AFFIDAVIT OF CHILD

TRAVELING WITHOUT PARENT / PARENTS

I, the undersigned (print both parents' names ____________________________________________________

______________________________________________________________________________________

hereby authorize _________________________________________________________________________

to travel with our child (full name) ____________________________________________________________

to ____________________________________________________________________________________.

SUBSCRIBED AND SWORN TO BEFORE ME

THIS _____ DAY OF __________ OF THE YEAR ________

SIGNATURE OF MOTHER ___________________________________________

SIGNATURE OF FATHER ____________________________________________

SEAL OF NOTARY