This article explains the form a nonparent can use to grant an adult caregiver the authority to make decisions for a child. I would get a notarized letter stating the grandparents have permission to act as medical surrogates in your absence.A grandparents' medical consent form allows a parent or legal guardian to hand over all responsibility regarding their child's healthcare decisions. Everything you need to write a declaration letter to the judge in your custody case: an example, a downloadable template, an outline and tips. This guide includes forms and instructions for a letter and affidavit to request that the court register an out-of-state custody order in Texas. Write a letter that I permit the school to drop off my kids without nanny or parent and I I am responsible in case something happens to my kids. I,. , parent or legal guardian of. This letter should have any special instructions ie: allergies, medications, Primary Care Physicians name and contact number. Clearly state who is authorizing the caregiver to take care of the child. The intention of this letter is to provide consent for a minor child to travel without the company of both legal parents.