AUTHORIZATION/PERMISSION SLIP TO TRAVEL WITH MINOR CHILD
Unforeseen matters may occur during a cruise, which require us to obtain specific consents from the responsible adult - “Guardian(s)” travelling with your minor child. When you allow your child to travel with someone other than their parent or legal guardian, you authorize the Guardian(s) to make decisions in the interests of your child, including all decisions which a parent or legal guardian can make.
The Guardian(s) may be asked to make decisions relating to matters such as your child’s safety, health and dietary requirements, medical treatment and decisions relating to disciplinary matters. Please complete the Authorization below and present a copy of this document at check-in on embarkation day. We recommend that the Guardian(s) carries this completed form during their cruise. It is also recommended that the Guardian(s) carry along with them any and all health insurance information, necessary health records (including immunization records and food allergy information) and passports of said minor child.
A copy of this Authorization Form must be provided to the cruise line representative at time of check-in and to Barbara Carpenter – Master Cruise Counselor – Cruise Planners/LM Vacations.Should you have any questions regarding this form, contact Barbara Carpenter at:
Phone No.: ________________________________________________
******************************************************************************************************** AUTHORIZATION TO TRAVEL WITH A MINOR
Parent(s) OR legal guardian(s) ______________________________________________________________________
of (“Child”) _________________________________________________________________________________________
Date of Birth of Minor Child _________________________________________________________________________
give consent to allow the Minor Child to travel from (place of residence)
_______________________________________________________________________ and to then sail onboard the
(Cruise Ship) _______________________________________________________________________________________
departing (Port) ____________________________________________________________________________________
without me/ us being present.
I/we agree to leave the minor child in the care and custody of his/her Guardian(s)
________________________________________________________________________, and agree that the Guardian(s) shall be responsible for monitoring and supervising the actions of the Minor Child in our absence at all times during the cruise, both on board and ashore.
I / we agree that the Guardian(s) are responsible for all decisions involving the Minor Child while onboard the Ship, including time critical decisions and decisions regarding the Minor Child’s medical care, health, safety and dietary requirements, and disciplinary matters.
In consideration of ______________________________________________________________Cruise Line permitting the Minor Child to sail with the Guardian(s), I/we hereby hold harmless, release from liability and relinquish all claims against said cruise line, the Ship, its officers, agents, insurers, contractors and employees including and not limited to Jon & Jona Van Zyle, Jeff & Joan Schultz, Barbara Carpenter/Master Cruise Counselor and Cruise Planners/LM Vacations and Iditarod from any and all liabilities which might arise from said cruise line permitting the Child to sail in the custody and control of the Guardian(s)
Guardian(s) shall be responsible for any property damage or injuries to others caused by the Child.
Mother / legal guardian’s signature _________________________________________________________________
Father / legal guardian’s signature __________________________________________________________________
both individually and on behalf of the Child individually and on behalf of the Minor Child named above