同意未成年出国声明 - 中英.doc

Statement of Consenting Minor to Go Abroad (同意未成年人出国声明) Father’s name ......................................... ( 父亲姓名) Date of birth............................................. （出生日期） Place of birth.......................................... ( 出生地) National ID No...................................... (身份证号) Name of minor........................................ (未成年人的姓名) Date of birth........................................... (出生日期) Place of birth.......................................... (出生地) Minor’s passport No................................ (未成年人的护照号) Mother’s name.......................................... (母亲姓名) Date of birth.............................................. （出生日期） Place of birth............................................. ( 出生地) National ID No..................... .................. (身份证号) Name of minor.......................................... (未成年人的姓名) Date of birth.............................................. (出生日期) Place of birth............................................. (出生地) Minor’s passport No................................ (未成年人的护照号) I agree with the above statement: Minor to travel abroad (本人声明同意上述未成年人出国旅游) From...............................................to................................................... (出国日期自。。。。。。。。至。。。。。。。。。) The minor go to abroad with...........................Father/Mother/ Guardian/Teacher (上述未成年人将由父亲/母亲/监护人/老师（姓名）。。。。。。。。陪同出国) Date of Birth......................Place of birth............................Passport No.......................... (出生日期) (出生地) (所持护照号) The minor go to abroad with...........................Father/Mother/ Guardian/Teacher (上述未成年人将由父亲/母亲/监护人/老师 (姓名)。。。。。。。。。。陪同出国) Date of Birth......................Place of birth............................Passport No.......................... (出生日期) (出生地)