Permission to Travel with Child: FORM

Simply: Fill Out Form - click Submit - and Print:

Your Name:
	First Name		Last Name

Relationship to child

Spouse's Name (only if s/he is not travelling with child)	Select "AND"
		First Name	Last Name

Relationship to child


Child’s full name:
	First Name	Middle Name	Last Name
Child's Date of birth (DD/MM/YY):
Place of birth:
	City/Town	Region/Country
Canadian passport number:
Date of issuance of Canadian passport (DD/MM/YY):
Place of issuance of Canadian passport:
	City/Town	Region/Country
Full name of accompanying person:
	First Name	Middle Name	Last Name
Canadian or foreign passport number:
Date of issuance of passport (DD/MM/YY):
Place of issuance of passport:
	City/Town	Region/Country
to visit ?, name of foreign country

during the period of
	Begin Date		End Date

name of person/place where child will be residing in foreign country & address:	First Name		Last Name

	Name of Hotel/Residence (if any)
	Street
	City
	Province/State
	Country/Region

Any questions regarding this consent letter can be directed to the under signed at:

	First Name		Last Name
	Street
	City
	Province/State
	Country/Region
	Postal/Zip Code
	Phone
	Mobile