Consent Parenting Plan Form - Georgia - Edit, Fill, Sign Online

Rev. 9/2015 Page 1

IN THE SUPERIOR COURT OF FULTON COUNTY

STATE OF GEORGIA

FAMILY DIVISION

,

Petitioner,

v.

,

Respondent.

Civil Action

Case Number ______________________

CONSENT PARENTING PLAN

This is an agreement between _____________________________________ and

____________________________________, the parents of the minor child(ren) whose

names and year(s) of birth are as follows:

CHILD’S NAME YEAR OF BIRTH

______________________________________ ____________________

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 the child while

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

Rev. 9/2015 Page 2

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.

SET FORTH BELOW IS THE AGREEMENT OF THE PARTIES ON EACH OF

THE ISSUES LISTED.

LEGAL CUSTODY (choose one):

□ with the mother

□ with the father

□ joint custody

PRIMARY PHYSICAL CUSTODY

NAME YEAR OF BIRTH MOTHER FATHER JOINT

____________________ ________________ □ □ □

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.

Education □ mother □ father □ Joint

Non-emergency health care □ mother □ father □ Joint

Religious upbringing □ mother □ father □ Joint

Extracurricular activities □ mother □ father □ Joint

____________________ □ mother □ father □ Joint

DISAGREEMENTS

Where parents have elected joint decision making in major decisions section above,

please explain how any disagreements in decision making will be resolved. i.e. explain

the process parents will use when a tie breaker is needed.

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________________________________________________________________________

____________________________________________________________

PARENTING TIME

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: (choose one)

□ 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

□ 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 (circle one):_________________________.

Weekday visitation will begin at _____am/pm and will end at (circle one)

7:00/8:00pm/______pm/when the child(ren) return(s) to school or day care the next

morning/Other:__________________________________________________________

______________________________________________________________________.

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This parenting schedule begins (check one):

□ _____________________ (date and time) 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 (choose one) □ 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 (choose

one ) □ 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:

________________________________________________________________________

____________________________________________________________________

______________________________________________________________________

______________________________________________________________________.

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:

______________________________________________________________________

Rev. 9/2015 Page 5

______________________________________________________________________

_________________________________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 Holiday

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.

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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 arrangement: (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 if 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:

Rev. 9/2015 Page 7

________________________________________________________________________

__________________________________________________________________

RELOCATION

If either parent decides to relocate more than ______ miles away for the other parent’s

home, the moving parent will give the other parent written notice of the intent to relocate

no less that (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 with 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 PROVISONS/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.):

______________________________________________________________________

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______________________________________________________________________

□ Excluding any agreed limitations on access rights below, both parents will have access

to child(ren) records and information, including but not limited to, education, health,

extracurricular activities and religious communications. Agreed limitations:

________________________________________________________________________

____________

______________________________________________________________________

□ 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:

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Place:_________________________________________________________________

______________________________________________________________________

Person/Organization supervising: ___________________________________________

______________________________________________________________________

Responsibility for cost: □ Mother □ Father □ both equally

Any transition to alter supervised parenting would require_________________________

______________________________________________________________________

MODIFICATION OF PLAN

Over time, as the child(ren) and families circumstances/change, parties may, by mutual

agreement, vary the parenting schedule. Such altered agreement 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 provision of this Parenting Plan

Agreement, this ________ day of ______________________, 20______________.

_____________________________

PETITIONER

Sworn and subscribed before me this

_______ day of __________________, 20__________.

______________________________

NOTARY PUBLIC

My commission expires:

Rev. 9/2015 Page 10

I have read, understand and agree to each of the provision of this Parenting Plan

Agreement, this ________ day of ______________________, 20______________.

_____________________________

RESPONDENT

Sworn and subscribed before me this

_______ day of __________________, 20__________.

______________________________

NOTARY PUBLIC

My commission expires:

Fillable Printable Consent Parenting Plan Form - Georgia

Fillable Printable Consent Parenting Plan Form - Georgia

Consent Parenting Plan Form - Georgia