Travel Consent Form

CONSENT FORM

FOR INTERNATIONAL TRAVEL

CHILD

This consent form relates to the following Child:

(1). Name

________

(2). Gender

Male

(3). Date of birth

________

(4). Place of birth

________

(5). Passport number

passport number: ________

(6). Parents and parental responsibility

________ is the Child's mother.

________ is the Child's mother. ________ holds parental responsibility for the Child.

In order to evidence the full details of the Child's parentage and the information about the parental responsibility in relation to them, a copy of the following documentation is provided with this consent form at 'SCHEDULE 1':

________

(7). Current court orders/living arrangements

A Child Arrangements Order was made by the Family Court sitting at ________ on ________.

The order stipulates that the Child shall live with ________ and that the Child spend contact time with ________.

DETAILS OF CONSENTING PARENT

(1). Name

________

(2). Date of birth

________

(3). Relationship to the Child

Mother

(4). Address

________

(5). Contact telephone number

________

PARTICULARS OF CONSENT

I, ________ (DOB: ________), of ________ sign this consent form in respect of the above named Child. I consent to the Child travelling with ________ (DOB: ________) in accordance with the details set out below:

OUTBOUND TRAVEL

(1). Departure information

The Child will travel with ________ via flight from ________, departing on ________ at ________.

(2). Outbound flight reference

The outbound flight reference is: ________

AGREED DESTINATION

(1).Arrival details

The Child are scheduled to arrive with ________ in ________ at ________ on ________.

(2).Destination town/city

The Child will then travel with ________ to the agreed destination of: ________

(3). Address of destination

It is agreed that the the Child will stay with ________ at:

________

(4). Purpose of travel

It is agreed that the trip is for the following purpose:

________

RETURN TRAVEL

(1). Return journey

The Child are scheduled to return with ________ to ________ on ________ at ________.

(2) Inbound flight reference

The inbound flight reference is ________.

5 8222852 2552 5 2528852 ________ 8825 8228222 22 255828 8825 252 85885 82 5882555282 8825 252 5225888 528858825 58282 2282. 5 252 82 822258225 22 252 5225888 822258225 58282 82 25525 22 825822 522 582282 22 252 8228222 85885 5 5582 25288525.

Signed: _____________________

________

Dated: ______________________

RELEVANT LEGAL PROVISIONS

It is a criminal offence under section 1 of the Child Abduction Act 1984 to take a child out of the United Kingdom without the consent of everybody with parental responsibility unless the Court gives permission.

While a Child Arrangements Order is in force which names a person with whom a child is to live, that named person may remove the child for a period of less than 1 month (28 days) without the consent of every other person with parental responsibility for the child. Consent must be obtained from all those with parental responsibility where the travel extends beyond this period.

The consent provided on this form therefore satisfies the above legal requirements.

'SCHEDULE 1'

A copy of the relevant documentation which evidences the child's parentage/those with parental responsibility for the child is attached below: