Child-Consent-Form

I   of – declare that I as the legal parent / guardian of

  • GENDER OF TRAVELR :
  • CHILD DATE OF BIRTH :
  • PASSPORT Number :
  • EXPRIING ON DATE:

My child – has my consent to travel to INCLUDING COUNTRIES with ARKanum Adventures and Its Affiliates, from and returning to the United States around , under the Supervision of , carrying Passport # .

Any questions regarding this document, my be addressed to me at:

PARENT MAILING ADDRESS – LINE 1 :

PARENT MAILING ADDRESS – LINE 2 :

City :

State :

Zip Code :

Primary Phone :

Secondary Phone :

 

Parent / Guardian Signature :

Signed and Agreed to on this date: