| Full Name: | Petra Verlová |
| Date of Birth: | 1978 |
| Nationality: | Czech Republic |
| Passport No.: | ................................. |
| Address: | ................................. |
| Relationship: | Mother |
| Full Name: | Jan Verl |
| Date of Birth: | 1978 |
| Nationality: | Czech Republic |
| Passport No.: | ................................. |
| Address: | ................................. |
| Relationship: | Father |
| Full Name: | Jan Verl |
| Date of Birth: | 2009 |
| Nationality: | Czech Republic |
| Passport No.: | ................................. |
| Full Name: | Vojtěch Verl |
| Date of Birth: | 2010 |
| Nationality: | Czech Republic |
| Passport No.: | ................................. |
| Travel Period: | 18 April – 10 May 2026 (22 days) |
| Purpose: | Tourism / Holiday |
| Transport: | Commercial airline flights, campervan rental |
| Turkey (Istanbul) | 18 – 20 April 2026 |
| Thailand (Bangkok) | 20 – 22 April 2026 |
| Australia (Perth, WA) | 22 April – 5 May 2026 |
| Indonesia (Bali) | 5 – 8 May 2026 |
I, Petra Verlová, the undersigned mother and legal guardian of the above-named minor children, hereby give my full and unconditional consent for my children to travel internationally with their father, Jan Verl, to the countries listed above during the specified period.
I confirm that: (a) I am aware of and agree to this international trip; (b) I authorize Jan Verl to make all necessary decisions regarding the care, welfare, and medical treatment of the children during the trip; (c) in case of medical emergency, I authorize Jan Verl to consent to any necessary medical treatment, hospitalization, or surgical procedure; (d) I authorize the issuance of any required travel visas, including the Australian eVisitor (Subclass 651) visa, Indonesian Visa on Arrival, and any other entry permits; (e) this consent is given freely and voluntarily, without coercion or duress; (f) this consent covers all transit countries and any unscheduled stops during the journey.
| Phone: | ................................. | Email: | ................................. |
This space is reserved for notarial verification of signatures / official stamp.
Tento prostor je vyhrazen pro notářské / úřední ověření podpisů.
Notes: 1. Fill in passport numbers and addresses before signing. 2. Both parents sign before a notary or at Czech POINT. 3. Carry the original during the trip; make 2–3 copies. 4. Bring copies of birth certificates (originals stay home).