Tennessee Power of Attorney for a Child Template
This Power of Attorney for a Child document is crafted in accordance with the Tennessee Code Annotated § 34-6-301 et seq., permitting a parent or guardian to grant authority to a designated agent to make decisions on behalf of their child in their absence. By completing this form, you ensure that your child's needs can be properly attended to by someone you trust during periods when you are not available to do so. Please fill in the details accurately to best reflect your intentions and ensure the well-being of your child.
NOTICE: This legal document grants temporary authority to an agent and does not relinquish parental rights. The duration of this Power of Attorney cannot exceed one year, as per Tennessee law, unless further authorized by a court of competent jurisdiction.
1. Parent/Guardian Information
Full Legal Name: ____________________________________________
Relationship to Child: ________________________________________
Primary Address: _____________________________________________
City: ___________________ State: _____ Zip Code: _______________
Contact Number: _____________________________________________
Email Address: ______________________________________________
2. Child's Information
Full Legal Name: ____________________________________________
Date of Birth: ______________________________________________
Primary Address (if different from above): _____________________
City: ___________________ State: _____ Zip Code: _______________
3. Agent's Information
Full Legal Name: ____________________________________________
Relationship to Child: ________________________________________
Primary Address: _____________________________________________
City: ___________________ State: _____ Zip Code: _______________
Contact Number: _____________________________________________
Email Address: ______________________________________________
4. Powers Granted
This Power of Attorney grants the following specific powers to the agent concerning the child:
- Authority to make medical decisions, including but not limited to, medical procedures and treatments.
- Authority to make educational decisions, including the enrollment or withdrawal of the child in a school or educational program.
- Authority to make decisions regarding extracurricular activities.
- Authority to make decisions regarding the child's travel.
- Other: ___________________________________________________
5. Term
This Power of Attorney shall commence on ___________________________ and shall remain in effect until ___________________________, not to exceed one year, unless extended by a court.
6. Signatures
All parties must sign the document in the presence of a notary public to ensure its legal validity.
_____________________________ _____________________________
Parent/Guardian Signature Date
_____________________________ _____________________________
Agent's Signature Date
State of Tennessee
County of _____________________
Subscribed and sworn to (or affirmed) before me on ____________________ (date), by ____________________________________ (name(s) of signatory(ies)).
_____________________________
Notary Public
My commission expires: ___________