Illinois Power of Attorney for a Child
This document serves as a template for the Power of Attorney for a Child in accordance with the laws of the State of Illinois. This form allows a parent or legal guardian to designate another individual to handle specific responsibilities and make decisions regarding their child’s well-being.
Please fill out the information below:
Parent/Guardian Information:
Name: ____________________________
Address: ____________________________
City: ____________________________
State: ____________________________
Zip Code: ____________________________
Phone Number: ____________________________
Attorney-in-Fact Information:
Name: ____________________________
Address: ____________________________
City: ____________________________
State: ____________________________
Zip Code: ____________________________
Phone Number: ____________________________
Child Information:
Name: ____________________________
Date of Birth: ____________________________
Address (if different from above): ____________________________
Scope of Authority: The following powers are granted to the Attorney-in-Fact:
- To make educational decisions, including enrollment and participation in school activities.
- To authorize medical treatment, including routine and emergency care.
- To manage travel arrangements, including consent for travel and accommodations.
- To provide day-to-day care and supervision of the child.
This Power of Attorney is valid from the date of signing and shall remain in effect until: ____________________________ (choose one: a) Date: ____________ or b) Until revoked by the parent/guardian in writing.)
Signatures:
Parent/Guardian Signature: ____________________________
Date: ____________________________
Attorney-in-Fact Signature: ____________________________
Date: ____________________________
Witnesses:
Witness 1 Name: ____________________________
Witness 1 Signature: ____________________________
Date: ____________________________
Witness 2 Name: ____________________________
Witness 2 Signature: ____________________________
Date: ____________________________
This Power of Attorney for a Child is executed in accordance with the Illinois Power of Attorney Act (755 ILCS 45/2-1 et seq.). It is advisable for parents or guardians to consult with a legal professional when creating this document to ensure compliance with all regulations and requirements.