Form Dhhs - Permission To Travel Form printable pdf download

Permission to Travel, DHHS

PERMISSION TO TRAVEL FORM

Complete this form and keep it with your passport!

In an international effort to prevent child abduction, many governments have initiated procedures at airport entry and

exit points. Such measures require documentary evidence of relationship and permission of the parent(s) or legal

guardian, not present, for the child's travel. Parents of minor children (under 18 years old) should carefully document

legal custody prior to traveling.

This form must be notarized and signed by both parents or legal guardian(s) of minors under 18 years of age. If one

parent is unable to sign, the form must be accompanied by a copy of a death certificate, divorce decree, or other legal

document that verifies the signing parent is the sole custodial parent. Guardianship papers should be attached when

applicable. If both custodial parents are unable to sign the same form, each parent can submit a separate signed and

notarized form.

Please ensure that students carry the notarized letter with them to the departure point.

PARENTS/GUARDIANS

We, ________________________ and ________________________ or ___________________________________

(Parent)

(Guardian(s))

domiciled at , __________________________________________________________________________________

(Addresses)

do hereby AUTHORIZE our son/daughter, ______________________________________

(Full Name)

to travel to _______________________ for the dates of ____________to_____________

(Destination Countries)

(dd/mm/yyyy)

with Dana Hills High School students under the supervision of Mrs. Dolores Dang-Wright.

Parent 1 Signature_____________________________________________________________

Parent 2 Signature ____________________________________________________________

Guardian Signature ___________________________________________________________

NOTARY

State of _________________________ County of ________________________

Subscribed and sworn (or affirmed) before me on this _____________ day of _________________

(Day)

(Month) (Year)

by ____________________________________________________________

(Parent and/or Guardian Names)

Personally known to me or proved to me on the basis of satisfactory evidence to

Place Notary Seal Here

be the person(s) who appeared before me.

Signature______________________________

Printed Name __________________________

Form Dhhs - Permission To Travel Form