Parenting Plan

Parenting Plan.pdf This form is used when coming to terms with the custody of the minor children in the marriage.Download

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                        COUNTY SUPERIOR COURT FAMILY DIVISION	 	
                                                                 
 
Petitioner: ___________________________________ 
 
Respondent: _________________________________ 
 
Civil Action # _____________________               
 
 	
 
PARENTING PLAN 
 	
  This is an agreement between _________________________________ and 
______________________________________, the parents of the minor child(ren) 
whose names and birthdates are as follows: 
 
NAME        BIRTHDATE 
 
______________________________________   ____________________ 
 
______________________________________   ____________________ 
 
______________________________________   ____________________ 
 
______________________________________   ____________________ 
 
______________________________________   ____________________ 
 
______________________________________   ____________________ 
 
______________________________________   ____________________ 
 
  
By signing below, the parties recognize that: 
 
A)  a close and continuing parent-child relationship and continuity in the child(ren)’s  life will be in the child(ren)’s best interest; 
 
B)  the child(ren)’s needs will change and grow as the child matures; 
  C)  each parent shall make decisions regarding the day-to-day care of a child while  that child is residing with that parent, including any emergency decisions 
affecting the health or safety of a child; decisions that affect the other parent’s 
parenting time shall be communicated promptly; and 
 
D)  both parents will have access to all of the child(ren)’s records and information,  including but not limited to, education, health, extra-curricular activities, and 
religious communications.

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SET FORTH BELOW THE AGREEMENT OF THE PARTIES ON EACH OF THE 
ISSUES	
 LISTED. 
 
LEGAL CUSTODY	
  
______________________________________________________________________ 
______________________________________________________________________
______________________________________________________________________ 
______________________________________________________________________ 
______________________________________________________________________ 
 
 
 PRIMARY PHYSICAL CUSTODY	
  
______________________________________________________________________ 
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________ 
______________________________________________________________________ 
______________________________________________________________________ 
 
 
MAJOR DECISIONS	
 
 
The parties will consult each other and attempt to arrive at consensus on major 
decisions. Should they be unable to reach consensus final decisions will be made as 
follows: 
 
Non-emergency health care    ( ) mother    ( ) father   
Education          ( ) mother    ( ) father   
Religious upbringing      ( ) mother    ( ) father   
Extracurricular activities      ( ) mother    ( ) father   
____________________      ( ) mother    ( ) father   
____________________      ( ) mother    ( ) father  
____________________      ( ) mother    ( ) father 
____________________      ( ) mother    ( ) father 
  
 
PARENTING SCHEDULE	
  
 
If the parties cannot otherwise agree, during the term of this parenting plan the non-
custodial parent, or in joint custodial arrangements the ( ) mother or ( ) father), shall have 
at a minimum the following parenting time: 
 
( )  First and third weekend of each month 
( )  First, third and fifth weekend of each month 
( )  Second and fourth weekend of each month 
( )  Every other weekend starting on _________________________________________ 
______________________________________________________________________. 
( )  Each _________________________________ starting at _____am/pm and ending 
at ________ am/pm.

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( )  Other: ______________________________________________________________ 
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________ 
( )  Weekday time 
  ( ) None 
  ( ) Every _____________________evening. 
  ( ) Every other ___________________evening during the week prior to a non-
 visitation weekend 
  ( ) Every _____________ and ____________ evening.   
  ( ) Other: _________________________________________________________ 
______________________________________________________________________
______________________________________________________________________  
______________________________________________________________________ 
 
For purposes of this parenting plan, a weekend will start at ______am/pm on (circle one) 
Thursday/Friday/Saturday/Other: ______________________ and end at _____am/pm 
on [Sunday/Monday/Other: _______________________________________________. 
 
Weekday time will begin at _____am/pm and will end at (circle one) 7:00pm./8:00pm/ 
______pm/when the child(ren) return(s) to school or day care the next morning/ 
Other: _________________________________________________________________ 
______________________________________________________________________. 
 
 
This parenting schedule begins (check one): ( ) _____________________________ 
or ( ) on the date of the Court’s Order. 
 
