Colorado Power of Attorney for a Child
This Power of Attorney is executed in accordance with Colorado Revised Statutes, Title 15, Article 14, concerning the delegation of parental responsibilities.
This document grants authority to the designated agent to make decisions on behalf of the child named below.
Child's Information:
- Name: ____________________________
- Date of Birth: _____________________
Parent/Guardian Information:
- Name: ____________________________
Agent Information:
- Name: ____________________________
- Phone Number: ____________________
Effective Date: This Power of Attorney shall become effective on: _____________________.
Duration: This Power of Attorney shall remain in effect until: ______________________.
Scope of Authority: The Agent shall have the authority to:
- Make decisions regarding the child's education.
- Authorize medical treatment for the child.
- Make decisions regarding the child's welfare.
Signature:
By signing below, I confirm that I am the parent or legal guardian of the child named above and that I am voluntarily granting this Power of Attorney.
Parent/Guardian Signature: ___________________________
Date: ___________________________
Witnesses:
Witness 1 Name: ___________________________
Witness 1 Signature: ________________________
Date: ___________________________
Witness 2 Name: ___________________________
Witness 2 Signature: ________________________
Date: ___________________________