Kentucky Power of Attorney for a Child
This document serves as a Kentucky Power of Attorney for a Child, allowing a parent or guardian to designate another adult to make decisions on behalf of their child. This authority can cover various aspects of the child's welfare, including medical and educational decisions.
In accordance with Kentucky state laws, this form is designed to ensure that your child's best interests are prioritized when you are unable to make decisions for them.
Principal Information
Parent/Guardian Name: ___________________________
Address: ___________________________
City: ___________________________
State: ___________________________
Zip Code: ___________________________
Phone Number: ___________________________
Child Information
Child's Name: ___________________________
Child's Date of Birth: ___________________________
Agent Information
Agent Name: ___________________________
Address: ___________________________
City: ___________________________
State: ___________________________
Zip Code: ___________________________
Phone Number: ___________________________
Authority Granted
The undersigned grants the Agent the authority to act on behalf of the child in the following areas:
- Medical decisions
- Educational decisions
- General welfare decisions
Effective Date
This Power of Attorney shall become effective on ___________________________ and shall remain in effect until ___________________________ or until revoked in writing by the Principal.
Signatures
By signing below, the Principal affirms that they are the legal guardian of the child and that they are granting this Power of Attorney willingly.
Principal Signature: ___________________________
Date: ___________________________
Agent Signature: ___________________________
Date: ___________________________
It is advisable to have this document notarized to ensure its validity.