Rhode Island Power of Attorney for a Child
This document is drafted to comply with the Rhode Island General Laws, specifically the sections dealing with powers of attorney. It is designed to temporarily assign parental rights and responsibilities from the parent(s) or legal guardian(s) of the child in question to a trusted individual. This authority allows the assignee to make decisions concerning the welfare, health care, and education of the child.
Before completing and signing this document, it is essential to understand that it does not terminate the parental rights of the parent(s) or legal guardian(s) but temporarily delegates certain powers to another person.
Please fill in all required fields accurately to ensure this document meets legal standards and accurately reflects your intentions.
Parties Information
Parent(s)/Legal Guardian(s) Information:
- Full Name(s): ___________________________________________________________________________
- Address (Street, City, State, Zip Code): ___________________________________________________
- Contact Number: ________________________________________________________________________
- Relationship to Child: ___________________________________________________________________
Appointed Guardian Information:
- Full Name: ______________________________________________________________________________
- Address (Street, City, State, Zip Code): ___________________________________________________
- Contact Number: ________________________________________________________________________
- Relationship to Child: ___________________________________________________________________
Child Information
- Full Name: ______________________________________________________________________________
- Date of Birth: __________________________________________________________________________
- Place of Birth: _________________________________________________________________________
Term
The power of attorney granted by this document shall commence on _______________ and will terminate on _______________, unless sooner revoked by the undersigned parent(s) or legal guardian(s).
Powers Granted
This power of attorney shall authorize the appointed guardian to:
- Make decisions regarding the child's education, including, but not limited to, school enrollment and participation in extracurricular activities.
- Authorize medical, dental, and mental health treatments and procedures for the child, including access to the child’s medical records.
- Make decisions regarding the child's religious activities and institutions.
- Care for and make decisions concerning the child's daily needs, including food, clothing, and housing.
Signatures
This document must be signed by the parent(s) or legal guardian(s) in the presence of a notary public to be legally binding.
Parent(s)/Legal Guardian(s) Signature: _______________________________________________ Date: ________________
Appointed Guardian Signature: _______________________________________________________ Date: ________________
State of Rhode Island
County of ___________________
Subscribed and sworn before me on this ________ day of ________________, ________.
Notary Public Signature: ___________________________________________________________
My commission expires: _____________________________________________________________