Docstoc Legal Agreements
This Power Of Attorney for Care of Children is intended to provide for the appointment of an
Attorney-in-Fact to take care of the principal's children and to make decisions regarding the
children's education and health care. This form grants the Attorney-in-Fact the right to
participate in decisions regarding the children's education and health care and to sign
documents regarding such matters. This power of attorney excludes the authority to
consent to the marriage or adoption of the children. It contains some of the standard
powers typically included in a power of attorney for care of children, but can be customized
to fit the specific needs of the principal. This document should be used by individuals
located in Indiana to appoint an Attorney-in-Fact for the care of their children.
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POWER OF ATTORNEY:
CARE AND CUSTODY OF CHILD OR CHILDREN
KNOW ALL PERSONS BY THESE PRESENTS:
That pursuant to [STATUTE] I, _______________________________ [Instruction: Insert the
name of the principal] (hereinafter referred to as “Principal”), residing at
______________________________________ [Instruction: Insert the address of principal]
execute this Durable Power of Attorney and do hereby make, constitute, and appoint:
___________________________________ [Instruction: Insert the name of agent] (hereinafter
referred to as "Attorney-in-Fact"), residing at __________________________ [Instruction:
Insert the address of agent], as my Attorney-in-Fact TO ACT IN MY NAME, PLACE, AND
STEAD in any lawful way with respect to the care and custody of my child(ren): [Instruction:
Insert the name of child(ren)]
a. _______________________________
b. _______________________________
c. _______________________________
d. _______________________________
1. Effectiveness of Power of Attorney: This instrument is to be construed and interpreted as a
General Durable Power of Attorney for the following purposes:
a. To participate in decisions regarding my children, their education including attending
conferences with their teachers or any other educational authorities, granting
permission for their participation in school trips and other activities, and making any
other decisions and executing any documents pertinent to their education.
b. To endorse and execute any document necessary for the performance of the powers
granted by this document, including, but not limited to, consent forms, releases,
waivers, insurance documents, claims, agreements, contracts, and legal documents.
c. To grant permission and consent to my children participating in any activity
sponsored by any group, association, or organization which activity my Attorney-in-
Fact may deem appropriate.
d. To make health care decisions on behalf of my children, including making decisions
regarding their medical or dental care, whether routine or emergency in nature,
including admissions to hospitals or other institutions; to consent to, to refuse to
consent to, or to withdraw consent to the provision of any care, tests, treatment,
surgery, service, or procedure to maintain, diagnose, or treat a physical or mental
condition, as well as the right to sign such medical forms as may be necessary to
carry out such decisions; to talk with health care personnel who may be treating my
child(ren) and to examine their medical records and to consent to the d