Form 67.39—B
	
Rule 67.39(2)
	
FORM OF CONSENT OF CHILD UNDER SECTION 84(1) OF THE ADOPTION AND CHILDREN (SCOTLAND) ACT 2007
	
	In the petition of …………………………………………………….
	
	(insert name and address of petitioner)
	
	I (full name of child) confirm that I understand the nature and effect of the permanence order for which the petitioner has applied in respect of me. I consent to the making of such an order
	
	I have signed this consent at (place of signing) on the ……… day of …………….
Two thousand and ………………..

	(signature)

This consent was signed in the presence of:-
	
	(signature of reporting officer)

[Full name of reporting officer]

Address