Whereas, ______________________ and ___________________, are the
parent and natural guardians of the following child(ren):
_______________________________________________________________

I designate _____________ of ___________, _________ to act as
guardian of the minor child(ren) stated above upon my incapacity
to so act.

Should _____________ be unable or unwilling to serve, I nominate
_____________ of _________, _________ to act as the guardian of
the minor children in the place of _____________.

Upon my disability, the designated guardian shall have the
following authority:

a) residential custody of the minor child(ren);

b) to approve medical treatment of any kind or type or to
disapprove the same within the bounds of the law;

c) to designate schooling for the minor children, and access to
any and all of their educational records;

d) to generally act in loco parentis.

In the event that I am the custodian of any property for the minor
children under the Uniform Transfer to Minor's Act, or the Uniform
Gifts to Minors Act or similar statute,  I designate the guardian
or successor guardian to act as custodian for all such custodial
property.

In the event that formal legal proceedings are commenced to
establish a guardian for the child, it is my desire that the
guardians mentioned herein have priority in appointment.

The failure to list an individual as a guardian or successor
guardian is intentional.


Dated: __________________________






________________________________________________________________
Principal(s)

STATE OF ________________
COUNTY OF _______________

Before me, the undersigned authority personally appeared the above
signatory (signatories) who acknowledged to me execution of this
durable power of attorney.




___________________________________________________________