Fillable Printable Affidavit of Consent for Children Travelling Abroad
Fillable Printable Affidavit of Consent for Children Travelling Abroad
Affidavit of Consent for Children Travelling Abroad
Affidavit of Consent for Children Travelling Abroad
To whom it may concern,
I / We,
,
full name(s) of parent(s) / person(s) / organization giving consent
Address:
street address, city
province, country
Telephone and email:
Telephone
email
am / are the parent(s), legal guardian(s) or other authorized person(s) or organization with custody rights, access rights or
parental authority over the following child:
Child Information:
Name:
child’s full name
Date and place of birth:
dd/mm/yyyy
city, province
Number and date of issue of passport (if
available):
Number
dd/mm/yyyy
Issuing authority of passport (if available):
country where passport was issued
Birth certificate registration number
Number
Issuing authority of birth certificate
province / country where birth certificate was issued
This child has my / our consent to travel alone ☐ or This child has my / our consent to travel with
Accompanying Person:
Name:
full name of accompanying person
Relationship to child:
mother, father, grandparent, sister, brother, relative, friend, other
Number and date of issue of passport:
Number
dd/mm/yyyy
Issuing authority of passport:
country where passport was issued
Contact Information during trip:
Destination(s):
name of destination country / countries
Travel dates:
date of departure to date of return
to stay with / at (if applicable)
name of person with whom child will be staying / hotel or other
accommodation
at the following address(es)
street address(es), city (cities)
province(s)/state(s), country (countries)
Telephone and email
This affidavit must be signed before an official who has the authority to administer an oath or a solemn declaration.
.
Signature (s)of person(s)giving consent Subscribed and sworn before me
________________________(signature) this ___________ day of __________, 20_______
Name:
At _____________________________________
________________________(signature) ___________________________(Signature)
Name: Name of Official ___________________________
Date: Title:_____________________________________________________
