Rhode Island Power of Attorney for a Child
This Power of Attorney for a Child document is created in accordance with the laws of the state of Rhode Island, allowing a parent or guardian to grant temporary guardianship and decision-making powers over a minor child to another trusted adult.
Please fill in the relevant details where indicated to complete your personalized Power of Attorney for a Child.
Part 1: Parties Involved
1. Principal Parent/Guardian Information:
- Full Name: ___________________________________________
- Relationship to Child: ________________________________
- Address: _____________________________________________
- Contact Number: ______________________________________
2. Attorney-in-Fact Information:
- Full Name: ___________________________________________
- Address: _____________________________________________
- Contact Number: ______________________________________
3. Child Information:
- Full Name: ___________________________________________
- Date of Birth: ________________________________________
Part 2: Powers Granted
This Power of Attorney grants the Attorney-in-Fact the following powers over the minor child, to be activated only during the timeframe specified below:
- Make educational decisions, including but not limited to enrollment, school activities, and tutoring services.
- Authorize medical and dental care, including surgeries and psychiatric evaluations, except as limited herein.
- Make decisions regarding the child's participation in extracurricular activities, including sports and camps.
- Travel with the child within and outside of the United States.
- Access child's records related to health, education, and welfare.
Part 3: Duration
This Power of Attorney will be effective from ______ [start date] and will remain in effect until ______ [end date], unless revoked earlier by the undersigned parent or legal guardian.
Part 4: Signature
This document must be signed in the presence of a notary public or two adult witnesses who are not parties to this power of attorney.
Parent/Guardian Signature: _______________________________ Date: _______
Attorney-in-Fact Signature: _______________________________ Date: _______
Witness Signatures:
- Witness 1 Signature: _______________________________ Date: _______
- Witness 2 Signature: _______________________________ Date: _______
Notary Public (if applicable):
State of Rhode Island, County of ______________________
Sworn and subscribed before me, a Notary Public, this ______ day of ____________, 20_____.
Notary Signature: ______________________________________
(Seal)