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1、无成人陪伴儿童乘机申请书（正面）无 成 人 陪 伴 儿 童 乘 机 申 请 书UNACCOMPANIED MINOR RE AIRGUILIN FOR CARRIAGE-HANDLING ADVICE儿童姓名NAME OF MINOR： 年龄AGE： 性别SEX：（包括儿童乳名-INCLUDING NICKNAME）与旅客关系RELATIONSHIP WITH PASSENGER：健康状况HEALTH：航班号FLT NO日期DATE始发站ON DEPARTURE经停/衔接站STOPOVER POINT到达站ON ARRIVAL航站STATION接送人姓名/有效证件号码NAME OF PERSO
2、N ACCOMPANYING AND VALID ID NO.电话、地址ADDRESS AND TEL.NO始发站ON DEPARTURE经停/衔接站STOPOVER POINT到达站ON ARRIVAL备注REMARK：儿童父母或监护人姓名、地址、电话号码PARENT/GUARDIAN-NAME. ADDRESS. TEL NO.：本单为一式三联：第一联为出票联，由出票单位留存；第二联为乘机联，交始发站值机部门留存；第三联为到达联，交到达站服务部门留存。This form is in triplicate: the first sheet is for issuing, kept by is
3、suing unit; the second sheet is for flight, kept by check-in department of airport of departure; the third sheet is for arriving, kept by the service department of airport of destination.无成人陪伴儿童乘机申请书（背面）声 明售票处：1、证实申请书中所述儿童在始发站、航班衔接站和到达站由我所证明的人负责接送。接送人将保证留在机场，直至航班起飞以后，以及按照航班时刻所列的航班到达时间以前抵达到达站机场。2、如果由
4、于申请书所列接送人未按规定进行接送，造成儿童无人接送时，为保证儿童的安全运输包括返回始发站，我授权承运人，可以采取必要的行为，并且同意支付承运人在采取这些行动中所垫付的必要和合理的费用。3、我保证儿童已具备有关国家政府法令要求的全部有效旅行证件。（护照、签证、健康证明书、户口簿）4、我作为申请书所列儿童的父母或监护人，同意和要求该儿童按无人陪伴儿童的规定，进行运输，并证明所提供的情况正确无误。申请人签字： 日期： DECLARATIONTo office:1. I declare that I have arranged for the minor mentioned on the rever
5、se side of this sheet to be accompamed to the airport on departure and to be met at stopover point (a) and upon arrival by the persons named. These persons will remain at the airport until the flight has departed and / or be available at the scheduled time of the arrival of the flight.2. Should the
6、minor not be met as stated on the reverse side of this sheet, I authorize the carrier(s) to take whatever action they consider necessary to ensure the minors safe custody, including return of the minor to the airport of departure, and I agree to indemnify and reimburse the carrier(s) for the necessa
7、ry and reasonable costs and expenses incurred by taking such action.3. I certify that the minor is in possession of all travel documents (passport, visa, health certificate, etc.) reair guilinired by applicable laws.4. I the undersigned father / mother or guardian of the minor mentioned on the rever
8、se side of this sheet agree to and reair guilinest the unaccompanied carriage of the minor named on the reverse of this sheet and certify that the information provided is accurate.SignatureDate填写样例：红色框内容为必填项无成人陪伴儿童乘机申请书（正面）无 成 人 陪 伴 儿 童 乘 机 申 请 书UNACCOMPANIED MINOR RE AIRGUILIN FOR CARRIAGE-HANDLING
9、 ADVICE儿童姓名NAME OF MINOR： 张三/多多 年龄AGE： 9岁 性别SEX：男（包括儿童乳名-INCLUDING NICKNAME）与旅客关系RELATIONSHIP WITH PASSENGER： 父子健康状况HEALTH： 健康航班号FLT NO日期DATE始发站ON DEPARTURE经停/衔接站STOPOVER POINT到达站ON ARRIVALGT10518月1日徐州-绵阳航站STATION接送人姓名/有效证件号码NAME OF PERSON ACCOMPANYING AND VALID ID NO.电话、地址ADDRESS AND TEL.NO始发站ON DE
10、PARTURE张XX/4587XXXXXXXX徐州市XX区XX街道XX号，手机：150XXXX经停/衔接站STOPOVER POINT-到达站ON ARRIVAL李XX/3561XXXXXXXXX绵阳市XX区XX街道XX号，手机：133XXXX备注REMARK：无特殊要求儿童父母或监护人姓名、地址、电话号码PARENT/GUARDIAN-NAME. ADDRESS. TEL NO.：父亲张XX，徐州XX区XX街道，电话158XXXX。姑姑张XX，徐州XX区XX街道，电话130XXXXX。本单为一式三联：第一联为出票联，由出票单位留存；第二联为乘机联，交始发站值机部门留存；第三联为到达联，交到达
11、站服务部门留存。This form is in triplicate: the first sheet is for issuing, kept by issuing unit; the second sheet is for flight, kept by check-in department of airport of departure; the third sheet is for arriving, kept by the service department of airport of destination.无成人陪伴儿童乘机申请书（背面）声 明售票处：1、证实申请书中所述儿童
12、在始发站、航班衔接站和到达站由我所证明的人负责接送。接送人将保证留在机场，直至航班起飞以后，以及按照航班时刻所列的航班到达时间以前抵达到达站机场。2、如果由于申请书所列接送人未按规定进行接送，造成儿童无人接送时，为保证儿童的安全运输包括返回始发站，我授权承运人，可以采取必要的行为，并且同意支付承运人在采取这些行动中所垫付的必要和合理的费用。3、我保证儿童已具备有关国家政府法令要求的全部有效旅行证件。（护照、签证、健康证明书、户口簿）4、我作为申请书所列儿童的父母或监护人，同意和要求该儿童按无人陪伴儿童的规定，进行运输，并证明所提供的情况正确无误。申请人签字： 张XX 日期：2018年X月X日
13、DECLARATIONTo office:5. I declare that I have arranged for the minor mentioned on the reverse side of this sheet to be accompamed to the airport on departure and to be met at stopover point (a) and upon arrival by the persons named. These persons will remain at the airport until the flight has depar
14、ted and / or be available at the scheduled time of the arrival of the flight.6. Should the minor not be met as stated on the reverse side of this sheet, I authorize the carrier(s) to take whatever action they consider necessary to ensure the minors safe custody, including return of the minor to the
15、airport of departure, and I agree to indemnify and reimburse the carrier(s) for the necessary and reasonable costs and expenses incurred by taking such action.7. I certify that the minor is in possession of all travel documents (passport, visa, health certificate, etc.) reair guilinired by applicable laws.8. I the undersigned father / mother or guardian of the minor mentioned on the reverse side of this sheet agree to and reair guilinest the unaccomp
