New Jersey Minor Child Power of Attorney Form

The New Jersey minor child power of attorney form is a legal document that would be presented by parent(s) to a temporary Guardian for proper care of their child(ren) in the even the parent(s) must be ill or absent. The parent(s) must consider careful review of the document prior to completion. If the parent(s) are unclear about the meaning of any portion of the form, they may wish to consider consultation with a Family Law Attorney to ensure that both the parent(s) as well as the child(ren) will have adequate protection by the laws of the state,

This document will require two unrelated witnesses as well as the witness of a licensed state Notary Public. The parent(s) should be aware that they may revoke this document at any time by written notice and delivery or service to the assigned Agent/Guardian or by assignment of a new temporary Guardian and completion of a new document, which will immediately revoke the current document.

How to Write

Step 1 – The Parties –

The Parent(s) must provide the following information:

  • Enter the name(s) of the temporary Parent(s)/ Natural Guardians
  • Name of the county of residence
  • Name of the state of residence
  • Mailing Addres
  • City of Residence
  • AND
  • Enter the following:
  • Child(ren’s) Names
  • Age(s)
  • Respective date(s) of Birth
  • AND
  • Known Allergies as follows:
  • Name of the child
  • The known Allergies of each child (if any)

Step 2 – Delegation of Temporary Guardian(s)

  • Enter the name(s) of temporary Guardian(s)
  • Provide the Guardian(s) address, city, state

The Parent(s) must read the following (Section 3 A through E) as follows:

  • “The Attorney-in-Fact named in paragraph three (3) shall have the following powers in regard to the health, education and general welfare of the Minor Child(ren) named in paragraph one (1), to wit:”
  • To act for and on behalf of the undersigned…
  • To do and perform any and all acts necessary or required that a natural parent would perform…
  • To perform and provide discipline to said Child(ren) as if said Attorney-infact were the Natural Guardian of said Minor Child(ren)…
  • To perform and act as Natural parent in reference to any and all legal matters necessary or desirable for the custody, care and education of said Minor Child(ren)…
  • “Authorize my/our aforesaid Attorney-in-Fact to execute, acknowledge and deliver any instrument under seal or otherwise, and to do all things necessary to carry out the intent hereof, hereby granting unto said Attorney-in-Fact full power and authority to act in and concerning the premises as fully and effectually as the Natural Parent(s)”…
  • (4) “The Natural Parent(s) hereby release the Attorney-in-Fact from any and all liability and damages of any kind or character whatsoever for the performance of the duties herein provided in consideration for the Attorney-in-Fact’s acceptance of the duties specified herein”
  • (5) Enter the commencement date of the powers document in dd/mm/yyyy format through the ending date if not before in dd/mm/yyyy format
  • Principal must read and review 6,7 and 8 prior to provision of signature(s)

Step 3 – Signatures of Witnesses – to only be signed before a notary as follows:

  • Date the Witnesses Signatures in dd/yyyy format
  • Enter at least two witnesses Names and Addresses

Notarization –

  • Once the notary has witnessed the signatures of all parties in their presence, the notary shall them provide their state required information in acknowledgement of the validity of the document and it’s signatories’

Step 4  – Information Sheet – Parent(s) must complete the following and provide to the temporary Guardians for future reference while the child(ren) are in the care:

One form must be completed per child as follows:

  • Name of Parent(s)
  • Parent(s) Signature
  • Date of Document Completion in mm/dd/yyyy format
  • Home Phone
  • Work Phone
  • Other Phone Number
  • Other Emergency Contact
  • Phone
  • Family Doctor
  • Phone
  • Family Doctor
  • Phone Number
  • Insurance Company ) Check if there is no insurance
  • Insurance Policy Name and Number
  • Enter any of the Child’s Medical Conditions
  • Medications
  • Allergies
  • Last Tetanus Immunization
  • Are blood transfusions allowed check yes or no
  • Other information important to the health of the child (physical and/or mental)