CANADA )

) IN THE MATTER OF
PROVINCE OF ) (INSERT NAME OF CHILD TRAVELING)
) trip to (CITY, STATE) for
) (REASON FOR TRIP)
BRITISH COLUMBIA )
TO WIT: )

I (INSERT NAME OF PARENT NOT GOING TO THE TOURNAMENT) of (INSERT HOME

ADDRESS), in the City of Kelowna, in the Province of British Columbia, Canada, telephone
number (INSERT YOUR PHONE NUMBER), do solemnly declare that:

1. I am the biological (INSERT MOTHER OR FATHER) and joint legal guardian of

(INSERT NAME OF CHILD TRAVELING) born (INSERT DATE OF BIRTH OF
CHILD).

2. I confirm that (INSERT NAME OF PARENT WHO IS TRAVELING TO THE

TOURNAMENT) is the biological (INSERT MOTHER OR FATHER) and the other joint
legal guardian of (INSERT NAME OF CHILD TRAVELING).

3. I hereby consent to (INSERT NAME OF CHILD TRAVELING) travelling to Bellingham

Washington with (INSERT NAME OF PARENT WHO IS TRAVELLING TO THE
TOURNAMENT) departing from Canada on (MONTH) (DAY), (YEAR) and returning
to Canada on (MONTH) (DAY), (YEAR) for the purpose of (REASON FOR TRIP).

AND I make this solemn declaration, conscientiously believing it to be true and knowing that it
is of the same legal force and effect as if made under oath and by virtue of the Canada Evidence
Act.

Declared before me at the City of )

Kelowna, in the Province of )
British Columbia, this ____ day of )
(MONTH), (YEAR). )
)
)
Notary Public in and for the )
Province of British Columbia

______________________________________
(TYPE NAME OF PARENT NOT
GOING TO TOURNAMENT)