North Carolina Power of Attorney for a Child Template
This North Carolina Power of Attorney for a Child (the "Agreement") is made in accordance with the North Carolina General Statutes Chapter 32A, specifically referencing Article 1 and 1A, which govern the creation and use of a power of attorney in the state. This document allows the undersigned parent or legal guardian (the "Principal") to grant certain powers regarding the care and custody of the indicated child/children to the named attorney-in-fact (the "Agent").
Principal Information:
- Full Name: ____________________________
- Address: ____________________________
- City, State, ZIP Code: ____________________________
- Phone Number: ____________________________
Agent Information:
- Full Name: ____________________________
- Address: ____________________________
- City, State, ZIP Code: ____________________________
- Phone Number: ____________________________
Child/Children Information:
- Full Name: ____________________________ Date of Birth: ____________________________
- Full Name: ____________________________ Date of Birth: ____________________________
- Full Name: ____________________________ Date of Birth: ____________________________
This Power of Attorney shall commence on the date of ____________________, 20____ and shall remain effective until ____________________, 20____, unless terminated earlier.
By this document, the Principal grants the Agent the authority to make decisions and act on behalf of the child/children in matters concerning:
- Education, including but not limited to school enrollment and participation in school activities
- Medical care, including the right to consent to any medical, dental, and mental health treatments
- Travel arrangements and permissions
- Access to government and legal documents pertinent to the child/children's wellbeing
- Any other areas the Principal deems necessary and specifies here: ____________________________
Signatures
This Power of Attorney must be signed by the Principal, acknowledged before a Notary Public, and may require witnesses as per North Carolina law.
Principal's Signature: ____________________________ Date: ____________________________
Agent's Signature: ____________________________ Date: ____________________________
State of North Carolina, County of ____________________________
Subscribed and sworn to (or affirmed) before me this ____ day of _______________, 20____, by ____________________________ (Principal) and ____________________________ (Agent).
Notary Public Signature: ____________________________
Printed Name: ____________________________
My Commission Expires: ____________________________