Connecticut Power of Attorney for a Child Template
This Power of Attorney for a Child is created in accordance with the laws of the State of Connecticut. This document allows a parent or legal guardian to designate another individual to make decisions regarding the care and custody of their child.
Important Information: Before using this template, ensure that you understand the implications of granting power of attorney. It is advisable to consult with a legal professional if you have questions.
Principal Information:
- Full Name of Parent/Guardian: ________________________
- Address: ____________________________________________
- Phone Number: ______________________________________
- Email Address: ______________________________________
Agent Information:
- Full Name of Agent: _________________________________
- Address: ____________________________________________
- Phone Number: ______________________________________
- Email Address: ______________________________________
Child Information:
- Full Name of Child: __________________________________
- Date of Birth: ______________________________________
- Address: ____________________________________________
Duration of Power of Attorney:
This Power of Attorney shall commence on the __________ day of __________, 20____, and shall remain in effect until the __________ day of __________, 20____, unless revoked earlier in writing.
Powers Granted: The Agent shall have the authority to:
- Make decisions regarding the child's education.
- Authorize medical treatment for the child.
- Provide for the child's daily care and supervision.
- Make decisions regarding the child's extracurricular activities.
Revocation: This Power of Attorney may be revoked at any time by the Principal through a written notice delivered to the Agent.
Signatures:
By signing below, the Principal affirms that they are the parent or legal guardian of the child named above and that they understand the terms of this Power of Attorney.
______________________________
Signature of Parent/Guardian
______________________________
Date
______________________________
Signature of Agent
______________________________
Date
Witness Information:
Witness Name: ________________________________________
Witness Signature: ____________________________________
Date: _______________________________________________
This document must be notarized to be valid in the State of Connecticut.