Indiana Power of Attorney for a Child
This Power of Attorney document is created in accordance with Indiana state laws to designate an individual as an agent to make decisions on behalf of a minor child. It is important to understand the rights and responsibilities this entails.
Principal's Information
- Name: ________________________________
- Address: ____________________________
- City, State, ZIP: ____________________
- Phone Number: ______________________
Agent's Information
- Name: ________________________________
- Address: ____________________________
- City, State, ZIP: ____________________
- Phone Number: ______________________
Child's Information
- Name: ________________________________
- Birth Date: __________________________
- Address: _____________________________
This Power of Attorney will grant the agent the authority to make decisions regarding the child’s medical treatment, educational matters, and general welfare, including but not limited to:
- Making decisions about medical care and treatment.
- Enrolling the child in school and educational activities.
- Making decisions about extracurricular activities.
- Communicating with healthcare providers and educators.
Effective Date
This Power of Attorney shall commence on the ____ day of __________, 20____, and shall remain in effect until revoked in writing by the Principal.
Signature of Principal
______________________________
Date: _________________________
Signature of Agent
______________________________
Date: _________________________
Witnessed By:
______________________________
Date: _________________________
This document should be kept in a place that is easily accessible, and copies may be provided to the Agent and relevant parties as necessary.