CHILD TRAVEL CONSENT FORM

Date: November 17, 2022

I. The Parent(s)
I/We, _______________________, am/are the lawful custodial parent(s) and/or non-
custodial parent(s) or legal guardian(s) of: 
II. The Minor
Full Name: _______________________
Date of Birth: _______________________
Place of Birth: _______________________
Passport Number (if applicable): _______________________
o Country of Issuance: _______________________
o Date Issuance: _______________________
o Date Expiration: _______________________
III. Traveling Alone/Accompanying Person
☐ - I authorize my child to travel alone.

☐ - I authorize my child to travel with the following individual/organization:

o Individual/Organization Name: _______________________
o Relationship to Child (if applicable): _______________________
o U.S. or Foreign Passport Number (if applicable): _______________________
o Country of Issuance: _______________________
o Date Issuance: _______________________
o Date Expiration: _______________________
IV. Itinerary
I authorize my child to travel to the following location _______________________ during the
period beginning on _______________________, 20____  and ending on
_______________________, 20____.
V. Signature(s)
Parent / Legal Guardian Signature: ____________________________ 
Date: _______________________
Full Name: _______________________
Parent / Legal Guardian Signature: ____________________________ 
Date: _______________________

Page 1 of 2
 Full Name: _______________________

NOTICE ALLBUSINESSTEMPLATES.COM
The information in this document is designed to provide an outline that you can follow when formulating business or personal plans.
Due to the variances of many local, city, county and state laws, we recommend considering professional legal counseling before entering into any contract or
agreement. AllBusinessTemplates.com herewith expressly rejects any liability incurred due to the use of any documents provided on its website.

Page 2 of 2