Louisiana Power of Attorney for a Child
This Power of Attorney for a Child document is specifically designed to comply with the laws of the State of Louisiana, allowing a parent or guardian to grant certain powers regarding the care and decisions for their child to another trusted individual. Please ensure all blanks are filled in with the correct information.
NOTICE: The powers granted by this document include the ability to make decisions about the child's education, health care, and other aspects of welfare. This document does not grant custody. The authority granted through this document is temporary and should not be used as a substitute for legal custody processes outlined by Louisiana state laws.
State of Louisiana
Parish of _______________
1. Child's Information:
- Full Name of Child: ______________________________
- Date of Birth: ______________________________
- Child's Address: ______________________________
2. Parent/Guardian Information:
- Full Name of Parent/Guardian: ______________________________
- Address: ______________________________
- Primary Phone: ______________________________
- Alternate Phone: ______________________________
3. Attorney-in-Fact Information:
- Full Name of Attorney-in-Fact: ______________________________
- Address: ______________________________
- Relation to Child: ______________________________
- Primary Phone: ______________________________
- Alternate Phone: ______________________________
4. Powers Granted:
This Power of Attorney grants the Attorney-in-Fact the following specific powers and duties in relation to the child:
- To make decisions regarding the child's education, including but not limited to enrollment in schools, participation in extracurricular activities, and access to school records.
- To make health care decisions, including but not limited to the authority to consent to medical, dental, and mental health treatment.
- To make decisions regarding the child's participation in religious activities.
- To make decisions regarding the child's travel arrangements and logistics.
5. Term:
The effective date of this Power of Attorney is _______________, and it shall remain in effect until _______________, unless it is revoked sooner by the undersigned parent or guardian.
6. Signatures:
The Parent/Guardian and the Attorney-in-Fact must sign and date this document in the presence of a notary public.
Parent/Guardian Signature: _______________________________ Date: _______________
Attorney-in-Fact Signature: _______________________________ Date: _______________
Notarization
This document was notarized on _______________ in the Parish of _______________.
Notary Public Signature: _______________________________
My commission expires: _______________