California Minor Power of Attorney Form

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A California minor power of attorney temporarily delegates a child's care. The form names a short-term guardian, lists each child, and sets when the authority starts and ends. Parents need it before a long absence, especially travel, hospital care or military deployment.

Key facts

  • The form names a short-term guardian to care for a minor child while the parent is away.
  • Each custodial parent or guardian signs and dates the form, and each short-term guardian signs a consent.
  • Where the Probate Code's power of attorney law reaches the form, it is dated, signed, and acknowledged before a notary public or signed by at least two witnesses who satisfy Section 4122 (Cal. Prob. Code § 4121).
  • Under that same law, a power of attorney can be revoked by a writing, a right its own terms cannot limit (Cal. Prob. Code § 4151).
  • A caregiver's authorization affidavit is a different form with its own rules (Cal. Fam. Code § 6550).
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What Is a California Power of Attorney for a Minor Child?

A California minor child power of attorney is a signed document in which a parent names a trusted adult to look after their child while the parent is away. The parent who signs it is the principal. The short-term guardian acts for the parent as the attorney-in-fact.

The form covers one or more children, each named with a full name and date of birth. It names one short-term guardian and, if the parent wants, a second one. Its terms also nominate the short-term guardians as guardians of the children and list the powers they receive. A nomination names the person the parent prefers as guardian; it does not by itself make that person the children's guardian.

The form is one of several California power of attorney forms. For other purposes, such as finances, see the forms by type.

When Parents Use a Temporary Power of Attorney for a Child

A temporary power of attorney for a child covers a planned absence of the parent, and the form asks for no reason. The parent picks the start and the end, so the authority lasts only as long as the absence.

Common reasons parents use one include:

  • A hospital stay for prolonged medical treatment
  • Military deployment
  • A period in jail or prison
  • Immigration issues
  • Extended travel without the children

The form also offers a start upon the deaths, incapacity or absence of all parents or guardians listed on it. A start on the parent's own incapacity works only if the form carries springing words like those of Cal. Prob. Code § 4124: "This power of attorney shall become effective upon the incapacity of the principal." The authority of an attorney-in-fact under a power of attorney ends at the death of the principal, except as to specific authority permitted by statute to be exercised after the principal's death (Cal. Prob. Code § 4152). The deaths option therefore cannot start or carry the short-term guardian's authority past a parent's death.

California Minor Child Power of Attorney Form Details

Document Name California Minor Child Power of Attorney Form
Other Name California Parental Power of Attorney
Relevant Laws Cal. Prob. Code §§ 4121, 4151 and 4152 (general power of attorney rules, where they reach the form)
Duration Set by the parent on the form
Avg. Time to Fill Out 15 minutes
# of Fillable Fields 86
Available Formats Adobe PDF

What the Short-Term Guardian Can Decide

The form grants the powers on its printed powers list to the short-term guardian. The parent removes any listed power by crossing it out and initialing it, as the form says. Every power left in place stays with the guardian until the form ends.

The child details on the form help the guardian use those powers well. Parents can attach a sheet with each child's needs, school contacts, behavior issues, food preferences and medical treatment preferences.

Medical and Dental Care Consent

Cal. Fam. Code § 6910 lets a parent or guardian authorize in writing an adult into whose care a minor has been entrusted to consent to medical care or dental care, or both, for the minor. The form's HIPAA paragraph lets the parent write limits or conditions on health information, or check None. Give the short-term guardian the child's health insurance card and the names of the child's doctors.

Travel Limits

The travel section sets where the guardian may take the children: within a mile radius, within a named city or county, to other places the parent lists, or anywhere. A parent who leaves the section blank leaves travel unrestricted.

The Foster Care Box

The foster care box sits at the end of the sentence about child protective custody or foster care in the form's terms. Read that whole sentence before you check the box, and leave it blank if the wording does not fit your family.

How to Fill Out the California Minor Child Power of Attorney Form

The California minor child form is filled in part by part, from the parent details at the top to the notary section at the end. Gather the names, addresses and dates of birth first, and fill in the form in one sitting.

The screenshots under each step show the FormsPal California Minor Child Power of Attorney template filled with sample entries in blue, so you can see where each answer goes. The names, addresses, dates and amounts are examples only.

  1. Enter the parents' or guardians' names. At the top of page 1, type the name of each custodial parent or court-appointed guardian in the two I/We lines. Use one line if only one person is signing.
    California California Minor Child Power of Attorney: DURABLE HEALTHCARE POWER OF ATTORNEY, filled with sample entries
    Step 1: sample entries, not a real document.
  2. Name the short-term guardians. Still on page 1, check whether you are parents or court-appointed guardians and enter your address. Then fill in guardian (1): name, address, telephone number(s) and relationship to you or the minors. Guardian (2) is marked optional on the form, so fill it in only if you want a second person.
    California California Minor Child Power of Attorney: Parents or, Courtappointed guardians of the and more, filled with sample entries
    Step 2: sample entries, not a real document.
  3. List each child. List each child's full name and date of birth on the Full name and DOB lines. The form says to attach additional sheets if you need more space.
    California California Minor Child Power of Attorney: Full name, Dob, filled with sample entries
    Step 3: sample entries, not a real document.
  4. Choose when it takes effect. Under "and will become effective (check one)", check one option: immediately, on a date you enter, or upon the deaths, incapacity or absence of all parents/guardians listed above. The death of the principal ends an attorney-in-fact's authority, except as to specific authority permitted by statute to be exercised after the principal's death (Cal. Prob. Code § 4152), so the deaths option does not carry the authority past a parent's death. Choose the incapacity start only if the form's terms carry springing words like those of Cal. Prob. Code § 4124, such as "This power of attorney shall become effective upon the incapacity of the principal."
    California California Minor Child Power of Attorney: and will become effective (check one), filled with sample entries
    Step 4: sample entries, not a real document.
  5. Add effective-date triggering events. If you choose the last option on the effective-date list, "the occurrence of the following triggering event(s)", write each event on the lines provided. Leave these lines blank otherwise.
    California California Minor Child Power of Attorney:  the occurrence of the following triggering event(s), filled with sample entries
    Step 5: sample entries, not a real document.
  6. Choose when it ends. At the top of page 2, under "will terminate upon the earlier to occur of", check one option for item (c): 60 days, a day, month and year you enter, or a triggering event.
    California California Minor Child Power of Attorney: required by applicable law, or (c) (check one), filled with sample entries
    Step 6: sample entries, not a real document.
  7. Add end-date triggering events. If you choose the triggering-event option for ending the appointment, write each event on the lines provided. Leave these lines blank otherwise.
    California California Minor Child Power of Attorney:  the occurrence of the following triggering event(s), filled with sample entries
    Step 7: sample entries, not a real document.
  8. Review the page 2 terms and the foster care box. Read the page 2 paragraphs, including the nomination of guardians and the powers list. The sentence about child protective custody or foster care ends with a box, so read it before you decide whether to check it. To exclude a listed power, cross it out and initial it, as the form says.
    California California Minor Child Power of Attorney: Box, filled with sample entries
    Step 8: sample entries, not a real document.
  9. Set the travel limits. On page 3, find the travel with the child(ren) lines and check one travel option if you want one: a mile radius, a city, county/parish or state, or leave travel unrestricted.
    California California Minor Child Power of Attorney: Mile, To travel with the children without limitations unless stated below and more, filled with sample entries
    Step 9: sample entries, not a real document.
  10. List travel places if you chose other. If you pick the "other" option, write the places the children may travel to and from on the lines provided.
    California California Minor Child Power of Attorney:  other (e.g., to/from the following places only), filled with sample entries
    Step 10: sample entries, not a real document.
  11. Add HIPAA limits or conditions. In the HIPAA paragraph, write any limits or conditions you want on the lines, or check None.
    California California Minor Child Power of Attorney: Instructions, Instructions none or, filled with sample entries
    Step 11: sample entries, not a real document.
  12. Sign as custodial parent or guardian. Each custodial parent or guardian signs, prints their name and adds the date signed on page 3. The same block also has an optional box for children 14 or older to sign the nomination.
    California California Minor Child Power of Attorney: CUSTODIAL PARENT(S)/GUARDIAN(S), filled with sample entries
    Step 12: sample entries, not a real document.
  13. Have the short-term guardians sign the consent. Each short-term guardian signs, prints their name and dates the Consent of Short-Term Guardians at the bottom of page 3 and the top of page 4.
    California California Minor Child Power of Attorney: Sign, Print name and more, filled with sample entries
    Step 13: sample entries, not a real document.
  14. Complete the notary acknowledgment. On page 4, the notary fills in the county, the date, their own name and the name of the person who appeared. Take the unsigned form to your notary, so you can sign with the notary present.
    California California Minor Child Power of Attorney: County of, On and more, filled with sample entries
    Step 14: sample entries, not a real document.
  15. Notary signature and seal. The Signature (Seal) line below the acknowledgment is for the notary, if you use the notary option. Where the Probate Code's power of attorney law reaches the form, it needs no notary when at least two witnesses who satisfy Section 4122 sign it instead (Cal. Prob. Code § 4121).
    California California Minor Child Power of Attorney: Signature, filled with sample entries
    Step 15: sample entries, not a real document.

How to Sign the Form

Where that law reaches the form, the form follows the general California signing formalities for a power of attorney: it is dated, signed, and either acknowledged before a notary public or signed by at least two witnesses who satisfy Section 4122 (Cal. Prob. Code § 4121). The signature comes from the principal, or from another adult who signs in the principal's name, in the principal's presence and at the principal's direction (Cal. Prob. Code § 4121).

Cal. Prob. Code § 4121 is one of the Probate Code's general power of attorney rules, and this page applies it to the form only where that law reaches the form. The form ends with a notary acknowledgment, which serves the notary option of Cal. Prob. Code § 4121. Who may sign as a witness under the other option is set by Section 4122, which Cal. Prob. Code § 4121 points to.

  1. Print the completed form and leave every signature line blank.
  2. Bring each custodial parent or guardian and each short-term guardian to the signing.
  3. Sign and date the parent block, since the date of execution is one of the requirements of Cal. Prob. Code § 4121 where that law applies.
  4. Have the notary complete the acknowledgment, or have at least two witnesses who satisfy Section 4122 sign (Cal. Prob. Code § 4121).
  5. Have each short-term guardian sign and date the Consent of Short-Term Guardians.
  6. Give each short-term guardian a signed copy and keep the original.

When the Form Starts and Ends

The form starts and ends on the dates or events the parent checks on the form. It starts immediately, on a date the parent enters, or on a triggering event, and it ends at the earlier of the end options the parent picks.

How to Revoke It

Where the Probate Code's power of attorney law reaches the form, a power of attorney can be revoked by a writing, and its own terms cannot limit that right (Cal. Prob. Code § 4151). The principal may also revoke it in accordance with the terms of the power of attorney (Cal. Prob. Code § 4151). An attorney-in-fact or third person who does not have notice of the revocation is protected from liability as provided in Chapter 5 of the Probate Code, which begins at Section 4300 (Cal. Prob. Code § 4151).

  1. Write a dated statement that revokes the form and names the children and the short-term guardians.
  2. Sign the statement.
  3. Give a copy to each short-term guardian.
  4. Give a copy to every school, doctor or dentist that holds the form.
  5. Keep a copy with the original form.

Events That End the Guardian's Authority

Where that same law reaches the form, the authority of an attorney-in-fact under a power of attorney ends on any of the events listed in Cal. Prob. Code § 4152:

  • Revocation of the attorney-in-fact's authority, as provided in Section 4153 (Cal. Prob. Code § 4152).
  • Death of the principal, except as to specific authority permitted by statute to be exercised after the principal's death (Cal. Prob. Code § 4152).
  • Extinction of the subject or fulfillment of the purpose of the power of attorney (Cal. Prob. Code § 4152).
  • Removal, resignation or death of the attorney-in-fact (Cal. Prob. Code § 4152).
  • Incapacity of the attorney-in-fact, except that a temporary incapacity suspends the authority only during the period of the incapacity (Cal. Prob. Code § 4152).
  • Dissolution or annulment of the marriage of the attorney-in-fact and principal, as provided in Section 4154 (Cal. Prob. Code § 4152).

An attorney-in-fact or third person who does not have notice of an event that ends the power of attorney is protected from liability as provided in Chapter 5 of the Probate Code (Cal. Prob. Code § 4152).

