Minor (Child) Travel Consent Form

Minor (Child)'s Name

First

Last

Birth Location & Date

Minor's Place of Birth

e.g. "Las Vegas, NV"

Minor's Date of Birth

Minor's Passport Information

Do you want to add the Minor Child's Passport information?

Yes No

This is recommended for International Travel

Minor's Passport Number

Passport Date of Issue

Passport Expiration Date

Traveling Alone

The Minor is traveling

Alone with Someone Else

Name of Person Traveling with the Minor

First

Last

Relationship to Minor

Do you want to enter their Passport Information?

Yes No

Highly Recommended. May be required for International Travel.

Passport Number

Passport Issuing Country

Date of Passport Issuance

Date of Passport Expiration

Itinerary

Where is the Minor traveling to?

Example "New York, NY, USA"

Start Date

End Date

Parent(s) / Legal Guardian(s)

How many Parents / Legal Guardians will be signing this form?

Parent / Legal Guardian's Name

First

Last

Parent / Legal Guardian's Name

First

Last

Parent / Legal Guardian's Name

First

Last

Witness / Notary Public

Will the Parent(s) or Legal Guardian(s) sign this form in the presence of a Witness or Notary Public?

Yes No

Recommended to be signed in the presence of a Notary Public.

Electronic Signature

Date of Signature

Sign and Print Name

Clear

Print Name

Parent / Legal Guardian

Sign and Print Name

Clear

Print Name

Parent / Legal Guardian