Kentucky Minor Child Power of Attorney Form

The Kentucky minor child power of attorney form is a legal document that allows a parent or parent(s) to name a guardian to care for their child(ren) in the event of illness or extended absence. This document will provide temporary guardianship for someone else to care for the children, providing all of the care needed for the child(ren) while not risking the loss of their child(ren) until they may return the child(ren) to their home.

While completing this document, should the parent(s) require added writing space to place the information for additional children, place the information on another sheet and attach it to this document. At the completion of this document, notarization will be required. The parent(s) may revoke this document on any day and time of their choosing, by delivering written notice to the Guardian(s)

How to Write

Step 1 – Parties – Download the document and enter the following:

  • Enter the name of the parent(s) in the first line of the document
  • City of residence
  • County of residence
  • State of residence
  • Complete address

Step 2 – Consent to Medical Care for the Child(ren) –

  • Enter the name of the parent(s)
  • Enter the City of residence
  • Enter the County of residence
  • Enter the State of residence
  • Provide a complete physical address
  • AND
  • Provide the name of the appointed Guardian(s)
  • Provide the complete address of the Guardian(s)

Step 3 – Educational Consent –

  • Enter the name(s) of  the child(ren) who will require consent. If there are more children who need to be listed add them on a separate sheet
  • The parent(s) should review the remainder of the medical consent information

Step -4 – Parental Consent for the Guardian to Oversee Educational Decisions –

  • Enter the name(s) of the child(ren) for whom educational decisions should be made (add a sheet if needed)
  • Enter the name of the Guardian(s)
  • Enter the address where the child(ren) reside, temporarily, with their guardian(s)
  • Parent(s) must review the remainder of the agreement, offering permission for the Guardian(s) to care for the children in their absence

Step 5 – Signatures – Parties must sign the document before a notary public:

  • Enter the date of the signatures in dd/mm/yyyy format
  • The Parent(s) name(s) and printed name(s)
  • Provide the guardian(s) signature(s) and printed name(s)

The Notary Public will witness the signature(s) of all parties and provide the required notary information that shall acknowledge the validity of the document.