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Schedule 1

Rule 3.		FORM 1.
Originating Summons on Application for an Adoption Order 20.........., No.
In the High Court
Mr. Justice
In the Matter of A.B. [1] ....................................................................... an infant and
In the Matter of the Adoption Act
Let .............................. of .............................. within 8 days after service of this summons, inclusive of the day of such service, cause an appearance to be entered for him or her to this summons which is issued upon the application of ....................................... of ....................................... for an order—
1. That a tutor ad hoc may be appointed for the purpose of safeguarding the interests of the said ............................................................................... [2]
2. That the applicant be authorised to adopt the said .......................................
3. That the costs of this application be provided for.
Dated the day of 20 .
This summons was taken out by .............................. of .............................., Attorney-at-Law for the above-named ...................................................................
The respondent may appear hereto by entering appearance either personally or by solicitor at the Registry, High Court, Castries.
If the respondent does not enter appearance within the time and at the place above mentioned, such order will be made and proceedings taken as the judge may think just and expedient.
Notes :
[1] Enter the first name (s) and surname which the infant is to bear after the adoption.
[2] Delete this paragraph if the Attorney General has consented to act as tutor ad hoc.

FORM 2.		Rule 6.
Undertaking to pay Costs of Attorney General when Acting as Tutor Ad Hoc.
In the High Court
Mr. Justice
In the Matter of A.B. [1] ...................................................................... an infant, and
In the Matter of the Adoption Act, 10.06
In consideration of your acting as the tutor ad hoc of A. B. an infant, I, the undersigned [attorney-at-law] [1] hereby personally [jointly and severally] [2] undertake and agree that as such tutor ad hoc and as attorney-at-law for the said A.B. you will duly receive and be paid all costs, charges and expenses which may be earned or incurred by you in relation to such tutorship or the duties thereof.
Dated the .......... day of .............................. 20..........
Signed ............................................................ [3]
To— The Attorney General,
Attorney General's Chambers,
Castries.
Notes :
[1] Delete if no attorney-at-law is acting for the applicant.
[2] The words in square brackets are required only if there is more than one partner in the firm of attorneys-at-law acting for the applicant.
[3] The undertaking should be signed by the attorney-at-law, or by a partner in the firm of attorneys-at-law, acting for applicant, or by the applicant if he or she is acting in person.

