I ___________________________________________________provide my consent for
NAME OF PARENT
my child(ren) ____________________________________________ to travel with
NAME OF CHILD(REN)
________________________________ to ____________________________ from
NAME(S) OF ADULT TRAVEL COMPANION(S) COUNTRY/COUNTRIES
________________________________ to ____________________________ .
DATE DATE
(List specific travel information in the space below such as airline, flight number, cruise line and ship or tour operator.) ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________
Signed_____________________________________________________________
PARENT'S NAME
Telephone/Contact:__________________________________________________ Address: ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ Signature of Notary:__________________________________________________ Notary's Printed Name: ____________________________________________ Notary Seal: