Child Travel Consent
We, [First parent: full name], of [First parent: address], telephone [First parent: phone], and [Second parent: full name], of [Second parent: address], telephone [Second parent: phone] (each a “Parent” and together the “Parents”), are the parents or legal guardians of the child named below (the “Child”). Custody status: [Custody status]. We make this Child Travel Consent (the “Consent”) voluntarily, so that carriers, immigration and customs officials, medical providers and any other person concerned may know that the Child is travelling with our knowledge and permission.
1. The Child
The Child is [Child: full name (as on passport)], born [Child: date of birth] at [Child: place of birth], passport [Child: passport number and country (or “None”)]. The Child is a minor and ordinarily resides with us at the address of the first Parent stated above, or as provided in any custody order.
2. The Accompanying Adult
We consent to the Child travelling in the care of [Accompanying adult: full name], the Child’s [Accompanying adult: relationship to child], of [Accompanying adult: address], telephone [Accompanying adult: phone], passport or identification number [Accompanying adult: passport or ID number] (the “Companion”). The Companion is an adult whom we know and trust, and we have asked the Companion to carry this Consent with the Child’s travel documents.
3. The Travel
The Child will travel to [Destination(s)], departing on [Departure date] and returning on [Return date]. The purpose of the travel is: [Purpose of travel]. The planned itinerary and accommodation are: [Itinerary and accommodation]. We consent to reasonable changes to the itinerary caused by delays, cancellations, weather or other circumstances beyond the Companion’s control, provided the Companion tells us promptly.
4. Consent to Travel and Temporary Care
We consent to the Child leaving and re-entering the United States and entering, staying in and leaving each destination named above, in the company of the Companion, during the period stated in Section 3. We authorise the Companion to have temporary care, custody and supervision of the Child during the travel; to make day-to-day decisions about the Child’s food, lodging, activities, transport and supervision; to present the Child’s passport and travel documents and sign customs, immigration, airline, cruise and lodging forms on the Child’s behalf; and to bring the Child home to us at the end of the travel. This Consent does not transfer legal custody or guardianship of the Child, and we retain every parental right not expressly delegated here.
5. Medical Authority
If the Child becomes ill or injured during the travel and we cannot be reached promptly, we authorise the Companion to obtain medical, dental and hospital care for the Child and to consent on our behalf to: [Medical authority given to the accompanying adult]. We authorise any licensed physician, dentist, hospital or clinic to provide that care on the Companion’s consent as if we had given it, and to disclose the Child’s health information to the Companion for that purpose. The Companion shall contact us as soon as possible about any illness or injury and shall follow our instructions once we are reached. We will be responsible for the cost of the Child’s care and will reimburse the Companion for any amount the Companion pays.
6. Health Information and Insurance
The Child’s allergies, medications and medical conditions are: [Allergies, medications and conditions (or “None”)]. The Child’s health and travel insurance is: [Health and travel insurance (carrier and policy no.)]. The Companion may present this information to any provider and may authorise treatment within the limits of Section 5 without waiting to confirm coverage.
7. Contact
During the travel we may be reached at the telephone numbers and email addresses in this Consent. If neither of us can be reached, the Companion may contact [Emergency contact other than the parents], who may relay our instructions. The Companion shall keep us informed of the Child’s whereabouts and shall notify us at once of any emergency, change of accommodation or contact from any official concerning the Child.
8. Duration and Revocation
This Consent is effective from the departure date until the return date stated in Section 3, and for any period of delay beyond the Companion’s control until the Child is returned to us. Either Parent may revoke it at any time by written notice to the Companion, and revocation is effective when the Companion receives it; a revocation does not affect a carrier or official who has already relied on this Consent. This Consent expires automatically at the end of the travel and does not authorise any later trip.
9. Reliance
Any airline, cruise line, railway, hotel, tour operator, school, immigration or customs official, medical provider or other person may rely on this Consent, or on a photocopy or scan of it, without further inquiry, and we release any person who does so in good faith from liability for allowing the Child to travel or for providing care in reliance on it. We confirm that no court order prohibits the Child from travelling as described, and that, to the extent any custody order requires the consent of a parent, that consent is given here.
10. Governing Law; Signatures
This Consent is governed by the laws of the State of [Governing law (state)]. It may be signed electronically and in counterparts, each of which is an original, and the electronic execution record, timestamps and document fingerprints kept by the signing platform are evidence of execution. We intend to have our signatures acknowledged before a notary public on a printed copy where a carrier, official or destination country requires it, and that copy shall be an original of this Consent. We each sign on the date shown in the execution record and declare that the statements in this Consent are true.
Signatures
First parent or guardian · Second parent or guardian