AUTHORIZATION FOR FOREIGN TRAVEL WITH A MINOR CHILD Date ______________

AUTHORIZATION FOR FOREIGN TRAVEL WITH A MINOR CHILD Date: ______________ To Whom It May Concern: I am the [choose appropriate option] parent / legal guardian of the minor child _____________________________ [insert name] (the “Child”), who is a Canadian citizen. The Child was born on __________ [insert date] at _____________________________ [insert location of child’s birth, including hospital (if any), city and province/territory]. The Child holds a Canadian passport with the number ________________. I do hereby represent and warrant as follows: 1. 2. I have legal custody of the Child, and as such, I have the right to give this Authorization and Consent; and No pending divorce or child custody proceedings involving the Child exist. I hereby give my full permission and consent for the Child to travel outside of Canada with ________________________ [insert name of adult], who is the Child’s ________________________________ [specify relationship of the adult to the child]. The purpose of the travel is for _____________________________ [specify, whether vacation, visiting family, etc.]. I have approved the following travel plans for the Child: Dates of Travel Destination Airline / Cruise Line / Tour Operator Flight No. or Ship Hotel I authorize ________________________ [insert name of adult traveling with child] to make any changes whatsoever to the approved travel plans. THIS IS A 2-PAGE DOCUMENT.

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