Single Parent Travel Authorization Form
I. Parent/Guardian Details
Name of Parent/Guardian
Contact Number
Address
Email
Relationship to Child
II. Child(ren) Details
Full Name(s) of Child(ren)
Date of Birth
Passport Number (if applicable)
III. Travel Information
Departure Date
Return Date
Destination(s)
Purpose of Travel
IV. Accompanying Adult (if not parent/guardian)
Name of Accompanying Adult
Relationship to Child
Contact Number
V. Authorization
Additional Notes/Instructions
Signature of Parent/Guardian
Date