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.
Many carriers will not allow a child to travel without a notarized permission letter from the other parent. Many carriers require that the form be their approved form.
Be sure to make sure that everything is done prior to travel dates.
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]
__________________ typed name
__________________ full address
__________, TX ____
__________________ phone number
__________________ email
State of Texas )
County of _____________ )
This instrument was acknowledged before me on __________________________,
20__ by _____________________________[name of
conservator or parent].
________________________________
Notary Public,
State of Texas
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