Kansas Power of Attorney for a Child
This document is designed to grant temporary guardianship and decision-making authority over a minor child to an appointed individual. It is intended to be used in accordance with the Kansas Power of Attorney for Care and Custody of Children Act.
Please fill in the requested information where applicable:
I, ______________________ (full legal name), residing at ______________________ (address, city, county, and state), being the parent/legal guardian with legal custody of the minor child(ren), do hereby appoint ______________________ (full legal name of the appointed guardian), residing at ______________________ (address, city, county, and state), as the attorney-in-fact to act in my place for the purposes herein stated.
This Power of Attorney shall concern the following child(ren):
- Child's Name: ______________________, Date of Birth: ______________________
- Child's Name: ______________________, Date of Birth: ______________________
- Additional children's names and dates of birth may be added as necessary.
The powers granted to the attorney-in-fact shall include, but not be limited to, the authority to make decisions regarding the child(ren)'s:
- Medical care, including any medical treatment or surgery
- Educational matters, including the school to be attended
- Participation in extracurricular activities
- Travel arrangements and permissions
- Residence location
This Power of Attorney is subject to the following conditions and limitations:
- This grant of power does not affect the rights of the child(ren)'s other parent or legal guardian in matters of custody and visitation.
- This Power of Attorney is effective from ______________________ (start date) until ______________________ (end date), not to exceed twelve (12) months, as per Kansas law.
- Either party may revoke this Power of Attorney at any time by providing written notice to the other party.
In witness whereof, I have hereunto set my hand and seal this ____ day of __________________, 20__.
Parent/Legal Guardian Signature: ______________________
State of Kansas
County of ______________________
On this ____ day of __________________, 20__, before me, a Notary Public in and for said state, personally appeared ______________________ (parent/legal guardian), known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged that they executed the same for the purposes therein contained.
Witness my hand and official seal.
Notary Public Signature: ______________________
My commission expires: ______________________
Please ensure that all provided information is accurate and complete. It is recommended to consult with a legal professional for guidance and clarification of any sections within this document.
