Temporary Guardian Travel Consent for Child
Child Information
Full Name
Date of Birth
Passport Number
Parent/Legal Guardian Information
Full Name
Address
Phone Number
Email
Temporary Guardian Information
Full Name
Relationship to Child
Address
Phone Number
Email
Travel Details
Destination(s)
Departure Date
Return Date
Additional Travel Information
Medical & Special Instructions
Medical Information / Allergies
Special Instructions
Consent & Authorization
Consent Statement
Signatures
Parent/Guardian Signature
Date