Child Care Agreement - Child Awaiting Adoption (Page 3 of 4) in pdf

Child Care Agreement - Child Awaiting Adoption Page 3

Adoption Act 1984

Adoption Regulations 2008

Schedule 19

Section 45

Regulation 34

LENGTH OF THIS AGREEMENT

I understand that this agreement will no longer apply -

if I revoke my consent to the adoption of my child; or

if I revoke from the agreement at any time; or

if a specified date has passed not exceeding 6 months from the day on which this

agreement was signed; or

if all consents needed for the adoption have been given or the court has decided that

any consent is not needed; or

if the Secretary or the principal officer of the adoption agency becomes guardian of the

child or if for some other reason I no longer have a right to custody or guardianship of

the child.

EXTENSION OF THIS AGREEMENT

I also understand that the agreement cannot be extended unless I agree.

AGREEMENT TO SECRETARY OR PRINCIPAL OFFICER CARING FOR

CHILD

Please tick appropriate boxes

I consented to the adoption of my child on

⁭

_______

________________

_______

(day)

(month)

(year)

I am considering giving consent to the adoption of my child.

⁭

I agree to the Secretary of Department of Human Services or the principal officer of

⁭

(insert

______________________________________________________

name of adoption agency)

adoption agency exercising my rights and carrying out my responsibilities for the child in

the ways described in this agreement for a period of not more than 6 months.

Signature

_____________________________________________________

(of Parent, Custodian or Guardian of Child)

Date

_____________________________________________________

Child Care Agreement - Child Awaiting Adoption Page 3