Rule 7.		FORM 3.
Statement in Support of Application for an Adoption Order [1].
In the High Court
Mr. Justice
In the Matter of A.B. [1] ...................................................................... an infant, and
In the Matter of the Adoption Act.
1. I, the undersigned, C.D./We, the undersigned, C.D. and F.D. desire to adopt A.B. [2], an infant, under the Adoption Act, 1953.
2. I am/We are resident and domiciled in Saint Lucia.
3. I am unmarried/a widow/widower/I am married to E.D. of ............................../We are married to each other and are the persons to whom the attached marriage certificate (or other evidence of marriage) relates.
4. The infant is of the .............................. sex and unmarried. He/She was born on ................................................. and is the person to whom the attached birth certificate [3] relates/was born on or about the ......................................................... in ..................................[4].
5. The infant is the child/adopted child [3] of F.B. of ............................./whose last known address was ............................................................................../deceased and G.B. of ....................................................................../whose last known address was .........................................................../deceased [5].
6. The tutor of the infant is H.K. of ............................................................./The tutors of the infant are H.K. of .................................................................. and J.B. of ...............................................[6].
7. L.M. of ...................................... is liable by virtue of an order or agreement to contribute to the maintenance of the infant [7].
8. I/We attach a document/documents signifying the consent of the said ..................................................[8] to the making of an adoption order upon my/our application.
9. I/We request the judge to dispense with the consent of the said .................................. [9] on the following grounds ..................................................
10. The infant was received into my/our care and possession on the ....................................... 20..............., from ......................................................... of ....................................... and has been continuously in my/our care and possession since that date.
11. A certificate as to physical and mental health of the infant signed by a registered medical practitioner on the ....................................... 20..........., is attached [10].
12. I/We have not received or agreed to receive, and no person has made or given or agreed to make or give to me/us, any payment or other reward in consideration of the adoption [except as follows: ...............................................................................................................................
13. I have not made/neither of us has made a previous application for an adoption order in respect of the same or any other infant to any court [except an application made to the ........................... court at ................................................... on the ................................................... 20.........., which was dealt with as follows: ............................................................................................................................... ...............................................................................................................................
14. For the purposes of my/our application reference may be made to N.O. of ....................................................................................[11]
15. I/We desire that my/our identity should be kept confidential, and the serial number of this application is ......................................................[12] or [I/We do not desire that my/our identity should be kept confidential].
16. Further particulars of myself/ourselves are set out in the annex to this statement.
17. If an adoption order is made in pursuance of my/our application, it is proposed that the infant should be known as
Dated the .......... day of .............................. 20..........
....................................................................
....................................................................
(Usual Signature of applicant/ applicants).
ANNEX TO FORM 3.
Further Particulars of Applicant or Applicants
Particulars of C.D.
Name in full (Block capitals) .....................................................................................
Address .................................................................................................................
Occupation .............................................................................................................
Date of Birth ...........................................................................................................
Relationship (if any) to the infant ..............................................................................
Particulars of E.D.
Name in full (Block capitals) .....................................................................................
Address .................................................................................................................
Occupation .............................................................................................................
Date of Birth ...........................................................................................................
Relationship (if any) to the infant ..............................................................................
Notes :
[1] This statement must be verified by affidavit, to which the statement, marriage certificate and other documents referred to in the statement should be exhibited.
[2] Enter the first name [s] and surname as shown in the birth certificate referred to in paragraph 4, if available; otherwise enter name [s] and surname by which the infant was known before being placed for adoption.
[3] If the infant, has previously been adopted, a certified copy of the entry in the Adopted Children Register should be attached, and not a certified copy of the original entry in the Registers of Birth; and the particulars given in paragraph 5 should relate to the parent or parents by adoption and not to the natural parent or parents.
[4] Where a birth certificate is not attached, enter the place (including country) of birth if known.
[5] If the infant is illegitimate, the father's name should not be given in this entry; but see paragraph 7.
[6] This paragraph should be completed only if the infant has a tutor other than the father or mother of the infant.
[7] If the infant is illegitimate, enter the name of any person known to the applicant who has been adjudged by an affiliation order to be the putative father of the infant or who has acknowledged himself to be the father of the infant and agreed to contribute to his or her maintenance.
[8] The names to be entered here (or in the following paragraph) are those of the persons named in paragraphs 5, 6 and 7, and (where the application is made by one of 2 spouses alone) of the spouse of the applicant.
[9] This paragraph should be completed with the name of any of the persons mentioned in the previous note who has not signified his or her consent. See Section 5 of the Act as to the grounds on which consent may be dispensed with.
[10] This paragraph need not be completed if the applicant or either of the applicants is a “relative” of the infant as defined by section 2 of the Act.
[11] This paragraph need not be completed if the applicant or either of the applicants is a “relative” of the infant as defined by section 2 of the Act. Where it is completed more than one referee may be named if desired.
[12] If the applicant wishes his or her name to be kept 'confidential, insert serial number obtained in pursuance of rule 4 of the Adoption of Children (High Court) Rules.

Rule 7.		FORM 4.
Consent to an Adoption Order in Respect of an Infant Named A.B. [1]
Whereas an application is to be made by CD./C.D. and E.D. [2] or [under the serial number ...........................................................................];
[Whereas the said A.B. (hereinafter called the infant) is not less than 6 weeks old, having been born in ....................................... on.............................................., and is the person to whom the birth certificate [3] now produced and shown to me marked “A” relates] [4]:
I, the undersigned ................................... of .................................. being [5] —
the mother [3] of the infant/
the father [3] of the infant/
a tutor of the infant/
a person liable by virtue of any order or agreement to contribute to the maintenance of the infant/
a person (acting on behalf of a body) having parental rights in respect of the infant/
the spouse of the said C.D., hereby state as follows—
(1) I understand that the effect of an adoption order is to deprive a parent or tutor of all rights in respect of the maintenance and upbringing of the infant.
(2) I understand that, when the application for an adoption order in respect of the said A.B. is heard by the judge, this document may be used as evidence of my consent to the making of the order unless I have notified the court that I no longer consent [6].
(3) I hereby consent to the making of an adoption order in pursuance of the said application [on condition that the religious persuasion in which the infant is brought up is .......................................] [7].
........................................................
(Signature)
Signed at ............................................. on ....................................... by the said .................................................... (who satisfied me that she fully understood the nature of the foregoing statement and was prepared to surrender her child for adoption) [4].
Before me (Signature) .......................................
(Address) .......................................
(Description) [6] .......................................
Notes :
[1] Insert name as known to the consenting party.
[2] Where the name of applicant is not known to the consenting party, and a serial number has been obtained for the application under rule 4 of the Adoption of Children (High Court) Rules, complete the entry contained in the second square brackets.
[3] If the infant has previously been adopted, a certified copy of the entry in the Adopted Children Register should be attached, and not a certified copy of the original entry in the Registers of Birth; and the description of the consenting party should include the words “by adoption” where appropriate.
[4] Delete the words in square brackets except where the consenting party is the mother of the infant.
[5] Delete all but one of the descriptions which follow.
[6] If the consenting party is the mother of the infant, the document will not be admissible as evidence unless the signature is attested in the manner prescribed in section 6 of the Act. In all cases the document, if so attested, will be admissible without further proof of execution.
[7] Delete the words in square brackets if the applicant is named or if, although the applicant is not named, the consenting party does not desire to impose conditions as to religious upbringing.

Rule 8.		FORM 5.
Notice of Application for an Adoption Order in Respect of an Infant Named A.B. [1]
To ..................................................... of ...................................................... [2]
Whereas an application has been made [by C.D./C.D. and E.D.] [3] or [under the serial number .....................................................................................];
And whereas I ................................................... of ........................................ am the tutor ad hoc of the said infant;
Take notice that while the said application is pending, you must not, except with the leave of the judge, remove the infant from the care and possession of the applicant.
Application for such leave may be made to the judge.
Dated the ............... day of ...................................... 20........
(Signature of tutor ad hoc) ........................................................................
Notes :
[1] Enter the name [s] and surname as known to the person to whom the notice is given.
[2] Enter the name and address of any parent or tutor of the infant who has signified his or her consent to the making of an adoption order.
[3] The name of the applicant must not be given where a serial number is specified in Form 3 (paragraph 15). In that case complete the second entry in square brackets.

Rule 10.	FORM 6.
Notice of Hearing of Application for an Adoption Order in Respect of an Infant Named A.B. [1]
To .................................................... of ............................................................
Whereas an application has been made [by C.D./C.D. and E.D.] [2] or [under the serial number ................................................................................................];
And whereas I ......................................... of ............................................... am the tutor ad hoc of the said infant;
Take notice:
A. [3] [That the said application will be heard at the High Court, Castries, on the ............................................... 20............ at the hour of .............................. in the .......................... noon, and that you may appear to show cause why the adoption order should not be made].
B. [3] [That if you do not consent to the making of the order, you should notify me on or before ............................. 20............ in order that a date and time may be fixed for you to attend and show cause why the adoption order should not be made. The form below may be detached and used for this purpose].
Dated the .................. day of ....................................... 20........
(Signature of tutor ad hoc) .................................................
Notes :
[1] Enter the name[s] and surname as known to the person to whom the notice is given.
[2] The name of the applicant must not be given where the notice is addressed to an individual and a serial number is specified in Form 3 (paragraph 15). In that case complete the second entry in square brackets.
[3] Form A should be completed and form B struck out where the applicant does not desire his or her identity to be kept confidential (see Form 3, paragraph 15). Where a serial number is specified in that paragraph and the notice is addressed to an individual, Form A must be struck out and Form B completed.
...............................................................................................................................
To:—The Attorney General, Attorney General's Chambers, Castries.
(If the Attorney General is not the tutor ad hoc the appropriate address should be substituted).
I have received notice of the hearing of the application for an adoption order in respect of A.B. an infant. [Delete (a) or (b) below]
(a) I consent to the making of this order.
........................................ or ........................................
(b) I do not consent to the making of this order and I wish a date and time to be fixed for my attendance when I may state my case.
.......................................		.......................................
(Signature)
.......................................		.......................................
(Date)		(Address)

FORM 7.				Rule 12.
Adoption Order in Respect of an Infant
In the High Court
Mr. Justice
In the Matter of A.B.[1] ....................................................................... an infant,
and
In the Matter of the Adoption Act.
Application having been made by C.D., by occupation ..................................... .................................... resident at ......................................... and domiciled in Saint Lucia [and E.D. his wife] (hereinafter called the applicant/applicants) for an order under the Adoption Act, authorising him/her/them to adopt A.B., an infant, the child/adopted child of F.B./F.B. and G.B.;
And the said A.B. (hereinafter called the infant) being of the ........................... sex, and never having been married;
And the applicant/one of the applicants .............................. having attained the age of 25 years and being at least 21 years older than the infant/.............................. having attained the age of 21 years and being a relative of the infant within the meaning of the said Act/.............................. being the mother/father of the infant;
[And the names by which the infant is to be known being P.D.][1]
[And it having been proved to the satisfaction of the judge that the infant is identical with A.B., to whom the entry numbered ........................................ and made on the ................................... 20........... in the Register of Births for the registration district of .............................. and sub-district of ................................... in the county of .................................... relates][2];
and the [probable][3] date of the birth of the infant appearing to be the ............................................. 20..........
[And the infant having been previously the subject of an adoption order dated the .................................................................. 20............, of which particulars are entered in the Adopted Children Register][4];
And all the consents required by the said Act being obtained or dispensed with;
It is ordered that the applicant/applicants be authorised to adopt the infant;
[And the following payment or reward is sanctioned: ..............................................................................................................................]
[And as regards costs it is ordered that: ..............................................................................................................................]
And it is directed that the Registrar of Civil Status shall make in the Adopted Children Register an entry recording the adoption in accordance with the particulars set out in the Schedule to this order.
[And it is further directed that the Registrar of Civil Status shall cause the said entry in the Register of Births to be marked with the word “adopted”][2].
[And it is further directed that the Registrar of Civil Status shall cause the previous entry in the Adopted Children Register relating to the infant to be marked with the word “re-adopted”][4].
Dated the .............. day of ....................................... 20........
Schedule to Form 7
Date[5] and country of birth of child	Name and surname of child [6].	Sex of child	Name and surname, address and occupation of adopter or adopters.		Date of adoption order and description of court by which made.

Notes:
[1] Delete where there is no change of name.
[2] Delete this entry—
(a) if the infant is not identified with a person whose birth is registered in the Registers of Births in Saint Lucia;
(b) if the infant has previously been adopted.
Where the infant is identified with a person whose birth is registered in any such register other than the Registers of Births in Saint Lucia, modify the entry accordingly.
[3] Delete “probable” where the precise date of the infant's birth is proved.
[4] Delete except where the infant has previously been adopted.
[5] Where a probable date of birth is specified in the body of the order, enter that date without qualification. If the infant is one of twins, include, if possible, the hour as well as the date of birth.
[6] Where there is a change, enter only the names by which the infant is to be known.

FORM 8.	Rule 12.
Interim Order in Respect of an Infant
In the High Court
Mr. Justice
In the Matter of A.B.[1] ....................................................................... an infant,
And
In the Matter of the Adoption Act.
Application having been made by C.D., by occupation ..................................... resident at ....................................... and domiciled in Saint Lucia [and E.D. his wife] (hereinafter called the applicant/applicants) for an order under the Adoption Act authorising him/her/them to adopt A.B. an infant, the child/adopted child of F.B./F.B. and G.B.;
And the said A.B. (hereinafter called the infant) being of the ......................... sex and never having been married;
And the applicant/one of the applicants .............................. having attained the age of 25 years and being at least 21 years older than the infant/.............................. having attained the age of 21 years and being a relative of the infant within the meaning of the said Act/.............................. being the mother/father of the infant;
And all the consents required by the said Act being obtained or dispensed with;
It is ordered that the determination of the application be postponed, and the custody of the infant be given to the applicant/applicants for a period ending on the .............................................. 20 ..........., by way of a probationary period, upon the following terms, namely ..................................................................................... .............................................................................................................................. and that the applicant/applicants shall at least 2 months before that date apply for the final determination of the application;
[And as regards costs it is ordered that ............................................................. .............................................................................................................................]
Dated the ............. day of ....................................... 20........

Rule 13.	FORM 9.
Notice of Further Hearing of Application for an Adoption Order in Respect of an Infant Named A.B.[1]
To .................................................. of ..............................................................
Whereas an application has been made by [C.D./C.D. and E.D][2] or [under the serial number ..................................................................................................];
And whereas I ................................................ of .............................................. am the tutor ad hoc of the said infant;
And whereas the determination of the said application was postponed and an interim order was made by the judge on the ....................................... 20.........
Take notice:
A.[3] [That the said application will be further heard before the judge at the High Court, Castries, on the ............................................................... 20........... at the hour of .................................... and that you may appear to show cause why the adoption order should not be made].
B.[3] [That if you do not consent to the making of the order, you should notify me on or before ............................................. 20 ............ in order that a date and time may be fixed for you to attend and show cause why the adoption order should not be made. The form below may be detached and used for this purpose].
Dated the .............. day of ....................................... 20........
(Signature of tutor ad hoc) ....................................................
Notes :
[1] Enter name[s] and surname as known to the person to whom the notice is given.
[2] The name of the applicant must not be given where the notice is addressed to an individual and a serial number is specified in Form 3 (paragraph 15). In that case complete the second entry in square brackets.
[3] Form A should be completed and Form B struck out where the applicant does not desire his or her identity to be kept confidential (see Form 3, paragraph 15). Where a serial number is specified in that paragraph and the notice is addressed to an individual Form A must be struck out and Form B completed.
........................................................ Perforation ....................................................
To–The Attorney General, Attorney General's Chambers, Castries. (If the Attorney General is not the tutor ad hoc the appropriate address should be submitted).
I have received notice of the further hearing of the application for an adoption order in respect of A.B. an infant. [Delete (a) or (b)]
(a) I consent to the making of this order.
........................................ or ........................................
(b) I do not consent to the making of this order and I wish a date and time to be fixed for my attendance when I may state my case
(Signature) ............................................................
.......................................		............................................................
(Date)		(Address)