District No.

In the matter of ......... a child

Name (if known) or description

....... Applicant

of .........

........ Respondent

of ..........

WHEREAS ON APPLICATION by the .......... Health Board, made under section 18 (1) of the above-mentioned Act, the Court on the ... day of .... 19... made a care order committing the above-named child to the care of the board for the period from the ... day of .....19.... to the ... day of ..... 19....

NOW, THE COURT on the application of the applicant herein for an order under section I8 (2) of the Act extending the operation of the care order,

being satisfied that notice of the application was duly served,

having heard the evidence tendered herein,

being satisfied—

that grounds for the making of a care order continue to exist with respect to the child,

and

that the welfare of the child so requires,

HEREBY ORDERS that the operation of the care order with respect to the above-

named child ......... be extended for a further period of ..... from the ... day of ..... 19.... to the ... day of ..... 19...

Dated this ... day of ........ 19....

Signed ............

Judge of the Children Court