TO WHOMSOEVER IT MAY CONCERN
Consent for International Travel Without Supervision
I, ________, of ________, declare and affirm that I am the parent/legal guardian of the following child:
-- ________, Male, born on ________ in ________, passport number ________
My child has consent to travel to ________ from ________ to ________, without an adult present and we have no objection to the same.
Special Medical Needs and/or Allergies:
My child has the following special medical needs and/or allergies:
-- ________
If there are any questions or concerns regarding this document, I may be contacted at:
________
Address: ________
Phone: ________
Email: ________
__________________________________
________
__________________
DATE
__________________________________
WITNESS
__________________
DATE
Enclosures as attached
1) Relevant passport page copy of both parents.
2) Copy of birth certificate to verify parents name.
3) ________
TO WHOMSOEVER IT MAY CONCERN
Consent for International Travel Without Supervision
I, ________, of ________, declare and affirm that I am the parent/legal guardian of the following child:
-- ________, Male, born on ________ in ________, passport number ________
My child has consent to travel to ________ from ________ to ________, without an adult present and we have no objection to the same.
Special Medical Needs and/or Allergies:
My child has the following special medical needs and/or allergies:
-- ________
If there are any questions or concerns regarding this document, I may be contacted at:
________
Address: ________
Phone: ________
Email: ________
__________________________________
________
__________________
DATE
__________________________________
WITNESS
__________________
DATE
Enclosures as attached
1) Relevant passport page copy of both parents.
2) Copy of birth certificate to verify parents name.
3) ________
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