I, [YOUR NAME], residing at [YOUR COMPANY ADDRESS] in the city of [YOUR CITY], state of [STATE], do declare that this is my voluntary act and deed to appoint a lawful attorney to act on behalf of my child in my absence.

I. Details of the Child

The full name of the minor child is [CHILD'S FULL NAME], born on [CHILD'S DATE OF BIRTH], residing at [CHILD'S RESIDENTIAL ADDRESS].

II. Designation of Temporary Guardian

I designate [AGENT'S NAME], residing at [AGENT'S ADDRESS], as the temporary guardian of my child during the period of this agreement.

III. Powers Granted

1. Healthcare Decisions: The Agent shall have the authority to make all healthcare decisions on behalf of the Child, including but not limited to, consenting to medical treatment, surgery, and administration of medication.

2. Educational Decisions: The Agent shall have the authority to make educational decisions for the Child, including enrolling the Child in school, signing school-related documents, and attending parent-teacher conferences.

3. Financial Decisions: The Agent shall have the authority to manage the Child's finances, including accessing bank accounts, paying bills, and making financial investments for the benefit of the Child.

4. Legal Decisions: The Agent shall have the authority to make legal decisions on behalf of the Child, including initiating legal proceedings, signing legal documents, and representing the Child in legal matters.

5. Day-to-Day Care: The Agent shall have the authority to provide day-to-day care for the Child, including ensuring the Child's safety, arranging for childcare, and making decisions regarding the Child's daily activities.

4. Effective Date and Termination

This Power of Attorney shall become effective on [EFFECTIVE DATE] and it will terminate on [TERMINATION DATE], or sooner as per my written notice.

5. Governing Law

This document shall be governed by the laws of the State of [STATE].

In witness whereof, the undersigned have executed this Power of Attorney on [Date].

[YOUR NAME][Principal]

[DATE]

[AGENT'S NAME]

[DATE]

Witness Acknowledgement

We, the undersigned witnesses, hereby acknowledge that the above-named Principal has signed this Power of Attorney in our presence on the date stated above.

[WITNESS NAME][WITNESS 1]

[DATE]

[WITNESS NAME][WITNESS 2]

[DATE]

Notary Acknowledgement

On this            day of               in the year               , before me, a Notary Public in and for said County and State, personally appeared [YOUR NAME], known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged that they executed the same for the purposes therein contained.

Witness my hand and official seal.

[NOTARY PUBLIC NAME]

[DATE]

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