Virginia Power of Attorney for a Child
This document serves as a Power of Attorney for a Child, as permitted under Virginia state law. It authorizes a designated individual to make decisions on behalf of a minor child.
Principal Information:
- Full Name: ____________________________________
- Address: ____________________________________
- City, State, ZIP: _____________________________
- Phone Number: ________________________________
Child Information:
- Child's Full Name: ___________________________
- Child's Date of Birth: ________________________
- Child's Address (if different from Principal): ____________________________________________________
Agent Information:
- Full Name of Agent: __________________________
- Address: ____________________________________
- City, State, ZIP: _____________________________
- Phone Number: ________________________________
Authority Granted:
The Agent shall have the authority to act for the Principal in matters concerning the child, including but not limited to:
- Enrolling the child in school.
- Making healthcare decisions.
- Traveling with the child.
- Obtaining medical records.
This Power of Attorney will commence on the ____ day of ___________, 2023, and shall remain in effect until ____ day of ___________, 20__, unless revoked earlier by the Principal.
This document must be signed and dated in the presence of a notary public.
Principal's Signature: ________________________
Date: ______________________________________
Notary Public Signature: ___________________
Date: ______________________________________
Witness Name: ______________________________
Witness Signature: __________________________
Date: ______________________________________
By executing this document, the Principal confirms their understanding of the authority being granted to the Agent herein.