Authorization for International Travel With Minor

Use this form if you want to permit your child to travel internationally with another adult.  This form is helpful if:

  • you want to take your child out of the country with the legal parent's consent.
  • you are the only legal parent and you want to authorize another adult to take the child out of the country.
  • you and the child's other legal parent want to authorize a third adult to take the child out of the country.

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See below for a full product description.

Alternate Selection
Label Contract Text
one parent

I, , am the parent or legal guardian of , a United States citizen born on , who carries United States passport number . I affirm that I have legal custody of my child, and that there are no pending divorce or custody proceedings that involve my child. I give my authorization and consent for my child to travel outside of the United States with , who is .

The purpose of the travel is . The travel plans, which  may modify as necessary, are as follows:

two parents

We,  and , are the parents or legal guardians of , a United States citizen born on , who carries United States passport number . We give our authorization and consent for our child to travel outside of the United States with , who is .

The purpose of the travel is . The travel plans, which  may modify as necessary, are as follows:

Dates of Travel: 

Destinations: 

 

Alternate Selection
Label Contract Text
one parent or guardian

Contact Information & Signature 

Name: 
Address: 
Phone:  
Email: 

Signature: _______________________________

Date: ___________________________________

two parents or guardians

Contact Information & Signatures 

Name: 
Address: 
Phone:   
Email: 

Signature: _______________________________

Date: ___________________________________
 

Name: 
Address: 
Phone:  
Email: 

Signature: _______________________________

Date: ___________________________________

 
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Certificate of Acknowledgment of Notary Public

State of _____________________________________________   )

                                                                                                          )           ss

County of ___________________________________________   )

 

On _______________ before me, _________________________________________ (here insert name and title of the officer) personally appeared _______________________________, who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.

I certify under PENALTY OF PERJURY under the laws of the State of ___________ that the foregoing paragraph is true and correct.

                                                            WITNESS my hand and official seal.

                                                            _____________________________________

                                                            Notary Public for the State of ______________

                                                            My commission expires __________________

[NOTARY SEAL]

 

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