Georgia Power of Attorney for a Child
This Power of Attorney (POA) for a Child document allows a parent or guardian (the "Principal") to grant certain powers regarding the care and supervision of their child/children to another individual (the "Agent"). This POA is established in accordance with the laws of the State of Georgia, specifically under the O.C.G.A. § 19-9-120 to 19-9-129, known as the "Georgia Power of Attorney for the Care of a Minor Child Act."
Principal Information
Full Name: ____________________________
Physical Address: ____________________________
City, State, Zip: ____________________________
Phone Number: ____________________________
Relationship to Child: ____________________________
Agent Information
Full Name: ____________________________
Physical Address: ____________________________
City, State, Zip: ____________________________
Phone Number: ____________________________
Child Information
Name of Child/Children: ____________________________
Date(s) of Birth: ____________________________
Granted Powers
Through this document, the Principal grants the Agent the following powers relating to the care of the child/children, unless specifically restricted within this document:
- Authority to enroll the child in school and extracurricular activities.
- Power to make healthcare decisions, including the authority to consult with healthcare providers and access medical records.
- Permission to travel with the child, including the ability to make arrangements for domestic and international travel.
- Authority to manage the child’s needs regarding food, lodging, and leisure.
Special Instructions (if any):
______________________________________________________________________
______________________________________________________________________
Term
This Power of Attorney will begin on __________ and will remain in effect until __________, unless otherwise terminated by the Principal in writing or as per Georgia state laws.
Signatures
This document must be signed in the presence of a notary public or two witnesses to be legally binding, in accordance with Georgia law.
Principal’s Signature: _____________________________ Date: __________
Agent’s Signature: _____________________________ Date: __________
Witness 1 Signature: _____________________________ Date: __________
Witness 2 Signature: _____________________________ Date: __________
Notary Acknowledgement
State of Georgia
County of _______________
On this day, __________, before me, _____________________________ (name of notary), personally appeared _____________________________, known to me (or satisfactorily proven) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged that he/she/they executed the same for the purposes therein contained.
In witness whereof, I hereunto set my hand and official seal.
Notary Public’s Signature: _____________________________
Seal: