Free Kansas Power of Attorney Form for a Minor Child

A Kansas power of attorney form for a minor child is a written document in which a parent names another person to act for the child. Kansas has no general statute for this document when a parent asks a relative or friend to care for a child. Kan. Stat. Ann. § 38-2403 covers only a placement through a host family program: a parent may place a child into a program set up under that section by executing a power of attorney that delegates to a host family any of the powers regarding the care and custody of the child.[1] This guide shows which rules apply to that program and what is common practice otherwise.

Last Updated: October 2026. This guide is reviewed and updated regularly to reflect current Kansas law. If you notice an error or outdated information, please contact us.

Kansas minor child power of attorney form preview

Create a high-quality Kansas Minor Child Power of Attorney Form now!

Build Your Document

Answer a few simple questions to make your document in minutes

Save and Print

Save progress and finish on any device, download and print anytime

Sign and Use

Your valid, lawyer-approved document is ready

... or download your Kansas Minor Child Power of Attorney Form as a  PDF file

What Is a Kansas Minor Child Power of Attorney?

In a Kansas minor child power of attorney, a parent, court-appointed guardian, or court-appointed conservator names another person to act for the child. That person is called the agent or the attorney-in-fact. The terms below appear on the FormsPal template and in the rest of this guide.

  • Parent, guardian or conservator: the person who signs the form. The form asks you to initial the blank before the role that fits you.
  • Agent: the person you appoint to act for your child. The form calls the agent the attorney-in-fact.
  • Successor attorney-in-fact: the alternate agent named on page 2 who steps in if the agent cannot serve.
  • Acknowledgment: the block on page 3 where a notary records that you signed the form.

Before you start the form, gather these details so you can fill it out in one sitting.

  • Your full name and address, and whether you sign as a parent, guardian, or conservator.
  • The child's full name, date of birth, and address.
  • The names of everyone who has legal custody of the child. A host family program placement needs the consent of all of them.[1]
  • The full name and address of the agent, and the name and address of an alternate agent.
  • The powers you want to delegate, and the start and end dates for them.

Kansas Power of Attorney Requirements for a Minor Child

A parent can use a power of attorney template like this one to delegate powers over a child to another person. The rules below come from Kan. Stat. Ann. § 38-2403 and apply only to a host family program, which a child placement agency, or a Kansas charitable organization working under an agreement with one, may set up to provide temporary care of children by placing a child with a host family.[1] They cover how long the document lasts, who must agree, which powers stay with the parent, and how to end it.

  • Duration: a power of attorney under this section cannot exceed one year in duration, but it may be renewed for one additional year.[1]
  • Active duty: a serving parent on active duty service may sign one for longer than one year. Its duration cannot exceed the term of active duty service plus 30 days.[1]
  • Consent: a placement is not allowed without the consent of all individuals who have legal custody of the child.[1]
  • Powers that stay with the parent: the power to consent to marriage or adoption of the child, the performance or inducement of an abortion on or for the child, and the termination of parental rights to the child cannot be delegated.[1]
  • Form: a power of attorney for a host family placement is deemed sufficient if it is in substantial compliance with the form set forth by the judicial council.[1] The FormsPal template is a general form, not that judicial council form.
  • Revocation: a parent who signs one has the authority to revoke or withdraw it at any time.[1]
You may also see this document called a Kansas temporary guardianship form. FormsPal lists that as another name for the same template. The form includes a printed statement about parental rights over and to the minor child on page 2. Signing it does not make the agent the child's guardian. In Kansas, a person becomes a guardian for a minor only on appointment by the court.[2]

Outside a host family program, no Kansas statute sets how long this document lasts or how it must be signed. The steps in this guide for those points are common practice, not legal requirements: pick a set end date, sign before a notary, and give copies to the child's school and doctors. People often use this document when they expect to be away from their child for a while. For a broader overview of healthcare, financial, and minor child authorizations, see all Kansas POA forms.

Kansas Minor Child Power of Attorney Form Details

Document Name Kansas Minor Child Power of Attorney Form
Other Name Kansas Parental Power of Attorney
Relevant Laws Kansas Statute, Section 38-2403 (host family program placements only)
Duration The end date you write on the form. For a host family program placement: up to one year, renewable for one additional year, or for a parent on active duty service, the term of active duty service plus 30 days.[1]
Avg. Time to Fill Out 10 minutes
# of Fillable Fields 44
Available Formats Adobe PDF

What a Kansas Minor Child Power of Attorney Lets the Agent Do

You hand some of your powers over your child to the agent. In a host family program placement, Kan. Stat. Ann. § 38-2403 lets a parent delegate to the host family any of the powers regarding the care and custody of the child, except a short list of powers that stay with the parent.[1] The agent acts for you in those matters while the document is in effect.

  • With option 1 on the form, the agent receives all authority that the laws of the State of Kansas allow you to delegate, including the power to arrange for and consent to the child's care.
  • With option 2, the agent receives only the limited powers you write on the lines provided.
  • In a host family program placement, consent to marriage or adoption, an abortion, and termination of parental rights stay with you under either option.[1]

Kansas does have a statute for one medical decision: a parent may delegate in writing the authority to consent to the child's immunization to a grandparent, an adult brother or sister, an adult aunt or uncle, a stepparent, or another adult who has care and control of the child.[3] If the agent may need to consent to vaccines while you are away, it is common to name that power in writing. Keep a copy of the signed document with you when you speak to the school or doctor, so you can show who may act for your child.

Filling Out the Kansas Minor Child Power of Attorney Form

The FormsPal template runs three pages. Work through the steps below in order. Each step names the part of the form it covers and the page it is on, so you can check your entries against the printed form as you go.

The screenshots under each step show the FormsPal Kansas 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. Your details, your role and the child (page 1). Enter your name and address, then initial the blank before Parent, Court-Appointed Guardian or Court-Appointed Conservator to show your role. Add the child's name, date of birth, and address.
    Kansas minor child power of attorney: ON BEHALF OF MINOR CHILD, filled with sample entries
    Step 1: sample entries, not a real document.
  2. Second parent or guardian and the agent (page 1). If there is more than one parent, guardian or conservator, complete the additional statement the same way. Otherwise leave it blank. Then enter the agent's name and address in the line that appoints the agent.
    Kansas minor child power of attorney: Name, Currently residing at and more, filled with sample entries
    Step 2: sample entries, not a real document.
  3. Powers granted and the successor agent (page 2). Option 1 grants all authority the form describes and has nothing to fill in. For option 2, write the limited powers on the lines provided. Then enter the agent's name, the alternate agent's name, and the alternate's address in the successor paragraph.
    Kansas minor child power of attorney: Agent's name, Alternate agent’s name and more, filled with sample entries
    Step 3: sample entries, not a real document.
  4. Effective date (page 2). Enter the date the power of attorney starts and the date it continues until. The printed statement about parental rights over and to the minor child needs no entry. For a host family program placement, pick an end date that fits the duration limit in the requirements section above. Otherwise, it is common to pick a set end date rather than leave the term open.
    Kansas minor child power of attorney: EFFECTIVE DATE, filled with sample entries
    Step 4: sample entries, not a real document.
  5. Date and signatures (page 2). Enter the day, month, and year, then sign and print your name on a signature line. A second parent, guardian, or conservator signs on the other line.
    Kansas minor child power of attorney: PARENTAL RIGHTS OVER AND TO THE MINOR CHILD, filled with sample entries
    Step 5: sample entries, not a real document.
  6. Acknowledgment details for the notary (page 3). Page 3 holds the notary acknowledgment block. The county, the date, the officer's name and title, and the signer's name are filled in for it.
    Kansas minor child power of attorney: STATE OF KANSAS, filled with sample entries
    Step 6: sample entries, not a real document.
  7. Notary signature and seal (page 3). The notary signs on the Signature line and adds the seal to complete the acknowledgment.
    Kansas minor child power of attorney: Signature, filled with sample entries
    Step 7: sample entries, not a real document.

The table below uses made-up names and addresses to show how entries on pages 1 and 2 fit together. Replace every entry with your own details.

Part of the formSample entry
ParentAnna Baker, 123 Main Street, Wichita KS 67202
ChildEmma Baker, born 01/01/2015
Agent (attorney-in-fact)Ben Carter, 456 Oak Avenue, Wichita KS 67202
PowersOption 2, limited: pick up the child from school and consent to routine care
Effective and end dates06/01/2027 until 05/31/2028, which is one year
Sign the form only after every entry is complete. A form signed with blank lines can be filled in later by someone else.

How to Sign and Use the Kansas Minor Child Power of Attorney

After you complete the form, review it with the agent, sign it, and get copies to the people who need them. The steps below cover creating the document, signing it, sharing copies, and ending it later.

  1. Download or create the template. Use the Create button on this page to fill the free form online, or download the free PDF, print it, and fill it by hand.
  2. Review the finished form with the agent. For a host family program placement, check that the dates fit the duration limit.[1]
  3. Sign the form. No Kansas statute requires a notary for it, but signing before one is common practice. If you complete the acknowledgment block on page 3, sign before the notary.
  4. Give the signed original to the agent and keep a copy for yourself. Share copies with the child's school, doctor, or other healthcare provider so they know who may act for your child.
  5. Keep the original in a safe place. In a host family program placement, a parent may revoke or withdraw the power of attorney at any time.[1] Outside a program, if plans change, it is common practice to revoke it in writing and tell the agent, the school, and the doctor.
Template Preview
Create a high-quality Kansas Minor Child Power of Attorney Form now!

Frequently Asked Questions

The answers below cover duration, revocation, the powers a parent keeps, whose consent is needed, and the form to follow. Each rule below comes from Kan. Stat. Ann. § 38-2403, which covers only placements through a host family program, and the source is cited after it. Read the answers together with the requirements section above before you sign.

How long does a Kansas minor child power of attorney last?

It depends on how you use it. Outside a host family program, no Kansas statute sets a limit, and the form asks you for an end date. A power of attorney for a host family program placement under Kan. Stat. Ann. § 38-2403 cannot exceed one year in duration, but it may be renewed for one additional year. A serving parent on active duty service may sign one for longer than one year, and its duration cannot exceed the term of active duty service plus 30 days.[1]

Can a parent revoke a Kansas minor child power of attorney?

Yes. For a host family program placement, a parent who executes a power of attorney under Kan. Stat. Ann. § 38-2403 has the authority to revoke or withdraw it at any time.[1] Outside a program, it is common practice to revoke it in writing and tell the agent, the school, and the doctor.

Which powers can a parent not delegate in Kansas?

In a host family program placement, a parent cannot delegate these powers to the host family.[1]

  • Consent to marriage or adoption of the child.
  • The performance or inducement of an abortion on or for the child.
  • The termination of parental rights to the child.

Other powers regarding the care and custody of the child can be delegated to the host family. Outside a program, no Kansas statute lists the powers a parent keeps. Option 2 on the form lets you hand over only the powers you write in.

Does everyone with custody have to agree?

For a host family program placement, yes. The placement is not allowed without the consent of all individuals who have legal custody of the child.[1] Outside a program, no Kansas statute sets this rule, but the form has room for a second parent, guardian, or conservator to join and sign.

What form does a Kansas power of attorney for a child have to follow?

A power of attorney for a host family program placement is deemed sufficient if it is in substantial compliance with the form set forth by the judicial council.[1] The FormsPal template is a general form, not that judicial council form.

General information, not legal or tax advice.

Sources

  1. Kan. Stat. Ann. § 38-2403.
  2. Kan. Stat. Ann. § 59-30,128. Accessed October 16, 2026.
  3. Kan. Stat. Ann. § 38-136. Accessed October 16, 2026.
Published: Jul 5, 2024
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.