PARENTING TIME PLAN

A parenting time plan should be consistent and reliable for your child(ren). It should also work with each parent's schedule. You can develop a plan by completing the sections below. Some common visitation options are provided to help you. Father: Sup. Ct. Case #: Mother : CUSTODY Select the parent(s) who will have legal and physical custody of the child(ren): Mother Father Joint Legal Custody – A parent’s right and responsibility to make decisions about a child’s health, education, and well-being. Physical Custody – The parent who will have the child with them the majority of the time. VISITATION SCHEDULE Father Mother is the parent exercising visitation for purposes of this plan.

If you want a flexible schedule without having set days each week, check the box below. Parents agree to reasonable visitation to be determined on an ongoing basis. If checked, you do not need to complete the rest of the Visitation Schedule section.

If you want specific days each week and holidays, select options below that work for you. 1. Weekends: Parents agree to the following weekend schedule starting :

Option 1: Option 2: Option 3:

Every other weekend Every weekend Other [specify]: from Friday 6:00 PM from Friday at 6:00 PM through Sunday at 6:00 PM. through Sunday at 6:00 PM.

2. Weekdays: Parents agree to the following weekday schedule starting :

Option 1: Option 2: Option 3:

One weekday evening One weekday overnight Other [specify]: each week on each week on from 6:00 PM from 6:00 PM through 9:00 PM. through the following day before school or 10:00 AM if child is not in school.

ParentingTimePlanAgreement.docx (Rev. 5/15/15) 1 3. Holiday/Special Days: Parents agree to the below holiday/special days. These days take precedence over the weekday/weekend schedule when they conflict.

Years Holiday/ Visitation Odd Even Special Days New Year’s Day From December 31 at 6:00 PM through January 1 at 6:00 PM. Memorial Day weekend From Friday at 6:00 PM through Monday at 6:00 PM. From July 4 at 10:00 AM July 4th through July 5 before school (or 10:00 AM, if child is not in school). Labor Day weekend From Friday at 6:00 PM through Monday at 6:00 PM. Thanksgiving From Wednesday at 6:00 PM through Sunday at 6:00 PM. From after school (or 10:00 AM, if child is not in school) Child’s Birthday through before school the next day (or 10:00 AM, if child is not in school). Other [specify]: From at through at . Other [specify]: From at through at . Other [specify]: From at through at .

TRANSPORTATION FOR VISITS Parents agree to transportation for visitation as follows: 1. Father Mother will provide transportation to the visits. Note: This parent will pick the child up from school anytime visitation starts when the school day ends. 2. Father Mother will provide transportation from the visits. Note: This parent will drop the child off at school anytime visitation ends when the school day begins. 3. Other [specify]:

ADDITIONAL TERMS Parents agree to the following additional visitation terms:

Date: Date:

Signature of Mother Signature of Father

ParentingTimePlanAgreement.docx (Rev. 5/15/15) 2 ParentingTimePlanAgreement.docx (Rev. 5/15/15) 3