in school activities.
- Authority to make healthcare decisions, including access to medical records, consent to medical treatments, and discussions with healthcare providers.
- Permission to attend and make decisions at meetings related to the child's welfare, such as parent-teacher conferences.
- The ability to make travel arrangements and grant permission for the child to travel with the temporary guardian.
- Any other powers deemed necessary for the child's care not expressly prohibited by law.
Section 6: Signatures
This document must be signed by the child's parent(s) or legal guardian(s), the temporary guardian, and notarized to be considered valid.
Signature of Parent(s) or Legal Guardian(s): __________________________ Date: ____________
Signature of Temporary Guardian: __________________________ Date: ____________
This document was notarized in the presence of a Notary Public, State of New York, on the _____ day of _______________, 20___.
Notary Public Signature: __________________________ Date: ____________
Notary Seal: