Wyoming Power of Attorney for a Child
This Power of Attorney (POA) document authorizes an appointed guardian (the "Agent") to
make decisions concerning the welfare and care of a minor child as stated under Wyoming Statutes.
It grants temporary guardianship powers and is not intended for use in permanent guardianship
situations. When using this template, it must be tailored to reflect the specifics of the
arrangement and comply with current Wyoming law.
1. Principal Information
Full Name of Parent/Legal Guardian (the "Principal"): _______________________________
Principal's Physical Address: _______________________________________________________
City: _______________________, State: Wyoming, Zip Code: _________________________
Principal's Contact Number: _____________________________________________________
2. Child Information
Full Name of Child: _____________________________________________________________
Child's Date of Birth: ____________________________________________________________
Child's Social Security Number (optional): _________________________________________
3. Agent Information
Full Name of Agent: ____________________________________________________________
Agent's Physical Address: _________________________________________________________
City: _______________________, State: Wyoming, Zip Code: __________________________
Agent's Contact Number: _________________________________________________________
4. Powers Granted
This POA authorizes the Agent to perform acts on behalf of the Principal concerning
the child’s care, including but not limited to:
- Medical care and treatment decisions
- Educational matters
- Participation in extracurricular activities
- Obtaining a passport and travel authorization
5. Term
This Power of Attorney becomes effective on ________________________ (date) and, unless
sooner revoked, shall expire automatically on ________________________ (date).
6. Signatures
Principal's Signature: ______________________________________ Date: _______________
Agent's Signature: __________________________________________ Date: _______________
Witness Signature: _________________________________________ Date: _______________
Notarization (if required)
This document was acknowledged before me on this date by ____________________________
(name of Principal), ____________________________ (name of Agent).
Notary Public Signature: ____________________________________
My commission expires: _______________________________________
This template is designed with the intent to conform to applicable laws in Wyoming regarding
the temporary delegation of parental or legal guardian powers concerning a minor child. However,
it's crucial to consult with a legal professional to ensure its compliance and appropriateness for
your specific situation.