I, (Husbands Name) give my ex-wife who has joint custody , permission to travel with (Name of child) on Oct 6, 2001 for the purpose of a cruise upon Carnival's Jubilee. Itsí itinerary is as such:
(Give a itinerary of cruise)
We also give permission for (son or daughter) to be treated medically if necessary before, during or after this cruise. I am fully aware and grant my consent.