Before using this form, check with the public carrier
and the embassies of the countries into or through which the child or children
will travel to determine if the carrier or the country requires a specific form
or other information for a valid consent.
For information regarding this issue
from the Department of State, see www.travel.state.gov/travel/cis_pa_tw/tw/tw_1764.html.
Consent for Child[ren] to Travel Outside the United
States
Date:______________________
To Whom It May Concern:
Re: Consent for Child[ren] to Travel Outside the United States of
America
I,___________________________, am the [mother/father/managing
conservator] of the following children:
NAME & DATE OF BIRTH
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
I give my consent and permission for [this/these]
child[ren] to travel outside the United States of America with ____________________________________[name of adult traveling with
child[ren]], who is the
child[ren]’s ___________________________ [describe relationship], during the period and to the locations stated in
this consent.
The child[ren] [is/are] scheduled to depart on or about _______________
[date] for ________________ [location of first intended
destination]. [If applicable, include interim
locations and dates of travel.]
The child[ren] [is/are] scheduled to arrive back in the United States of
America on or about ____________________
[date].
_________________________________
[Name of conservator or parent]
State of Texas
County of____________________
This instrument was acknowledged before me on __________________________,
20__ by [name of
conservator or parent].
______________________________
Notary Public,
State of Texas
No comments:
Post a Comment