Power of Attorney vs. Caregiver's Authorization Affidavit

The minor child form differs from the caregiver's authorization affidavit, a separate form that a caregiver signs under Cal. Fam. Code § 6550(a). A parent signs the form to hand over authority, while the affidavit is a caregiver's own sworn statement.

PointMinor child formCaregiver's authorization affidavit
Who signsThe parent or guardian; each short-term guardian signs a consentThe caregiver (Cal. Fam. Code § 6550(a))
NotaryGeneral power of attorney formality, where that law reaches the form: acknowledged before a notary public or signed by at least two witnesses who satisfy Section 4122 (Cal. Prob. Code § 4121)This form is not required to be notarized (Cal. Fam. Code § 6552)
What it coversThe powers left on the form's powers list, travel and health informationSchool enrollment and school-related medical care, for a caregiver 18 years of age or older who completes items 1 to 4 (Cal. Fam. Code § 6550(a))
CustodyNo custody rule for this form in the page's sources; where the general power of attorney law reaches the form, the parent may revoke it by a writing (Cal. Prob. Code § 4151)Does not mean that the caregiver has legal custody of the minor (Cal. Fam. Code § 6552)
When it stopsWhere the general power of attorney law reaches the form: revocation by a writing (Cal. Prob. Code § 4151) or an event in Cal. Prob. Code § 4152Invalid after the school, health care provider or health care service plan receives notice that the minor no longer lives with the caregiver (Cal. Fam. Code § 6550(f))

A caregiver who is a relative and who completes items 1 to 8 of the affidavit and signs it has the same rights to authorize medical care and dental care that guardians have under Section 2353 of the Probate Code (Cal. Fam. Code § 6550(a)). A parent's contrary decision on medical or dental care supersedes the caregiver's decision, provided the parent's decision does not jeopardize the life, health or safety of the minor (Cal. Fam. Code § 6550(b)). The affidavit ends with a declaration under penalty of perjury under the laws of the State of California (Cal. Fam. Code § 6552).

Common Mistakes to Avoid with the California Minor Power of Attorney Form

The most common slips on the form are wrong names, wrong dates and blank options. Read the finished pages with the other parent or guardian and compare every name, address and date with the originals before you print the form for signing.

  • Typing a nickname instead of the full name shown on each person's ID.
  • Entering a child's date of birth from memory instead of checking the birth certificate.
  • Leaving out the school contacts and healthcare providers the short-term guardian will need.
  • Skipping the effective and end date lines, so the dates stay unclear.
  • Crossing out a power without initialing it.
  • Checking the foster care box without reading the sentence it ends.
  • Keeping only one copy, when every parent, guardian and caregiver named on the form could use one.

Frequently Asked Questions

How long does it take to fill out the form?

The details table on this page lists an average of 15 minutes and 86 fillable fields. Gather the names, addresses and dates of birth first, so you can fill in the form in one sitting.

What details should I have ready before I start?

Have these ready, so the form goes quickly:

  • The full names and addresses of the parents or guardians
  • The name, address and telephone number of each short-term guardian
  • Each child's full name and date of birth
  • The dates you want the appointment to start and end
  • Any places the children will travel to

Can I name two short-term guardians?

Yes, the form has a second guardian line, marked optional. Fill it in only if you want a second person to share the care.

Can my child sign the form?

Yes, an older child can sign the nomination of guardians. The same block also has an optional box for children 14 or older to sign the nomination.

Does the form keep working if the parent becomes incapacitated?

The answer depends on the form's wording: Cal. Prob. Code § 4124 gives the words a durable power of attorney uses, "This power of attorney shall not be affected by subsequent incapacity of the principal." Read the form's terms for words to that effect before you sign.

Who keeps the signed form?

The parent keeps the original and gives a signed copy to each short-term guardian. Give a copy to the child's school and doctors too, so they can see who may act for the child.

General information, not legal or tax advice.

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Mara Erlach
Mara Erlach
Writer & Attorney
Mara has been practicing estate planning and trust law in California since 2003, taking pride in helping clients of all backgrounds and asset profiles form a complete and customized estate plan. Her specialties are: estate planning, wills and trusts, trust and probate administration.