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1. Date and Place of Execution: Current date and location where the consent letter is being signed
2. Parent/Guardian Information: Complete details of parent(s)/legal guardian(s) including full name, ID number (KTP), address, and contact information
3. Child Information: Complete details of the child including full name, place and date of birth, current address, and any relevant identification numbers
4. Purpose of Consent: Clear and specific statement of what activities or purposes are being consented to
5. Duration: Time period for which the consent is valid
6. Declaration of Consent: Explicit statement of consent with any conditions or limitations
7. Authentication: Signatures of parent(s)/guardian(s), with space for witness signatures if required
1. Medical Information: Include when consent involves medical treatment or activities where medical information might be relevant
2. Travel Details: Include when consent is for travel purposes, including destination, accommodation, and accompanying adult details
3. Emergency Contacts: Additional contact information for emergencies, particularly relevant for travel or extended activities
4. Special Instructions: Any specific care instructions or restrictions that need to be observed
5. Third Party Authorization: When authority is being granted to specific individuals or organizations to act on behalf of the parents
1. Copy of Parent's Identity Card: Certified copy of parent's KTP (Indonesian ID card) or passport
2. Copy of Child's Birth Certificate: Certified copy of child's birth certificate or relevant identification
3. Supporting Documentation: Any additional documents relevant to the specific purpose (e.g., travel itinerary, program details, medical records)
Find the document you need
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