1. The Licensee shall proceed to 15, Buckingham Street, Strand, W.C. and shall not without the consent of the Society or person under whose charge he has been placed, remove from that place or such other place as may be named by the Society or person.
2. He shall obey such instructions as he may receive with regard to punctual and regular attendance at employment or otherwise; he shall report himself periodically, either personally or by letter, if required to do so; he shall not change his address without permission.
3. He shall abstain from any violation of the law, shall not associate with persons of bad character, and shall lead a sober and industrious life to the satisfaction of the Borstal Association.
Attention is directed to the following Provisions of "The Prevention of Crime Act, 1908."
Section 5. (3) A licence under this section may be revoked at any time by the Prison Commissioners, and where a licence has been revoked the person to whom the licence related shall return to the Borstal Institution, and if he fails to do so may be apprehended without warrant and taken to the Institution.
(4) If a person absent from a Borstal Institution under such a licence escapes from the supervision of the Society or person in whose charge he is placed, or commits any breach of the conditions contained in the licence, he shall be considered thereby to have forfeited the licence.
(6) The time during which a person is absent from a Borstal Institution under such a licence shall be treated as part of the time of his detention in the Institution; provided that where that person has failed to return to the Institution on the licence being forfeited or revoked, the time which elapses after his failure so to return shall be excluded in computing the time during which he is to be detained in the Institution.
I hereby acknowledge that I am aware of the above-named conditions, &c., which have been explained to me.
Inmate.
Governor.