Minor Travel Consent Form

Company
This field is for validation purposes and should be left unchanged.
Required for Ages 14-17 yrs
I. The Parent(s) I/We,
Name*
am/are the lawful custodial parent(s) and/or non-custodial parent(s) or legal guardian(s) of:
II. The Minor
Name
First Last
Date of Birth*
Month
Day
Year
Age*
III. Traveling Alone/Accompanying Person
I authorize my child to travel alone:*
- Yes
- No
I authorize my child to travel with the following individual:*
Explain relationoship to child (if applicable)
IV. Optional – Travel Limits
I authorize my child to travel to the following location:
Location
during the period beginning on
Date
Month
Day
Year
and ending on
Date
Month
Day
Year
Parent / Legal Guardian Signature*
Parent / Legal Guardian Signature
Date of signature*
Month
Day
Year
Date of signature
Month
Day
Year
Name*
First Last
Name
First Last

248-887-4979