I Parent Or Guardian S Name , Am the Parent Or Legal Guardian of Child S Name , a United

I [parent or guardian’s name], am the parent or legal guardian of [child’s name], a United States citizen born on [child’s birthdate], who carries United States passport number [passport #]. I affirm that I have legal custody of my child, and that there are no pending divorce or custody proceedings that involve my child. I give my authorization and consent for my child to travel outside of the United States with Seacoast United Sports Club of Hampton, NH for the Class of ’92 Manchester Tour.

The purpose of the travel is to experience playing soccer in England with academy clubs. The travel plans, which Seacoast United Sports Club may modify as necessary, are as follows:

Tuesday 18th April: Depart Boston/Logan Airport for London/Heathrow Airport Wednesday 19th April: Arrive London/Heathrow Airport, travel by bus to Manchester, England

April 18th – April 27th: Travel within England (based in Manchester) to various locations

Thursday April 27th: Depart London/Heathrow Airport, Arrive Boston/Logan Airport

Dates of Travel: Depart April 18th 2017; Return April 27th 2017

Destination(s): London, England; Manchester, England

Sincerely,

[Parent or guardian name] [address] [phone] [email]