North Carolina Power of Attorney for a Child Template
This Power of Attorney is executed pursuant to North Carolina General Statutes § 32A-1 et seq. It grants authority to a designated individual to care for a minor child.
Principal Information:
- Full Name: ______________________________
- Address: ______________________________
- City: ______________________________
- State: ______________________________
- Zip Code: ______________________________
- Phone Number: ______________________________
Agent Information:
- Full Name: ______________________________
- Address: ______________________________
- City: ______________________________
- State: ______________________________
- Zip Code: ______________________________
- Phone Number: ______________________________
Child Information:
- Full Name: ______________________________
- Date of Birth: ______________________________
- Address: ______________________________
The undersigned Principal hereby appoints the above Agent as the Principal's attorney-in-fact to act on behalf of the Principal with respect to the care and custody of the minor child named above. This authority includes, but is not limited to, the following:
- Making decisions regarding education.
- Accessing medical records and consenting to medical treatment.
- Arranging for the child's care and supervision.
- Enrolling the child in applicable programs.
This Power of Attorney shall remain in effect until the child reaches the age of 18 or until revoked in writing by the Principal. The undersigned certifies that they understand the nature and effect of this document.
Principal's Signature: ______________________________
Date: ______________________________
Witness Signature: ______________________________
Date: ______________________________
Notary Public Signature: ______________________________
Date: ______________________________
My Commission Expires: ______________________________