Minor Travel Consent (Unaccompanied/Third Party) Template

Date: [Date]

1. Child Information

1.1 Child Full Legal Name: [Name]
1.2 Date of Birth: [MM/DD/YYYY]
1.3 Place of Birth (Optional): [City/Country]
1.4 Passport Number (if any): [Passport #]
1.5 Passport Issuing Country (if any): [Country]
1.6 Passport Expiration Date (if any): [Date]

2. Parent/Legal Guardian Information

Parent/Guardian #1:
2.1 Full Name: [Name]
2.2 Relationship: ☐ Mother ☐ Father ☐ Legal guardian ☐ Other: [Relationship]
2.3 Phone/Email: [Contact]
2.4 Address: [Address]
2.5 Passport/ID Number (Optional): [ID details]

Parent/Guardian #2 (if applicable):
2.6 Full Name: [Name]
2.7 Relationship: ☐ Mother ☐ Father ☐ Legal guardian ☐ Other: [Relationship]
2.8 Phone/Email: [Contact]
2.9 Address: [Address]
2.10 Passport/ID Number (Optional): [ID details]

3. Traveling Adult / Responsible Party (If Applicable)

3.1 Full Name: [Name]
3.2 Relationship to Child: [Relationship]
3.3 Phone/Email: [Contact]
3.4 Address: [Address]
3.5 ID/Passport Number (Optional): [ID details]

4. Travel Details

4.1 Travel Type: ☐ Unaccompanied minor ☐ Traveling with third-party adult (Section 3)
4.2 Destination(s): [Countries/Cities]
4.3 Travel Dates: From [Start Date] to [End Date]
4.4 Itinerary / Transportation (Optional): [Flights, trains, routes]
4.5 Lodging Address(es) (Optional): [Hotel/host address]
4.6 Emergency Contact (Optional): [Name, phone, relationship]

5. Consent and Authorization

5.1 We, the undersigned parent(s)/legal guardian(s) of [Child Name], give our full consent for the child to travel as described above.
5.2 We authorize [Traveling Adult Name / Airline Unaccompanied Minor Service / Responsible Party] to supervise the child during travel as applicable.
5.3 We authorize the responsible adult to obtain emergency medical care for the child if needed, including medical treatment and hospital admission, if we cannot be reached.

6. Custody Information (Optional)

6.1 Custody status: ☐ Joint custody ☐ Sole custody (attach proof) ☐ Other: [Details].
6.2 Relevant court order (if any): [Court, date, case number].
6.3 Additional notes (Optional): [Notes about travel restrictions, required approvals].

Signatures

Parent/Guardian #1: [Full Name]
Date: [Date]
Signature: ___________________________

Parent/Guardian #2 (if applicable): [Full Name]
Date: [Date]
Signature: ___________________________

Notary / Notarization (Optional)

State of [State]
County of [County]

On [Date], before me, [Notary Name], personally appeared [Parent/Guardian Name(s)], known to me (or satisfactorily proven) to be the persons whose names are subscribed to this document, and acknowledged that they executed it for the purposes stated.

Notary Public Signature: _______________________
My Commission Expires: _______________________
Notary Seal (if applicable): ___________________