AUTHORIZATION FOR A MINOR CHILD TO TRAVEL TO CANADA
I authorize ________________________________________________ ________________________________________________ _____ / _____ / _____ (DD/MM/YY) ________________________________________________ ________________________________________________ Telephone: ___________________________________ (country code/regional code/ number)
Family name: Given name(s): Date of birth:
Complete address:
to travel to Canada from _____ / _____ / _____ (DD/MM/YY) to The child: will be met in Canada by (if applicable): Family name: ______________________
_____ / _____ / _____ / (DD/MM/YY).
will be travelling with (if applicable): Family name: Given name(s): ______________________ ______________________ ______________________ ______________________ ______________________ Relationship: ______________________ e.g. aunt, friend, teacher, etc.
Given name(s): ______________________ Complete address: ______________________ ______________________ Telephone: ______________________ Passport number : Complete address:
Relationship: ______________________ e.g. aunt, friend, summer camp counsellor, etc.
Signature of BOTH parents or of legal guardian (obligatory): Family name, given name(s): __________________________________________ Signature: _________________________________ Date : _____ / _____ / _____ (DD/MM/YY) Family name, given name(s): __________________________________________ Signature: _________________________________ Date : _____ / _____ / _____ (DD/MM/YY)
A photocopy of an identity document (with signature) for each parent or for the legal guardian MUST be attached, along with a letter of invitation if applicable.
Autorisation de voyage pour enfant mineur A (03/04)