Guardian Authorization Form

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Guardian Authorization Form
I, ____________________________________, hereby authorize ______________________________
Parent
Adult
as legal guardian of my son (daughter) ____________________________________, age ______,
while in Puerto Rico on vacation from _____ of ____________ through _____ of _____________,
Day
Month
Day
Month
200____. I further authorize my son (daughter) ________________________________ , to go with
his (hers) _____________________________, _______________________________, on an Adventure
Relationship
Adult
Expedition (Caving / Canyoning) with an organization by the name of Aventuras Tierra Adentro, Inc.
,
and
for ______________________________________, to sign the Release Form completed by me.
Adult
SWORN STATEMENT
IN WITNESS WHEREOF, I ___________________________________, do hereby declare
that the information contained in this document is correct.
This _____ of ________________, 20_____.
__________________________________
Parent Signature
SWORN AND SUBSCRIBED TO BEFORE ME BY:
________________________________________, of the following personal circumstances:
legal age___________ , resident of____________________________, whom I personally know.
In _______________________________, on ______________________, 200____.
_________________________________
NOTARIAL SEAL
Public Notary

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