Parental Consent Affidavit Form - Republic Of South Africa
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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)
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_______________****
and / or** is a student / cared for at _____________________________________________________________
situated at (address) ________________________________________________________________________
Contact number of learning institution/place of care: _______________________________________________
The child is accompanied / will be received in South Africa by (delete appropriately):
Surname, Name
Relationship
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
Residential Address
Work Address
Contact No: Work
Mobile
Residence
Signature and date
Attach copy of mother’s ID or passport.
Father:
Surname, Name
Residential Address
Work Address
Contact No: Work
Mobile
Residence
Signature and date
Attach copy of father’s ID or passport.
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