Statutory Declaration by Parents for Child Travel

We,

Parent 1 (Full Name):
Parent 2 (Full Name):

of

Address:

do hereby solemnly declare and affirm as follows:

  1. Child's Full Name:
  2. Date of Birth:
  3. Passport Number:
  4. Destination Country:
  5. Travel Dates:
  6. Accompanying Adult(s):

We give our consent for our aforementioned child to travel to the specified destination(s) for the period stated above, accompanied by the person(s) named.

Declared at

City:
Date:
Signature of Parent 1
Signature of Parent 2

Notary Public

Name:
Commission Number:
Signature & Stamp:
Date: