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Travel Consent Form

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Select whether the trip will be international or domestic. If the trip will begin domestically and then go to another country, select "International."

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Consent for International Travel Without Supervision


I, ________, of ________ declare 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.

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 the above stated address or alternatively by using the following email address and telephone number:

Telephone: ________
Email Address: ________



__________________________________
________



__________________
DATE



__________________________________
WITNESS (________)


__________________
DATE

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Consent for International Travel Without Supervision


I, ________, of ________ declare 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.

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 the above stated address or alternatively by using the following email address and telephone number:

Telephone: ________
Email Address: ________



__________________________________
________



__________________
DATE



__________________________________
WITNESS (________)


__________________
DATE