AUTHORIZATION TO TRAVEL TO A FOREIGN COUNTRY
(Necessary for all participants under age 18) Consul General: We / I ______________________________ of _______________________________________ (Parents Name) Street Address in ________________________________________________ are parents or guardians and have (City) (State) (Zip) legal custody of __________________________ , a minor child, who resides with us at the address set forth above. We / I hereby authorize the minor to travel in _____________________ (Country) during the dates of __________________________________ . (Trip Dates) The designated group leader(s), _________________________ , _________________________ (Group Leader’s Name) (Group Leader’s Name) _____________________________ _____________________________ __________________ (Parent / Legal Guardian) (Parent / Legal Guardian) (Date)
Note: In the case of two parent families/legal guardians, BOTH parents/legal guardians must sign this form and have it notarized. In the case of single parent families, the sole parent/legal guardian may sign.
NOTARY: STATE OF __________________________ COUNTY OF ________________________
Be it remembered, that on this day, ___________________ , before me, the undersigned, a Notary Public in and for the County and State afforesaid, came _______________________________ who is personally (Parent/Guardian) known to me to be the same person(s) who executed the above and foregoing instrument, and they duly acknowledge the execution of this same. IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed my official seal on the day and year above written. _________________________ Date Commission Expires _____________________________________________ Notary Public