Yellow Bear Journeys, Inc. Parental Consent Form
Date:____________________________________

I(We):___________________________________________________
authorize my/our minor child(ren):
__________________________________________________________
__________________________________________________________
__________________________________________________________
to travel on the following tour: ______________________________
on the following dates: __________________________________
accompanied by: _________________________________________.

In addition, I (we) authorize my(our) child(ren):
__________________________________________________________
__________________________________________________________
__________________________________________________________
to consent to any necessary routine or emergency medical treatment during the previously mentioned trip.


Signed:____________________________________(Parent)
Signed:____________________________________(Parent)
Address:_____________________________________
_____________________________________________
_____________________________________________
_____________________________________________
Telephone:________________________


Sworn to and signed before me, a Notary Public,
this ________ day of ________________, ____
_______________________________________________
Notary Public Signature and Seal