Date:_____________________
I (we):______________________________________________________________
authorize my/our minor child(ren):___________________________________________
to travel to:_________________________________ on:_________________________
aboard Airline/Flight Number:________________________________________
and/resort :_____________________________________________ with:
____________________________________________________________. Their expected
date of return is _______________________.
In addition, I (we) authorize:______________________________________ to consent
to any necessary routine or emergency medical treatment during the aforementioned trip.
Signed:_________________________________ (Parent)
Signed:_________________________________ (Parent)
Address:________________________________________
_______________________________________________
Telephone:______________________________________
Sworn to and signed before me, a Notary Public,
this _______ day of _______________, 20____
________________________________________
Notary Public Signature and Seal


 

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