Massachusetts Power of Attorney for a Child
This document acts as a Power of Attorney for a child, allowing a designated person to make decisions on behalf of your child. In Massachusetts, this is governed by Chapter 201B of the Massachusetts General Laws.
Please fill in the blanks below to properly complete this document. Ensure to keep a signed copy for your records.
Parties:
Parent/Guardian Name: __________________________
Address: __________________________
Phone Number: __________________________
Child's Name: __________________________
Date of Birth: __________________________
Agent's Name: __________________________
Address: __________________________
Phone Number: __________________________
Effective Date:
This Power of Attorney will become effective on __________________________.
Duration:
This Power of Attorney is valid until __________________________ or until revoked in writing by the parent/guardian.
Powers Granted:
- To make decisions regarding medical care and treatment.
- To enroll the child in school or daycare services.
- To handle routine matters concerning the child's welfare.
- To give consent for emergency medical treatment if necessary.
Signatures:
Parent/Guardian Signature: __________________________
Date: __________________________
Witness Signature: __________________________
Date: __________________________
Make sure that the document is signed in the presence of a witness. Once completed, this Power of Attorney should be treated as a legal document.