PARENTING PLAN

______________________________________________________________________________

Parenting Plan — April 2011 Page 1 of 10

Provided by the Chattahoochee Judicial Circuit

IN THE SUPERIOR COURT OF ________________ COUNTY

STATE OF GEORGIA

____________________________________,

Petitioner, Civil Action

vs. Case Number _____________________

____________________________________,

Respondent.

PARENTING PLAN

The parties have agreed to the terms of this plan and this information has been furnished

by both parties to meet the requirements of OCGA Section 19-9-1. The parties agree on the

terms of the plan and affirm the accuracy of the information provided, as shown by their

signatures at the end of this order.

This plan has been prepared by the __________________________ only.

This plan has been prepared by the judge.

This plan is a new plan.

modifies an existing Parenting Plan dated ____________________.

modifies an existing Order dated ___________________________.

Child’s Name Date of Birth

______________________________________________________________________________

Parenting Plan — April 2011 Page 2 of 10

Provided by the Chattahoochee Judicial Circuit

1. Custody and Decision Making:

a) Legal Custody shall be (choose one:)

with the Mother

with the Father

Joint

b) Primary Physical Custodian

For each of the children named below the primary physical custodian shall be:

Child’s Name D.O.B. Mother Father Joint

WHERE JOINT PHYSICAL CUSTODY IS CHOSEN BY THE PARENTS OR ORDERED BY

THE COURT, A DETAILED PLAN OF THE LIVING ARRANGEMENTS OF THE

CHILD(REN) SHALL BE ATTACHED AND MADE A PART OF THIS PARENTING PLAN.

c) Day-To-Day Decisions

Each parent shall make decisions regarding the day-to-day care of a child while the

child is residing with that parent, including any emergency decisions affecting the

health or safety of a child.

d) Major Decisions

Major decisions regarding each child shall be made as follows:

Educational decisions Mother Father Joint

Non-emergency health care Mother Father Joint

Religious upbringing Mother Father Joint

Extracurricular activities Mother Father Joint

______________________ Mother Father Joint

______________________________________________________________________________

Parenting Plan — April 2011 Page 3 of 10

Provided by the Chattahoochee Judicial Circuit

e) Disagreements

Where parents have elected joint decision making in Section I.D above, please

explain how any disagreements in decision-making will be resolved.

_____________________________________________________________________

2. Parenting Time/Visitation Schedules

a) Restrictions (Check if applicable)

1) No Parenting Time

The non-custodial parent shall have no contact with the children until further

court order. All parenting decisions shall be made by the residential parent.

2) Supervised Parenting Time

Whenever parenting time is exercised by the non-custodial parent as outlined

below, including day-to-day visitation and holiday or vacation visitation, it

shall be conducted with a supervisor present. Supervised parenting time shall

apply during the day-to-day schedule as follows:

Place: _________________________________________________________

Person/Organization supervising: ___________________________________

Responsibility for cost

Mother Father divided equally

b) Parenting Time/Visitation Schedules

During the term of this parenting plan the non-custodial parent shall have at a

minimum the following rights of parenting time/ visitation (choose an item):

The weekend of the first and third Friday of each month.

The weekend of the first, third, and fifth Friday of each month.

The weekend of the second and fourth Friday of each month.

Every other weekend starting on _________________________________.

______________________________________________________________________________

Parenting Plan — April 2011 Page 4 of 10

Provided by the Chattahoochee Judicial Circuit

Each _____________________ starting at ________ a.m./p.m. and ending ________

a.m./p.m.

Other: _______________________________________________________________

_____________________________________________________________________

For purposes of this parenting plan, a weekend will start at ________ a.m./p.m. on

[Thursday / Friday / Saturday / Other: _____________________ ] and end at

________ a.m./p.m. on [Sunday / Monday / Other: _____________________].

Any weekday visitation will begin at ________ a.m./p.m. and will end [______ p.m. /

when the child(ren) return(s) to school or custodial parent the next morning /

Other:_____________________].

This parenting/visitation schedule begins:

_______________________ OR date of the Court’s Order

(day and time)

c) Major Holidays and Vacation Periods

1) Thanksgiving

Define Thanksgiving vacation time:

_______________________________________________________________

2) Winter Vacation

Define winter vacation time:

_______________________________________________________________

The mother father shall have the child(ren) for the first period from

the day and time school is dismissed until December _____ at ________

a.m./p.m. 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 6:00 p.m. on the evening before school

resumes. Unless otherwise indicated, the parties shall alternate the first and

second periods each year.

______________________________________________________________________________

Parenting Plan — April 2011 Page 5 of 10

Provided by the Chattahoochee Judicial Circuit

Other agreement of the parents:

_______________________________________________________________

3) Summer Vacation

Define summer vacation time:

_______________________________________________________________

4) Spring Vacation (if applicable)

Define: ________________________________________________________

5) Fall Vacation (if applicable)

Define: ________________________________________________________

6) Other Holiday Schedule (if applicable)

Indicate if child(ren) will be with the parent in ODD or EVEN numbered

years or indicate EVERY year:

MOTHER FATHER

Martin Luther King Day _____________________ _____________________

Presidents’ Day _____________________ _____________________

Mother’s Day _____________________ _____________________

Memorial Day _____________________ _____________________

Father’s Day _____________________ _____________________

July Fourth _____________________ _____________________

Labor Day _____________________ _____________________

Halloween _____________________ _____________________

Child(ren)’s Birthday(s) _____________________ _____________________

Mother’s Birthday _____________________ _____________________

Father’s Birthday _____________________ _____________________

Religious Holidays:

_____________________ _____________________ _____________________

Other:

_____________________ _____________________ _____________________

______________________________________________________________________________

Parenting Plan — April 2011 Page 6 of 10

Provided by the Chattahoochee Judicial Circuit

7) Other extended periods of time during school, etc. (refer to the school

schedule)

_______________________________________________________________

d) Start and end dates for holiday visitation

For the purposes of this parenting plan, the holiday will start and end as follows

(choose one):

Holidays shall start at ________ a.m. on the day of the holiday.

Holidays shall end at ________ p.m. on the day of the holiday.

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: __________________________________________________________

e) Coordination of Parenting Schedules

Check if applicable:

The holiday parenting time/visitation schedule takes precedence over the regular

parenting time/visitation schedule.

When the child(ren) is/are with a parent for an extended parenting time/visitation

period (such as summer), the other parent shall be entitled to visit with the child(ren)

during the extended period, as follows:

_____________________________________________________________________

f) Transportation Arrangements

For visitation, the place of meeting for the exchange of the child(ren) shall be:

_____________________________________________________________________

The ___________________ will be responsible for transportation of the child at the

beginning of visitation.

The ___________________ will be responsible for transportation of the child at the

conclusion of visitation.

______________________________________________________________________________

Parenting Plan — April 2011 Page 7 of 10

Provided by the Chattahoochee Judicial Circuit

Transportation costs, if any, will be allocated as follows:

_____________________________________________________________________

Other provisions: ______________________________________________________

g) Contacting the child

When the child or children are in the physical custody of one parent, the other parent

will have the right to contact the child or children as follows:

Telephone

Other: _______________________________________________________________

_____________________________________________________________________

Limitations on contact

_____________________________________________________________________

h) Communication Provisions

Please check appropriate provision:

Each parent shall promptly notify the other parent of a change of address, phone

number or cell phone number. A parent changing residence must give at least 30 days

notice of the change and provide the full address of the new residence.

Due to prior acts of family violence, the address of the child(ren) and victim of family

violence shall be kept confidential. The protected parent shall promptly notify the

other parent, through a third party, of any change in contact information necessary to

conduct visitation.

3. Access to Records and Information

Rights of the Parents

Absent agreement to limitations or court ordered limitations, pursuant to O.C.G.A. § 19-

9-1 (b) (1) (D), both parents are entitled to access to all of the child(ren)’s records and

information, including, but not limited to, education, health, extracurricular activities, and

religious communications. Designation as a non-custodial parent does not affect a

parent’s right to equal access to these records.

______________________________________________________________________________

Parenting Plan — April 2011 Page 8 of 10

Provided by the Chattahoochee Judicial Circuit

Limitations on access rights:

Access to the child(ren)’s records and information outlined above poses a potential safety

concern for the child(ren) or parent; therefore, access to such documents is restricted as

follows:

________________________________________________________________________

Other Information Sharing Provisions:

________________________________________________________________________

4. Modification of Plan or Disagreements

Parties may, by mutual agreement, vary the parenting time/visitation; however, such

agreement shall not be a binding court order. Custody shall only be modified by court

order. No parent may coerce, intimidate, threaten, or harm the other parent to secure an

agreement to changes in this parenting plan.

5. Child Safety

The parents shall follow the safety rules checked below (check all rules that apply):

The following person(s) present a danger to the child(ren) and shall not be present during

parenting time: ___________________________________________________________

The child(ren) shall not be physically disciplined.

There shall be no firearms in the parent’s home, car, or in the child(ren)’s presence

during parenting time.

Neither party shall consume alcohol or illegal drugs and then operate a motor vehicle

when the child(ren) is/are in his or her custody.

Neither parent shall be intoxicated or under the influence of any controlled substance

(e.g. illegal or non-prescribed drugs) during the period of time that s/he is with the

child(ren).

The child(ren) shall not be left alone until they reach at least _______ years of age.

______________________________________________________________________________

Parenting Plan — April 2011 Page 9 of 10

Provided by the Chattahoochee Judicial Circuit

Other: __________________________________________________________________

________________________________________________________________________

6. Special Considerations

Please attach an addendum detailing any special circumstances of which the Court should

be aware (e.g., health issues, educational issues, etc.)

There has been family violence by the ____________________ against the

____________________. The safety of the victim and the child(ren) shall be the primary

focus of interactions between the abuser, the victim, and the child(ren).

________________________________________________________________________

7. Parents’ Consent

Please review the following and initial:

1) We recognize that a close and continuing parent-child relationship and continuity

in the child’s life is in the child’s best interest.

Mother’s Initials: _______________ Father’s Initials: _______________

Reason for not signing:

There has been domestic violence by the ____________________ against the

____________________ and/or minor child(ren) and a close and continuing

parent-child relationship or continuity in the child(ren)’s life is not in the

child(ren)’s best interest. O.C.G.A. §19-9-3(a)(4).

2) We recognize that our child’s needs will change and grow as the child matures;

we have made a good faith effort to take these changing needs into account so that

the need for future modifications to the parenting plan are minimized.

Mother’s Initials: _______________ Father’s Initials: _______________

3) We recognize that the parent with physical custody will make the day-to-day

decisions and emergency decisions while the child is residing with such parent.

Mother’s Initials: _______________ Father’s Initials: _______________

______________________________________________________________________________

Parenting Plan — April 2011 Page 10 of 10

Provided by the Chattahoochee Judicial Circuit

We knowingly and voluntarily agree on the terms of this Parenting Plan. Each of

us affirms that the information we have provided in this Plan is true and correct.

_____________________________________ ____________________________________

Father’s Signature Mother’s Signature

ORDER

The Court has reviewed the foregoing Parenting Plan, and it is hereby made the order of this

Court.

This ______ day of _________________, 20____.

_____________________________________

JUDGE

________________ County Superior Court