Fill and Sign the Quoteither of Themquot or Quotany One of Themquot to Indicate How They Must Act as Form

POWER OF ATTORNEY: CARE AND CUSTODY OF CHILD OR CHILDREN KNOW ALL MEN BY THESE PRESENTS: That the undersigned, __________________________________________, parent(s) of the child(ren) identified below, residing at _____________________________________________ hereby make, constitute and appoint ____________________________ (if more than one attorney-in-fact is appointed, add 'Jointly," "either of them" or "any one of them" to indicate how they must act) as the true and lawful Attorney(s)-in- Fact of the undersigned, to act in name, place and stead of the undersigned, to do and execute all or any of the following acts, deeds and things with respect to the care and custody of the following child(ren): ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ (a) To participate in decisions regarding the child(ren)’s education including attending conferences with the child(ren)’s teachers or any other educational authorities, granting permission for the child(ren)’s participation in school trips and other activities, and making any other decisions and executing any documents pertinent to their education. (b) To grant permission and consent to the child(ren) participating in any activity sponsored by any group, association or organization which activity the Attorney(s)-in-Fact may deem appropriate. (c) To make health care decisions on behalf of the child(ren), including making decisions regarding the child(ren)’s medical or dental care, whether routine or emergency in nature, including admissions to hospitals or other institutions; to consent to, to refuse to consent to, or to withdraw consent to the provision of any care, tests, treatment, surgery, service or procedure to maintain, diagnose or treat a physical or mental condi
- sure condition. (d) to be responsible for the child’s education including the child’s attendance at school, and any educational decisions which the attorney(s)-in-fact inin their opinion’‒ should be made in connection with the child’s enrollment in an educational institution. (e) to supervise the child’s medical, dental, dental hygiene and other health care needs including, but not limited to his or her attendance at school, providing him or her with the prescribed medications or other treatment, and approving or denying any such health care actions by such an educational institution or other institution or person. (f) to make all decisions regarding the child’s financial and other support including, but not limited to, his or her attendance at school and the child’s financial needs, including but not limited to the amount of financial support or support withholding that the attorney’d-in-fact will pay the chilmenen) or provide and pay to any custodial person. (g) to perform all or any part of the acts and OC- curries set forth in the first paragraph in connection with the child(men). (h) to maintain a health insurance plan for the child(men), for the benefit of the child(ren), for the child/men's benefit and for the benefit of the child(men’s health(or the child’s dependents’) if the chmen(ren) does not have health insurance through a member or sponsor of insurance. In the absence of a private group health insurance plan, the attorney shall be liable for the health insurance premiums of the child(men) or their dependents and any penalties, fines or other amounts charged by the insurance company for denial, denial acceptance, reduction, cancellation or any noncompliance with a claim. If the attorney’s personal injury liability insurance policy for the child(men) and child(ren's dependents) is insufficient, they may acquire an additional policy for the child(men) with a single employer and the costs of these additional policies shall be the responsibility of the client, not the attorney. The child is in trust for the custodial person (or persons) with whom the child(men) has resided and for the benefit of the child(men) until they attain age fifteen (15). The personal representative(s) of a child under age fifteen (15) may file a written petition with the court to be appointed as.