of .........................

.....................Respondent

of .........................

UPON HEARING AN APPEAL brought before this Court to-day by the above-named appellant, being the *registered proprietor *person intending to be the registered

proprietor of a children's residential centre situated at .........................

in the functional area of the respondent health board and in the said court district, under section 62 of the above-mentioned Act against the decision of the board—

*(to refuse to register the centre,)

*(to remove the centre from the register,)

*[*(to attach a condition) *(to amend/revoke a condition attached) to the registration of the centre,]

made on the ..... day of ............. 19...., and

THE COURT being satisfied that notice of the appeal was duly served, having heard the evidence tendered,

*(HEREBY CONFIRMS the said decision of the respondent health board,)

*[HEREBY DIRECTS the respondent health board to

*(register the said centre,)

*(restore the registration of the said centre,)

*(withdraw the said condition) *(withdraw the *amendment to *revocation of the said condition.)

*(attach the following condition to the registration—

.)

*(made an amendment to a condition of the registration, as follows:—

.)]

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

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

Judge of the Children Court

*(assigned to the said district)

* Delete words inapplicable