                                                              
FALL VACATION	
  
 
The day to day schedule shall apply except as follows: __________________________ 
______________________________________________________________________ 
______________________________________________________________________ 
______________________________________________________________________ 
_____________________________ beginning on _____________________________.  
 
 
WINTER VACATION	
 
 
The ( ) mother ( ) father shall have the child(ren) for the first period from the day and 
time school is dismissed until December __________at ______am./pm in ( ) odd 
numbered years ( ) even numbered years ( ) every year.  The other parent will have the 
child(ren) for the second period from the day and time indicated above until 
_____________________________ at __________ am/pm.  The parties shall alternate 
the first and seconds periods each year. Or the parties choose a different winter vacation 	
plan as set out here	: 
______________________________________________________________________
______________________________________________________________________ 
______________________________________________________________________ 
______________________________________________________________________.

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SPRING VACATION	:  The day to day schedule shall apply except as follows: 
______________________________________________________________________
______________________________________________________________________ 
______________________________________________________________________ 
______________________________________________________________________
______________________________________________________________________
_____________________________beginning ________________________________. 
 
 
SUMMER VACATION
: 	The day to day schedule shall apply except as follows: 
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________ 
______________________________________________________________________ 
_______________________________beginning ______________________________.  
 
 
NOTICE:    Parents will confer with each other by_________________________ 
each year to confirm school breaks/vacations and by_________________________ 
to determine summer parenting schedule. 
 
 
SPECIAL DAYS AND HOLIDAYS	
:   Indicate whether the child(ren) will be with the 
parent in ODD or EVEN numbered years or EVERY year:   
 
 
           MOTHER      FATHER      START/STOP TIME 
Martin Luther King Day 
                     	
President’s Day 
    
Mother’s Day 
    
Memorial Day 
    
Father’s Day 
    
July Fourth 
    
Labor Day 
    
Halloween 
    
Thanksgiving Day and 
Friday     
Child(ren)’s Birthday 
    
School Free Days 
    
Mother’s Birthday 
    
Father’s Birthday 
    
Religious Holidays: 
    
 
    
 
    
Other:

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Schedule Conflicts:   When holiday parenting times conflict with extended/summer 
parenting time (choose one): 
  ( ) holiday schedule will be observed 
  ( ) extended visitation will be uninterrupted 
  ( ) other: _________________________________________________________ 
 
If there is conflict between the regular schedule and the holiday schedule, the holiday 
schedule will prevail. 
 
For the purposes of this parenting plan, the holiday will start and end as follows (choose 
one): 
( ) Holidays that fall on Friday will include the following Saturday and Sunday 
( ) Holidays that fall on Monday will include the preceding Saturday and Sunday 
( ) Other:  ______________________________________________________________ 
______________________________________________________________________ 
______________________________________________________________________. 
 
 
TRANSPORTATION ARRANGEMENTS	
 
 
Exchanging the child(ren) between parents shall take place as follows: 
______________________________________________________________________ 
______________________________________________________________________
______________________________________________________________________ 
______________________________________________________________________ 
 
Payment of long distance transportation costs, if applicable, will be paid by (choose 
one): 
( ) mother    ( ) father     ( ) both equally 
 
Long distance for purposes of transportation is defined as: 
______________________________________________________________________ 
______________________________________________________________________. 
 
Other transportation arrangements: (Ex: disabled parent, parent without valid driver’s 
license, other approved transporters, etc.) 
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________ 
______________________________________________________________________ 
 
Should the parent picking up the child(ren) exceed a ________ minute grace period 
without prior notification or alerting the other parent by phone of an unavoidable 
breakdown or delay en route, the parenting time for that period is forfeited.   
 
Should either party repeatedly cause delay by not having the child(ren) prepared for 
exchange or being late for pick-up or return, a modification of parenting time may be 
sought.  Repeatedly causing delay is defined as: _______________________________ 
______________________________________________________________________ 
______________________________________________________________________  
______________________________________________________________________

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RELOCATION	 
 
If either parent decides to relocate more than ______ miles away from the other parent’s 
home, the moving parent will give the other parent written notice of the intent to relocate 
no less than (choose one) ( ) 30 days  ( ) 60 days  ( ) 90 days  ( ) 180 days prior to the 
date of moving. 
 
 
COMMUNICATION ACCESS	
 
 
The parents agree that when the child(ren) reside with one parent, the other parent will 
have the right to unimpeded telephone conversations with the child(ren) as follows 
(check all that apply): 
 
( ) Unrestricted telephone access during reasonable hours and of reasonable duration. 
( )  ______ telephone calls to the child(ren) per day/week with the duration of each call 
not to exceed ______minutes within the following time consideration:______________ 
_____________________________________________________________________. 
( ) The child(ren) are allowed to call either parent at any time. 
( ) Other agreed provisions for telephone/email access: _________________________ 
______________________________________________________________________
______________________________________________________________________ 
 
   
OTHER PARENTING TIME PROVISIONS/AGREEMENTS	
 
 
 
( ) Each parent shall promptly notify the other parent of a change of address, phone 
number or cell phone number so that the other parent may exercise their parenting time, 
notify the other parent as needed, and reach the child(ren) while they are in the other 
parent’s household. 
 
 
( ) When making childcare arrangements while the child is with them, parents agree to 
the following (Ex: age before child(ren) will be left alone, appropriate caregivers, right of 
first refusal to provide care, etc.): 
______________________________________________________________________
______________________________________________________________________ 
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________ 
 
( ) Excluding any agreed limitations on access rights below, both parents will have 
access to child(ren)’s records and information, including but not limited to, education, 
health, extracurricular activities and religious communications. 
Agreed limitations: 
______________________________________________________________________ 
______________________________________________________________________
______________________________________________________________________ 
______________________________________________________________________

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( ) Mother ( ) Father will notify school authorities where child(ren) are enrolled each year 
to list both parents to receive all notifications, reports. 
 
( ) Each parent shall promptly notify the other parent of any information received through 
the child(ren) concerning parent meetings, reports or school activities in which the 
child(ren) may be engaged or interested.  
   
( ) Parents will consult with each other prior to scheduling any activity that will impact 
time the other parent spends with the child(ren). 
 
Additional agreements:  
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________ 
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________ 
______________________________________________________________________ 
______________________________________________________________________ 
 
 
 
SUPERVISED PARENTING TIME	
 
 
  
( ) Supervised parenting time shall apply during the day-to-day schedule as follows: 
 
Place: ________________________________________________________________ 
______________________________________________________________________ 
______________________________________________________________________ 
 
 
Person/Organization supervising: ___________________________________________ 
______________________________________________________________________ 
______________________________________________________________________ 
 
 
Responsibility for cost:  ( ) Mother   ( ) Father   ( ) both equally 
 
 
Any transition to alter supervised parenting would require ________________________ 
______________________________________________________________________ 
______________________________________________________________________ 
______________________________________________________________________ 
______________________________________________________________________
______________________________________________________________________.

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MODIFICATION OF PLAN 	 
 
Over time, as the child(ren)’s and families circumstances/needs change, parties may, by 
mutual agreement , vary the parenting schedule.  Such altered agreements shall not be 
a binding Court Order and custody shall only be modified by Court Order. 
 
( ) Prior to involving the Court in resolving disagreements, parties will attempt further 
mediation, consultation with a child specialist/family counselor or __________________ 
______________________________________________________________________.  
 
 
 
I have read, understand and agree to each of the provisions of this Parenting Plan 
Agreement, this ______day of _____________________, 20________.  
 
_______________________________    
PETITIONER        
 	
Sworn and subscribed before me this the       
____ day of _________________, 20____.       
 
 
______________________________ 
NOTARY PUBLIC       
My commission expires:     	
 
 
 
 
I have read, understand and agree to each of the provisions of this Parenting Plan 
Agreement, this ______day of _____________________, 20________.  
 
_______________________________ 
RESPONDENT 
 	
Sworn and subscribed before me this the 
____ day of _________________, 20____. 
 
 
______________________________________ 
NOTARY PUBLIC 
My commission expires: