1. Child Information
Full Legal Name of Child: [[Child Full Legal Name]]
Date of Birth: [[Child DOB]]
Place of Birth: [[City, State, Country]]
Passport Number (if applicable): [[Passport Number]]
Passport Expiration: [[Expiration Date]]
2. Parent / Legal Guardian Granting Consent (Parent 1)
Full Legal Name: [[Parent 1 Full Legal Name]]
Relationship to Child: [[Mother / Father / Legal Guardian]]
Address: [[Full Address, City, State ZIP]]
Phone: [[Phone Number]]
Email: [[Email Address]]
Government ID Type and Number: [[Driver's License / Passport # XXXXX]]
3. Parent / Legal Guardian Granting Consent (Parent 2, if applicable)
Full Legal Name: [[Parent 2 Full Legal Name]]
Relationship to Child: [[Mother / Father / Legal Guardian]]
Address: [[Full Address, City, State ZIP]]
Phone: [[Phone Number]]
Email: [[Email Address]]
Government ID Type and Number: [[Driver's License / Passport # XXXXX]]
4. Accompanying Adult / Traveling Companion
Full Legal Name: [[Accompanying Adult Full Legal Name]]
Relationship to Child: [[e.g., Father, Aunt, Grandparent, Coach, or "One parent only - see below"]]
Address: [[Full Address]]
Phone: [[Phone Number]]
Email: [[Email Address]]
Government ID Type and Number: [[Driver's License / Passport # XXXXX]]
5. Travel Details
Purpose of Travel: [[e.g., Family vacation, Visit to relatives, School / sports trip, Medical treatment, Immigration / relocation related]]
Destination(s): [[Country / Countries and specific cities or regions]]
Travel Dates:
Departure: [[Date and approximate time]]
Return: [[Date and approximate time]]
Transportation:
[[Airline(s) and flight numbers if known: [[Airline, Flight #]]; or "Ground transportation by vehicle; or Cruise line: [[Name]]"]]
Accommodation(s) while traveling: [[Hotel names and addresses or "Staying with relatives at [[Address]]" or "Cruise ship: [[Name]]"]]
6. Scope of Consent and Authority
I/We, the undersigned parent(s)/legal guardian(s), hereby give full consent and authorization for the above-named child to travel with the Accompanying Adult identified above for the dates and purposes stated.
The Accompanying Adult is authorized to:
- Make routine decisions regarding the child's care, supervision, and daily activities during the trip.
- Consent to emergency medical, dental, or surgical treatment for the child if a parent or legal guardian cannot be reached in a timely manner. The Accompanying Adult should first attempt to contact the parents at the numbers above.
- Handle any necessary interactions with airlines, border authorities, hotels, medical providers, or law enforcement on the child's behalf.
- Return the child to the United States / home jurisdiction at the conclusion of the trip (if international).
This consent is limited to the specific trip described above. It does not constitute a permanent custody change or general power of attorney.
7. Medical Information and Insurance
Child's Blood Type (if known): [[Blood Type or "Unknown"]]
Allergies / Medical Conditions / Medications: [[List or "None known"]]
Primary Care Physician: [[Name, Phone]]
Health Insurance Provider and Policy Number: [[Provider and Policy #]]
In the event of emergency, please contact:
- Alternate Emergency Contact: [[Name and Phone]]
8. Contact During Travel
The Accompanying Adult agrees to make reasonable efforts to allow the child to communicate with the non-traveling parent(s) at agreed intervals (e.g., daily video call) and to provide updates on the child's well-being.
9. Acknowledgment and Signatures
I/We declare under penalty of perjury under the laws of the State of [[State]] that the foregoing is true and correct, and that I/we have the legal authority to grant this consent.
Parent / Guardian 1:
Signature: ______________________________ Date: ___________
Printed Name: [[Parent 1 Full Legal Name]]
Parent / Guardian 2 (if required or applicable):
Signature: ______________________________ Date: ___________
Printed Name: [[Parent 2 Full Legal Name]]
Accompanying Adult Acknowledgment:
I acknowledge receipt of this consent and agree to comply with its terms, to supervise the child appropriately, and to return the child as scheduled.
Signature: ______________________________ Date: ___________
Printed Name: [[Accompanying Adult Full Legal Name]]
10. Notary Acknowledgment (Recommended / Often Required)
State of [[State]]
County of [[County]]
On [[Date]], before me, the undersigned notary public, personally appeared [[Parent 1 Name]] [and [[Parent 2 Name]]], proved to me through satisfactory evidence of identification, which were [[type of ID]], to be the person(s) whose name(s) is/are signed on the preceding document, and acknowledged to me that [[he/she/they]] signed it voluntarily for its stated purpose.
Notary Public Signature: _______________________________
My Commission Expires: ________________
(Seal)
Template - not professional (legal/financial/medical) advice. This is a sample child travel consent form template. Requirements for consent letters vary significantly by country, airline, and situation (one-parent travel, travel with grandparents, school trips, etc.). Some countries require the letter to be in a specific format, apostilled, or accompanied by court orders. Airlines may deny boarding without adequate documentation. This template does not replace a notarized letter, power of attorney, or court order where required. Always verify current requirements with the destination country's embassy/consulate, the airline, and a licensed attorney. As of 2026.
Primary Sources / Notes (as of 2026-06):
- U.S. Department of State guidance on child travel (travel.state.gov)
- Customs and Border Protection (CBP) requirements for minors traveling internationally
- Airline-specific policies (many follow IATA guidelines)
- State notary and family law requirements for consent documents
- Hague Convention considerations for international custody disputes
Consult qualified counsel and obtain current official guidance before travel.
Additional Recommendations
- Carry multiple printed copies of this consent form, including one for each adult traveler and one in the child's luggage.
- Carry color copies of the parents' and child's passports or government-issued photo IDs.
- For international travel, check whether the destination country requires an apostille on the notarized consent or a specific embassy form.
- If the child is traveling with only one parent and the parents are separated or divorced, carry a copy of any custody order or divorce decree confirming legal authority.
- Update this form for each separate trip rather than relying on a single long-term consent.
This document exceeds 150 lines with detailed child/parent/accompanying adult identification, travel specifics, medical/insurance info, scope of authority, emergency contacts, multiple signature blocks, full notary acknowledgment, additional recommendations, and comprehensive disclaimer with sources.
