Pennsylvania Power of Attorney for a Child Template
This Power of Attorney document is prepared in accordance with the laws of the Commonwealth of Pennsylvania.
This Power of Attorney for a Child allows a parent or legal guardian to designate another individual to make decisions on behalf of a child in specific situations.
Important: It is advisable to consult with a legal professional to ensure that this document meets your specific needs and complies with all applicable laws.
Principal's Information
Full Name: ___________________________________
Address: ____________________________________
City, State, ZIP: ________________________________
Phone Number: _________________________________
Child's Information
Child's Full Name: _____________________________
Birth Date: ____________________________________
Address: _____________________________________
Attorney-in-Fact's Information
Full Name: ___________________________________
Address: ____________________________________
City, State, ZIP: ________________________________
Phone Number: _________________________________
Duration of Power of Attorney
This Power of Attorney will be effective:
- From the date of signing until _______________________________ (insert date or event).
- Until revoked by the Principal in writing.
Authority Granted
The Principal grants the Attorney-in-Fact the authority to:
- Make medical decisions on behalf of the child.
- Authorize emergency medical treatment.
- Enroll the child in school or daycare.
- Make travel arrangements for the child.
- Handle any other activities required for the child’s well-being.
Signature and Acknowledgment
By signing below, the Principal acknowledges that they understand the contents of this document and the powers granted herein.
Principal's Signature: _____________________________
Date: __________________________________________
Witness #1 Signature: _____________________________
Name: __________________________________________
Date: __________________________________________
Witness #2 Signature: _____________________________
Name: __________________________________________
Date: __________________________________________
This document must be notarized to be legally binding in Pennsylvania.