Parental Consent Affidavit Form
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1
2Annexure C
SUGGESTED FORMAT: PARENTAL CONSENT AFFIDAVIT
(CONSENT FOR PERSON UNDER THE AGE OF 18 TO TRAVEL TO OR FROM THE REPUBLIC OF SOUTH
AFRICA)
I/We* hereby declare my/our consent that my/our daughter/son whose Unabridged Birth Certificate (UBC) or
**Equivalent document is attached may travel to and from South Africa:
Surname: ______________________ Name: ___________________ Date of birth ___________________
Identified by Passport no: _____________________ is travelling from ______________________ to
____________________ for the period _________________ to _____________________ 20_________.****
The child is accompanied / will be received in South Africa by (delete appropriately):
Surname, Name
Relationship
Identified by**
I.D. no.
Passport no.
Residential Address
Work Address
Contact no. Work
Mobile
Residence
Attach copy of South African ID or if a foreign national attach passport and visa of person receiving the child in SA.
Mother:
Surname, Name
Residential Address
Identified by**
I.D. no.
Passport no.
Contact no. Work
Mobile
Residence
Signature
Date
Attach copy of mother’s ID or passport.
Father:
Surname, Name
Residential Address
Identified by**
I.D. no.
Passport no.
Contact no. Work
Mobile
Residence
Contact no.
Signature
Date
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