The life we live often throws unexpected challenges our way, especially when caring for our beloved children. Entrusting another with your child’s well-being is a weighty decision; having a structured format to navigate this process is invaluable.

This document allows you to legally designate another trusted adult’s right to make specific decisions for your minor child, offering peace of mind when you can’t be present.


Step 1: Your Name


It all begins with you. By inscribing your name here, you temporarily transfer your specific parental powers to someone you trust.



I, Robert Johnson



Step 2: Address


By providing your address, you not only assert your place of residency but also offer a point of contact or reference.



whose address is 123 Maple Street, Baton Rouge, LA?



Step 3: Appointee’s Name and Address 


Here, you detail the individual you’re choosing, defining the linchpin of this entire document. Their address works the same way yours does, offering location and reference.



appoint Emily Davis, whose address is 456 Pine Lane, New Orleans, LA.



Step 4: Your Child’s Name and Date of Birth


These details provide clarity about whom these decisions pertain to, eliminating ambiguity and ensuring the well-being of the right individual.



of my child ward, Rebecca Johnson, born on April 9th 2010.



Step 5: Duration


Every good thing has its duration, and this power isn’t an exception. This period ensures that your authority isn’t indefinitely in someone else’s hands and offers a foreseeable end to this arrangement.



This power of attorney shall last from January 1st, 2024, to December 31st, 2024.



Step 6: Date of Execution


A testament to the current relevance and timeliness of the document.



Dated this 15th day of December 2023.



Step 7: Parent’s Signature


Your signature is your nod of approval; it’s your word rendered in ink. It affirms everything you’ve penned down above.



Step 8: Notary Section


A notary’s involvement reinforces the authenticity of this agreement. Their presence ensures the legally binding nature of this document.


SUBSCRIBED AND SWORN TO before me this 16th day of December 2023, at Baton Rouge, Louisiana.




The Louisiana Delegation of Powers form is like a lighthouse, guiding you safely through the potentially stormy process of assigning specific responsibilities to another individual for your child.

It’s not merely about assigning tasks; it’s about trust, well-being, and future security. When life’s unpredictabilities arise, this document ensures your child’s consistent care remains a priority, even in your absence.