INTERNATIONAL FLIGHT TRAVEL CONSENT
I/We are the parent(s) or legal guardian(s) of the child named below. This sample is parental travel permission only. It is not an airline Unaccompanied Minor form, passport, visa, Form DS-3053, or government exit permit.
Parent / Legal Guardian
Full Legal Name
Traveling Adult, if applicable
Traveling Adult Full Legal Name
Relationship to Child
Child
Child's Full Legal Name
Date of Birth
Passport / Travel Document Number
Issuing Country
Travel Details
Airline
Flight Number(s)
Destination(s)
Departure Date
Return Date
Flight / Lodging / Contact Details
Parent / Guardian Contact
Address
City / State / Postal Code
Telephone
Parent / Legal Guardian
Signature
Printed name
Date
Second Parent / Legal Guardian, if applicable
Signature
Printed name
Date