Wyoming Power of Attorney for a Child
This Power of Attorney form is designed for residents of Wyoming. It allows a parent or guardian to appoint an individual to make decisions on behalf of their child, as permitted by the Wyoming Statutes.
It’s important to fill out this document carefully and ensure that the designated person understands their responsibilities. This agreement is effective until the specified expiration date or until it is revoked by the parent or legal guardian.
Below is the template. Please fill in the blanks with the appropriate information.
Children’s Information:
- Child's Full Name: _____________________________
- Date of Birth: ________________________________
Parent/Guardian Information:
- Full Name of Parent/Guardian: _____________________________
- Address: _______________________________________________
- Phone Number: ________________________________________
- Email: _____________________________________________
Agent's Information:
- Full Name of Agent: ________________________________
- Address: _______________________________________________
- Phone Number: ________________________________________
- Email: _____________________________________________
This Power of Attorney grants the Agent the authority to:
- Make decisions regarding the child’s education.
- Access medical records and make healthcare decisions.
- Make decisions about the child’s welfare, including travel and living arrangements.
- Handle other matters related to the child as necessary.
Effective Date: This Power of Attorney will become effective on the following date: ________________________.
Expiration Date: This Power of Attorney will expire on the following date: ________________________.
By signing below, I acknowledge that I am the parent or legal guardian of the above-named child and I give my consent for the Agent to act on behalf of my child as described in this document.
Signature of Parent/Guardian: ____________________________
Date: _______________________
Notarization:
State of Wyoming, County of ________________________.
On this ____ day of ____________, 20____, before me, a notary public, personally appeared _________________, known to me to be the person whose name is subscribed to the within document.
In witness whereof, I hereunto set my hand and official seal.
Signature of Notary Public: ______________________________
My Commission Expires: _________________________________