{"text":"Q%%(\u2018 \nForm No. SW2\/7 (Continued) \nNAME AGE ADDRESS \n\/ \nBrothers or Sisters not shown \/ \nelsewhere on this form. \/ \nNAMI & RELATIGNSHIP AGE ADDRESS \nClose relatives or persons \/ \ninterested in child \nPARENTAL UNDERTAKING \nbeing the parent\/legab\u2014guasdien of ....... Ca\"@n_ .. Smm ............... Ceeiveaees \nhereby request the Highland Regional Council to receive the above child\/ren into care, under Section 15, \nSocial Work (Scotland) Act, 1968, and hereby agree that the child\/ren may receive such medical, surgical or \ndental treatment as may be deemed necessury by a registered medical or dental practitioner. I further agrec \nthat the child\/ren may be given a gencral anaesthetic if in the opinion of a medical practitioner thisis felt to be \nnecessary. \n(a) 1 understand that I am liable 1o contribute towards the cost and maintenance of the children. \n(b} I understand the law requires me to kvep the Social Work Department informed of any changes in my \ncircumstances, including change of address, and undertake to co-operate with the Highland Regional \nCouncil in formulating future plans lor the care of the child\/ren. \n(c) The contenss-of the leaflet - \u201cA Li -\u20acar ave Tcen-fully explain\u00e9d to me-bythe-Hightand \nRegionl Co __unczls\u2018_ wo\u00abo\/@H. - : \nSIBNEA e vnreerener e e e ? Ao, \/Xao\/;\ufb02\/b ' \n+ Father\/Mother\/Legal Guardian \nAddress ..... 34\u2018%&%0[{&0;% ......... \nRelationship to Child\/ren .............L..5%\u00a2 et ... iearesaiaaa, \nDatcnga'rf\u2019{ ..... ? L. \nWitness ....... M %W\u00e9c\u2019\u00e9{\ufb02, ......... Veeeeenn \nDesignation ................ 5W W% e 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