Fillable Printable Guardianship of Minor Form - Colorado

Guardianship of Minor Form - Colorado

Student Support Services

Revised: 8-11-11

STATE OF COLORADO

COUNTY OF __________________________

POWER OF ATTORNEY / LIMITED GUARDIANSHIP

Pursuant to Section 15 -10-104, C.R.S., I hereby delegate to

_____________________________________________________________________________

Name(s) of Guardian(s)

_____________________________________________________________________________

Address of Guardian(s)

Whom I designate my attorney in fact for this purpose, all of my power regarding custody, well being

(and property) of my minor child, ____________________________________, which are delegable

under the Colorado Probate Code, including the power to consent to surgical procedures and medical and

dental treatment (and to receive delivery or payment of money and property due the said minor child).

In accordance with the said Section, this delegation does not include power to consent to marriage or

adoption. This delegation is made for a period not exceeding twelve months and shall terminate on

_______________________. This power of attorney shall not be affected by disability of the principal

and shall remain in effect, to the extent permitted by Section 15-14-104 of the said Code,

notwithstanding later disab ility or incapacity of the pr incipal is dead or alive. It is agreed that both

parents have a right to visit with the children.

Date: ____________________________ ___________________________________

Signature of Mother

___________________________________

Signature of Father

Accepted by:

_________________________________ ___________________________________

Signature of Guardian Address of Guardian

Subscribed and sworn to before me on ___________________________________

Date

My commission expires on: ___________________________________

Date

____________________________________ ___________________________________

Notary Public Signature Address

Guardianship of Minor Form