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Consent for International Travel Without Supervision
I, ________, of ________, declare that I am the parent/legal guardian of the following child:
-- ________, Male, born on ________ in the following location: ________, passport number: ________
My child has consent to travel to ________ from ________ to ________, without an adult present.
Travel Details
The trip will include the following transportation details:
________
Special Medical Needs and/or Allergies
My child has the following special medical needs and/or allergies:
________
________
________
________
________
__________________________________
________
__________________
DATE
__________________________________
WITNESS
__________________
DATE
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