APRIL 29.] THE NEW ZEALAND GAZETTE.

woman, say "wife of," &c., adding name, address, and occupation of
husband], (hereinafter called "the parent") of the other part:
Whereas the parent is [Delete descriptions not required]—
One of the parents
The guardian
The person having for the time being the custody or control
of [Full name of child] (hereinafter called “the said child”).
And whereas the parent has made application to the Superintendent
and the Superintendent has agreed to assume control of the said child
pursuant to the provisions of section 12 of the Child Welfare Act, 1925,
for the period and upon the terms hereinafter appearing.
Now, it is hereby agreed by and between the parties hereto as follows :—

1. The Superintendent shall have control of the said child as from the
   day of , 192 , to the day of 192 , both
   dates inclusive :
   Provided always that the Superintendent may at any time, at the cost
   of the parent, deliver up the said child or by notice in writing to the parent
   call upon the parent to assume control of the said child, and thereupon this
   agreement shall be deemed to terminate, but such termination shall be
   without prejudice to any claim the Crown or the Superintendent may have
   against the parent for arrears of maintenance, medical and dental treatment,
   clothing, travelling-expenses, and any other expenses of whatsoever nature.
2. The parent shall pay to the Superintendent for the maintenance
   of the said child the sum of [Amount in figures]—say, [Amount in words] a
   week, to be computed from the , day of 192 , and to be
   continued so long as the said child remains an “inmate” within the
   meaning of the Act.
3. The said payments shall be made weekly, and the first of such pay-
   ments shall be made on the day of , 192 .
4. The parent shall on demand refund to the Superintendent in one
   sum or by instalments to be fixed by the Superintendent all moneys expended
   by the Superintendent at his discretion on the said child by way of medical
   and dental treatment, clothing, travelling-expenses, and any other expenses
   of whatsoever nature.
5. Any such payments and moneys may be recovered at the suit of the
   Superintendent or any person authorized by him in that behalf at the time
   when the payment becomes due.
6. The parent shall in the event of the death of the said child pay the
   expenses incurred by the Superintendent of and incidental to the death of
   the said child.
7. The provisions hereinbefore contained are without prejudice to the
   rights of recovery of the moneys hereby agreed to be paid or any of them
   as a debt due to the Crown pursuant to section 44 of the said Act and
   Part VII of the Destitute Persons Act, 1910.
8. Any demand or notice to be made or given hereunder shall be sufficient
   if made in writing, signed by the Superintendent or by any person purporting
   to be an Officer of the Child Welfare Branch of the Department of Educa-
   tion on behalf of the Superintendent, and served either personally or by being
   sent by registered post addressed to the person to be served at the usual
   or last-known place of abode of such person, and shall be sufficient not-
   withstanding that such person may be deceased and may not have any
   legal personal representative appointed, and no error or omission in such
   demand shall in any way affect the validity thereof.
9. A certificate in writing signed by the Superintendent setting forth
   that any amount stated therein is due and owing to the Superintendent
   by the parent hereunder shall be prima facie evidence that the said amount
   is so owing at the date of the said certificate.
10. This agreement shall enure so as to bind the executors and adminis-
    trators of the parent, and the term “parent” wherever used herein
    shall include the executors and administrators of the parent where the
    context so requires or admits.
    In witness whereof the said parties have executed these presents the
    day and year first hereinbefore written.
    ............, Superintendent.
    Signed by [ , Deputy Superintendent for and on behalf of] the
    said Superintendent, in the presence of [Witness : Name, occu-
    pation, address].
    ..........., [As] Parent.
    Signed by the said in the presence of—[Witness : Name, occu-
    pation, address].