美利坚合众国驻        领事馆：

我们的孩子             ，男/女，出生于       年    月    日，护照号码：                     ，就读于                            学校。参加美洲集团主办的“2010年美之旅冬令营”活动。我们保证他遵守一切规定，听从领队老师的命令，不私自离队，不单独行动，按时回国，他在美期间的一切费用由我们承担，如出现滞留不归的现象，我们愿意承担由此引起的一切经济后果和法律责任。

父亲签字：

母亲签字：

日 期:        年    月    日

 

 

Consulate General of the United States of America in           :

Our child:              ,male/female, born on:                   ，passport No:                                , studying at                                    , will take part in the "2009 All Americas’ Winter Camp” sponsored by All Americas Exposition Inc. We promise that he/she will comply with all regulations, abide by commands of leading teachers, never disaffiliate himself/herself from the group without authorization to act separately, and return to the motherland in time. All expenses during his/her stay in the USA will be covered by us. If he/she overstays in the USA, we are willing to undertake all economic consequences and legal responsibility resulting from her action.

Signed by father:

Signed by mother:

Date: