ATTORNEY FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA COUNTY OF SACRAMENTO, JUVENILE DIVISION 3341 Power Inn Road Sacramento, CA 95826 In the Matter of CASE NUMBER: Related Dependency Case No: AGREEMENT and ORDER TO PARTICIPATE IN VOLUNTARY DEPENDENCY DRUG COURT I AGREE TO THE FOLLOWING as conditions of my participation in Voluntary Dependency Drug Court: A. I received, read and understood the Dependency Drug Court Standing Order SSC-JV-01-040. B. I understand that I am ordered to report to the STARS program located at 3600 Power Inn Rd., Suite D-3 within 48 hours of today’s date. C. I understand that I am ordered effective today not to use or consume alcohol or a controlled substance without a valid prescription in addition to all other orders in the Standing Order. D. I understand that my successful participation in the Alcohol and Drug Treatment Programs and Dependency Drug Court will be a significant factor in meeting requirements of the substance abuse aspects of my reunification case plan. E. After consultation with my attorney, I agree to participate in the Alcohol and Drug Treatment Programs and Dependency Drug Court. DATE: ___________________ ___________________________________ ►________________________________________ Print Name of Participant Signature of Participant ORDER You are hereby ordered to participate in Alcohol and Drug Treatment Programs and Voluntary Dependency Drug Court as outlined in the Dependency Drug Court Rules. You must appear for your first compliance hearing on _______________________ in Department 132 at ________________ o’clock. DATE: ___________________ ►____________________________________ Judge/Referee of Superior Court Court No: ____________________________ JC\E-310 (2/10) Agreement and Order to Participate in Voluntary Dependency Drug Court American LegalNet, Inc. www.FormsWorkFlow.com