Florida Power of Attorney for a Child
This Power of Attorney for a Child is designed specifically for use in the state of Florida. Under Florida law, this document allows a parent or guardian (the “Principal”) to designate another individual (the “Agent”) to make decisions regarding the child’s care when the Principal is unavailable.
Principal Information:
- Name of Principal: ____________________________
- Address of Principal: ____________________________
- Phone Number of Principal: ____________________________
Child Information:
- Name of Child: ____________________________
- Date of Birth of Child: ____________________________
Agent Information:
- Name of Agent: ____________________________
- Address of Agent: ____________________________
- Phone Number of Agent: ____________________________
In accordance with Florida Statutes § 709.2101-709.2402, the Principal appoints the Agent to act on behalf of the Principal concerning the following matters:
- Medical decisions, including consent for treatment.
- Educational decisions, including enrollment in school.
- Consent for participation in extracurricular activities.
- Management of routine care and supervision.
This Power of Attorney shall become effective on __________ (date) and shall remain in effect until __________ (date) or until revoked by the Principal in writing.
By signing below, the Principal acknowledges that they have read and understood this document and are voluntarily granting the specified powers to the Agent.
Signature of Principal: ____________________________
Date: ____________________________
Signature of Agent: ____________________________
Date: ____________________________
Witnesses:
- Name: ____________________________ Signature: ____________________________ Date: ____________________________
- Name: ____________________________ Signature: ____________________________ Date: ____________________________
Notary Public:
State of Florida
County of ____________________________
Sworn to and subscribed before me on this ____ day of __________, 20__.
____________________________
Notary Public Signature
My Commission Expires: __________