I, the undersigned, ___________________________________________________________ hereby agree to provide for _________________________________________________________ now of the age of _________________________________________ years, until the said boy shall reach the age of 18 years, according to the following terms and conditions, and with the full understanding that the Society reserves the right to remove the child previous to legal adoption if at any time the circumstances of the home become such as in the judgment of the agent are injurious to the physical, mental or moral well-being of the child.

The terms and conditions for the retention of the boy in my family being as follows: -- To care for him in sickness and health, to send him to school during the entire free school year until he reaches the age of 14 years, and thereafter during the winter months at least, until he reaches the age of 16 years; also to have him attend Church and Sunday School when convenient, and to retain him as a member of my family until he reaches the age of 17 years, and thereafter for the final year, until he is 18 years old, to pay the boy monthly wages in addition to his maintenance, the amount thereof to be previously determined after consultation with the Society's local agent and his approval. In case he proves unsatisfactory, I agree to notify the society and pending his removal, to keep him a reasonable length of time after such notice has been given. I agree, moreover, to use my best endeavor than and at all times, to detain him, should he try to leave me, until the Society can take steps for his removal. I agree to keep him at all times as well supplied with clothing as he was when I received him.

I agree to write to the Society at least once a year, and should I change my address I will notify the Society.

We take pleasure in notifying you that the little ___girl___ which you so kindly ordered will arrive at __Anytown, Rock Is. Train__ on __Thurs. January 30____ on train due to arrive at __5:15 A.M.__, and ask that you kindly be at Railway Station to receive child, 30 minutes before train is due, and avoid any possibility of missing connection, as train will not wait should you not be there.

The name of child, date of birth, and name and address of party to whom child is assigned will be found sewn in the Coat of boy and in the hem of Dress of girl.

This receipt must be signed in ink by both husband and wife, and is to be given up in exchange for child who will have corresponding number.

Yours very truly,
SISTERS OF CHARITY.

We beg to acknowledge receipt of the little orphan as numbered above and promise faithfully to raise said child in the Roman Catholic faith and to send h_____ to school and give h____ all the advantages that we would give to a child of our own, and report to Sisters of Charity as to health and general condition when requested, notifying them of any change in address.