2445 boul. St-Laurent Blvd. Suite B1-110 Ottawa, Ontario K1G 6C3 : (613) 260-5580 : (613) 260-0341 : www.athletics.ca : email@example.com
Minor Travel Authorization Form (Athletes under 18 yrs old) To Whom It May Concern: I, __________________________________________________ parent/guardian of the (Name of parent/guardian) following child: Name: Address: DOB: Passport #: _________________________________________________________ _________________________________________________________ _________________________ _________________________ Expiry date: _______________
I hereby grant permission for the said child to travel outside of Canada, and into Port-of-Spain with Chaperone/Head coach Mike Murray and Support Staff Janet Neufeld, José Sant, Jill Mallon, Laurier Primeau, Ron Bunting, Dr. Margaret Burghardt, Blaise Dubois, and Tracy McLaughlin to compete for the Canadian Athletics National Team at the 2009 Panamerican Junior Championships. My child will be traveling in the company and under the guidance and supervision of the Athletics Canada appointed staff for the period of July 28 to Aug. 3 or for such other longer time if necessary.
__________________________________ Signature of Parent/Guardian