AFFIDAVIT OF CONSENT
STATE OF
COUNTY OF
I/We,
, residing at
,
in the county of
in the state of
and being duly sworn, do hereby depose and attest that:
1. I/We am/are the legal guardian(s) of
,
who is a minor until
.
2. My/Our relationship(s) to the child is/are:
3. The minor is traveling to
for the purpose of
4. I/We am/are unable to accompany the minor because
5. I/We authorize the minor to travel with
,
who is the minor’s
6. The minor will begin traveling on
,
and return on
AFFIANT
Subscribed and sworn to before me
this
day of
20
(Notary Public),
County.
My commission expires
20