Notary Form for Child Travel
Parent/Guardian Information
Full Name:
Address:
City/State/Zip Code:
Phone Number:
Email:
Child Information
Full Name:
Date of Birth:
Passport Number (if applicable):
Country of Issuance (if applicable):
Travel Information
Destination(s):
Travel Dates:
Purpose of Travel:
Accompanying Adult Information
Full Name:
Relationship to Child:
Passport Number (if applicable):
Contact Information:
Authorization
I, Parent/Guardian Full Name hereby authorize Accompanying Adult’s Nameto travel with my child, Child’s Full Name to the destination(s) specified above on the travel dates listed. This authorization is granted for the specified period only and for the purpose of ensuring my child's safe travel.
Parent/Guardian Signature
Date:
Notary Public Section
State of:
County of:
On this _______ day of _________, 20, before me, the undersigned, personally appeared Parent/Guardian Full Nameknown to me or satisfactorily proven to be the person who signed the foregoing instrument, and acknowledged that they executed the same for the purposes therein contained.
Notary Public Signature
Commission Expires:
Seal
![]()
Notary Templates @ Template.net
![]()
Thank you for completing this form!
Get ready to achieve your fitness goals with us!
Create free forms at
