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California TNESS my hand and official seal. Signature __________________________________ (Seal) -4- ntity upon behalf of which the person(s) acted, executed the instrument I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct WI within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the eonally appeared _____________________________ _______________________________________, who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to thegment State of California County of ________________________ ) ) ss ) On __________ before me, ______________________________________________________ (here insert name and title of the officer), pers Witness Signature: ___________________________________ Name: ___________________________________ City: __________________________________ State: ___________________________________ Notary AcknowledSignature of Parent Witness Signature: ___________________________________ Name: ___________________________________ City: __________________________________ State: ___________________________________e expiration date at any time by providing written notice to the Attorney-in-Fact. Signed on ________________ (date), at _______________________ (city), California. ________________________________ by operation of law, any person relying in good faith on the authority of this document, without notice of such termination, shall be held harmless. -3- I may revoke this Power of Attorney before thwledge of the revocation. I agree to indemnify the third party for any claims that arise against the third party because of reliance on this power of attorney. If this Power of Attorney is terminated partial invalidity. Any third party who receives a copy of this document may act under it. Revocation of the power of attorney is not effective as to a third party until the third party has actual knocument is held to be invalid, illegal or unenforceable under applicable law, then the remaining unaffected parts of the document shall still remain in full force and effect and not be affected by any hereby granted. The Attorney-in-Fact shall be entitled to reimbursement of all reasonable expenses incurred as a result of carrying out any provision of this Power of Attorney. If any part of this dostand the full import of this grant of powers to the Attorney-in-Fact named herein. I hereby ratify and confirm all acts by the Attorney-in-Fact done by virtue of this power of attorney and the rightshis power of attorney shall be in effect from _______________ to _______________ ("expiration date"). By signing here, I indicate that I am fully informed as to the contents of this document and understaining procedures for any child/children; (ii) have the power to consent to the marriage of any of the child/children; (iii) have the power to consent to the adoption of any of the child/children. Tuments, claims, agreements, contracts and legal documents. Notwithstanding other provisions in this Power of Attorney, Attorney-in-Fact shall not (i) have the authority to withhold or withdraw life susurance company. 6. Endorse and execute any documents necessary for the performance of the powers granted by this document, including but not limited to consent forms, releases, waivers, insurance doc. 5. Apply for, purchase, maintain and/or deal with any health and other insurance for the child/children and to make and file any medical or other type of claim against any health or other type of ink, demand, sue and take any and all legal steps necessary on behalf of the child/children and to adjust, compromise and settle any claim, the child/children may have against any other person or entityntain the customary living standard of the child/children, including, but not limited to, provisions of living quarters, food, clothing, entertainment and other customary matters. -2- 4. Request, asricular activities; review any school records of the child/children; allow the child/children to participate in activities and events offered by any group, organization or educational facility. 3. Maiormance of operations, diagnostic and other procedures. 2. Determine the education of the child/children and to register and enroll the child/children in any educational programs, schools and extracurthorities incident to the provision of medical, surgical or dental care to the child/children. Health care shall include but not be limited to the administration of anesthesia, X-ray examination, perfbe needed for such health care; review and if necessary disclose the contents of any medical records; execute any consent, release or waiver of liability required by medical, dental or other health auted to, the powers to: 1. Provide for, approve, authorize and decline any health care at any hospital or other institution; employ any physicians, dentists, nurses, or other person whose services may er and authority to act entirely in loco parentis and to do all acts necessary or desirable for maintaining the health, education, and welfare of my above named child/children, including, but not limimy true and lawful agent and attorney-in-fact for me and in my name, and in my behalf to act as the guardian of my above-named minor child/children: The above named Attorney-in-Fact shall have the pow_______ born on __________ I hereby make and appoint ________________________________________ ("Attorney-in-Fact") maintaining an address at: _____________________________________________________ as, ______________________________ born on __________ Name: _________________________________ born on __________ Name: _________________________________ born on __________ Name: __________________________ am an adult and I am the custodial parent having full legal custody of: Name: _________________________________ born on __________ Name: _________________________________ born on __________ Name: ___Y FOR THE CARE OF CHILDREN KNOW ALL PERSONS BY THESE PRESENTS: I, ___________________________________________________ ("Parent"), maintaining an address at: ________________________________________. Irney is important to you. If you do not understand the power of attorney, or any provision of it, then you should obtain the assistance of an attorney or other qualified person. -1- POWER OF ATTORNE. A power of attorney that may affect real property should be acknowledged before a notary public so that it may easily be recorded. You should read this power of attorney carefully. The power of attoor signed by two witnesses. If it is signed by two witnesses, they must witness either (1) the signing of the power of attorney or (2) the principal's signing or acknowledgment of his or her signatureginal. You have the right to revoke or terminate this power of attorney at any time, so long as you are competent. This power of attorney must be dated and must be acknowledged before a notary public otherwise terminate the power of attorney. You can amend or change this power of attorney only by executing a new power of attorney or by executing an amendment through the same formalities as an ori payment for services provided under this power of attorney unless you provide otherwise in this power of attorney. The powers you give your agent will continue until the expiration date or unless yourney, you should know these important facts: Your agent (attorney-in-fact) has no duty to act unless you and your agent agree otherwise in writing. Your agent will have the right to receive reasonableorney Warning A power of attorney is an important legal document. By signing the power of attorney, you are authorizing another person to act for you, the principal. Before you sign this power of attoation that is not state specific. Whenever appropriate, the instructions included with the forms packages offered for sale, generally include state specific instructions. -2- California Power of Attney be witnessed, it is always a very good idea to do so. Please note that this information is not intended as and is not a substitute for legal advice. Furthermore, this information is general informur state does not require it. Notarization will make it more difficult for any third party to challenge the validity of the Power of Attorney. Although, some states don't require that a Power of Attorning and an "end/expiration" date, the Parent can revoke the document at any time even before the expiration date. The Power of Attorney for the Care of Children should always be notarized, even if yoe Attorney-in-Fact. The Parent should also be careful in instructing the Attorney-in-Fact as to what the Attorney-in-Fact should do. Although the Power of Attorney for the Care of Children has a begine of document. The Parent should be very careful in the selection of the Attorney-in-Fact, as the powers granted by this document are very broad and sweeping and the children are being entrusted to throblems when, for example, arranging for medical, dental or any other type of care. Medical personnel will also generally feel more comfortable dealing with an Attorney-inFact who can provide this typhildren to the Attorneyin-fact. By having this type of document available, the Attorney-in-Fact will be able to better deal with any types of emergency involving the children and can avoid potential pwelfare decisions. This can be useful if the Parent will be absent for a period of time. The powers granted by this instrument are very broad. The Parent is basically giving temporary custody of the cyone can be appointed an Attorney-in-Fact by a power of attorney. This form allows the Attorney-in-Fact to make decisions for the children in place of the Parent, including health care, education and d/children on a temporary basis. The word "attorney" is not used here to mean "lawyer". The person acting as the Attorney-in-Fact for the Parent or the children does not need to be a lawyer. Almost ancalled the "Principal" or "Grantor") of one or more children, who has full/sole legal custody of the child/children to appoint another person to act as his or her Attorney-in-Fact to care for the chilver it becomes necessary to allow someone else to provide for the care of your children, a Power of Attorney for the Care of Children form can be used. This document allows a single parent (sometimes se of these forms, is subject to the Disclaimers and Terms of Use found at findlegalforms.com -1- Information Power of Attorney for the Care of Children (Single Parent / One Custodial Parent) Whenese forms are not intended and are not a substitute for legal advice. These forms should only be a starting point for you and should not be used without consulting an attorney first. The purchase and uul giving instructions to the Attorney-in-Fact. The Parent should also be very careful in the selection of the Attorney-in-Fact, as the powers granted by this document are very broad and sweeping. Thee power of attorney or (2) the Parent's signing or acknowledgment of his or her signature. The Agent, the Agent's spouse or children, and the Notary should not be witnesses. The Parent should be caref In California, the power of attorney must be dated and must be acknowledged before a notary public or signed by two witnesses. If two witnesses sign it, they must witness either (1) the signing of th of Attorney for the Care of Children document should be given to the Attorney-in-Fact. The Parent should keep a copy of the Power of Attorney for the Care of Children document for his or her records.with full/sole legal custody) needs to sign the Power of Attorney for the Care of Children. The Power of Attorney for the Care of Children document should be signed before a Notary. The original Powere instructions plus a checklist; and (3) additional useful information about Power of Attorney for the Care of Children - (Single Parent / One Custodial Parent). The Custodial Parent (i.e. one parent Instructions & Checklist California Power of Attorney for the Care of Children (Single Parent / One Custodial Parent) This package contains a (1) Power of Attorney for the Care of Children; (2) simpl California