Foster Parent Travel Authorization for Child
Child Information
Child's Full Name
Date of Birth
Child's Case Number
Social Worker Name
Foster Parent Information
Foster Parent Name(s)
Relationship to Child
Address
Travel Details
Destination(s)
Purpose of Travel
Departure Date
Return Date
Mode of Transportation
Additional Information
Authorization
This section serves as authorization for the foster parent(s) named above to travel with the child listed in this document.
Foster Parent Signature
Date
Social Worker Signature
Date