Leaving Child with Grandparents Letter [Sample]

Learn how to write a leaving child with grandparents letter. Use our sample leaving child with grandparents letter as a template for your letter.

Leaving Child With Grandparents Letter Sample

[William and Elizabeth Smith]
[120 Jisco West Rd.]
[Jackson, Ohio 45640]


[Kimberly and Jamie Harr]
[98745 St. Rt. 149]
[Rosemount, Ohio 45662]

Re: Leaving child with grandparents consent

From [DATE till DATE], [William and Elizabeth Smith] give temporary custody of their daughter, [Andrea Ford], to grandparents, [Jamie and Kimberly Harr]. 

This temporary guardianship letter will serve as a legal and binding document that will allow them to obtain medical treatment and to make any decisions regarding the needs of the child for this period.

[William and Elizabeth] will be in [Europe] on business for the dates listed above. They will not be able to provide medical treatment and see to the needs of their child during these time periods.

Trusting in good faith, [Jamie and Kimberly Harr], they allow temporary guardianship so they may make decisions regarding their child’ care.

The address of the hotel that the Smith’s will be stay in is [7890 Piccadilly Square, London, England]. The phone number there is [+44 20 8988 8300].

Since London is five hours ahead of the United States, consideration must be made when calling.

The child’s medical doctor is [Jill Neff at McCarty Lane Pediatrics in Jackson]. Their phone number is [555-286-5245]. [Adreauna’s dentist is Dr. Rebo at Rebo Health Professionals] , and the phone number is [555-286-0989]. A copy of this letter will be on file at both locations.


[William and Elizabeth Ford]

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