Child Welfare Forms




THE NEW ZEALAND GAZETTE.

[C.W. 2.

The Child Welfare Act, 1925 (Section 20).

AGREEMENT FOR BOARDING-OUT CHILD.

AGREEMENT made this day of , one thousand nine hundred
and , between , Superintendent for the time being of the
Child Welfare Branch of the Department of Education (hereinafter with
his successors in the office of Superintendent called “the Superintendent”)
of the one part and [Name in full], of [Address], [Occupation ; if married
woman, say “wife of ” &c., adding name, address, and occupation of husband]
(hereinafter called “the said person”) of the other part:

Whereas one [Full name of child] (hereinafter called “the said child”)
is now an inmate within the meaning of the Child Welfare Act, 1925 (here-
inafter called “the said Act”):

And whereas the said person has agreed with the Superintendent to take
charge of, maintain, and train the said child:

And whereas the Superintendent is satisfied that the said person is a
suitable person for that purpose:

And whereas the approval of the Minister of Education hereto has been
duly had and obtained:

Now, therefore, in pursuance of the said agreement and of Section 20
of the said Act and in consideration of the premises it is hereby agreed by
and between the parties hereto as follows:-

  1. The said person shall take charge of the said child as from the
    day of , 192 , to the day of , 192 .

  2. If the said child shall with the approval of the Superintendent con-
    tinue in the charge of the said person after the last-mentioned date the said
    child shall be deemed to be in the charge of the said person upon the same
    terms as are herein set out, and this agreement shall continue in force
    subject to the rights of determination herein contained.

  3. The said person shall at all times during the continuance of this
    agreement lodge, board, and maintain the said child at [insert his or
    her] own cost and in [insert his or her] own home with all proper
    and sufficient meat, drink, medicine, apparel, lodging, washing, and all
    other things necessary and suitable for the said child.

  4. The said person shall use all endeavours to procure the regular school
    attendance of the said child, and shall afford all proper facilities for home
    study in accordance with school requirements, and shall personally train
    the said child in habits of physical, mental, and moral propriety and in
    habits of diligence and usefulness.

  5. The Superintendent shall pay through a postal money-order office
    to the said person for the support and maintenance of the said child the
    sum of [Amount in figures]-say, [Amount in words]-a week, computed by
    equal monthly payments from the day of , 192 , and to be
    continued so long as such child is maintained by the said person to the
    satisfaction of the Superintendent.

  6. This agreement shall be deemed to be subject to all regulations
    under the said Act for the time being in force, except in so far as such
    regulations are repugnant to the express provisions hereof.

  7. This agreement may be terminated at any time by the Superintendent
    or by the said person upon giving one week’s notice in writing to the other
    of them: Provided always that this stipulation is without prejudice to the
    right of determination conferred on the Superintendent by section 20 of
    the said Act.

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,
occupation, address].

......

Signed by the said [Name in full], in the presence of-[Witness : Name,
occupation, address].

[C.W. 3.

The Child Welfare Act, 1925 (Section 20).

AGREEMENT FOR PLACING CHILD AT SERVICE.

AGREEMENT made this day of , one thousand nine hundred
and , between , Superintendent for the time being of the
Child Welfare Branch of the Department of Education (hereinafter with his
successors in the office of Superintendent called “the Superintendent”) of
the one part and [Name in full] of [Address], [Occupation ; if married woman



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🏥 Child Welfare (Forms and Procedure) Regulations, 1926 (continued from previous page)

🏥 Health & Social Welfare
Child Welfare Act, Regulations, Forms, Procedures, Boarding-out, Service