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Power Of Attorney For Minor Children
[Name], the "parent" of [Name], herewith appoints [Name] of [Address], as their attorney in fact, to act in the place and stead and with the same authority as Principal would have to do the following acts:
To act as the guardian of the person of my minor children:
including the right to act entirely in loco parentis; including the authority to approve or to decline medical treatment of any kind for the child and including the right to review medical records or school records of the child.
This power of attorney shall be in effect from to .
[Name], As Principal
This Section for Notary:
STATE OF -------)
) ss: [Date]
COUNTY OF ------)
On [Date] before me, [Name of Notary], notary, personally appeared [Name of Person(s) Involved], personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
Witness my hand and official seal.
[Name of Notary Public]
My commission expires: [date]