Colorado Power of Attorney for a Child
This Power of Attorney for a Child document is designed to comply with the laws of the State of Colorado and grants temporary authority for the care and custody of one or more children. This document should be used by parents or guardians who wish to appoint another adult to make decisions and act in their stead regarding their child’s education, health, and welfare for a temporary period.
By executing this document, the signatory(ies) understand they are not relinquishing their parental rights but are granting temporary decision-making authority to another trusted adult.
NOTICE: This legal instrument will not be effective for longer than twelve months from the date of its execution, as per Colorado law, unless otherwise specified within the document.
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1. Parent/Guardian Information
Name: ___________________________________________________
Address: _________________________________________________
City, State, Zip: __________________________________________
Phone Number: ____________________________________________
Email: ___________________________________________________
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2. Child(ren) Information
Add the name, birthdate, and gender of each child below:
- Name: _______________________, Birthdate: _______________, Gender: ________
- Name: _______________________, Birthdate: _______________, Gender: ________
- Add additional lines as necessary.
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3. Attorney-In-Fact Information
Name: ___________________________________________________
Address: _________________________________________________
City, State, Zip: __________________________________________
Phone Number: ____________________________________________
Email: ___________________________________________________
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4. Powers Granted
Here, specify the decisions the attorney-in-fact can make on behalf of the child(ren). For example:
- Medical care and treatment decisions
- Educational matters and school enrollment
- Participation in extracurricular activities
- Travel authorization
- Other: (specify) _____________________________________
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5. Effective Dates
This Power of Attorney shall become effective on ________(Date) and, unless sooner revoked, will terminate on ________(Date), but no later than twelve (12) months from the date of executing this document.
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6. Additional Provisions
(Optional) Include any additional stipulations, restrictions, or conditions limiting or extending the powers granted to the attorney-in-fact:
_________________________________________________________
_________________________________________________________
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7. Signatures
All parties involved should provide their signatures below to indicate their agreement to the terms described within this document.
Parent/Guardian Signature: ________________________________ Date: ___________
Attorney-In-Fact Signature: ________________________________ Date: ___________
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8. Witness or Notary Acknowledgment (if required by law or desired)
Optional: Notary Public or witness signatures may be required to validate this Power of Attorney.
Witness/Notary Signature: _________________________________ Date: ___________
Print Name: ______________________________________________
My commission expires: ___________________________________