Petition

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  • NOTE: Please fill out the below fields that has an *


    for

    Child Custody/Access Mediation Program, State of ________________

  • Parenting Agreement

  • , Mother or Father, and Defendant/Respondent, have reached an equitable agreement on a Parenting plan for our child/child(ren), whose name(s) and dates of birth are as follow,
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  • This Parenting Agreement represent in good faith the best interest of our child/child(ren).

    We understand that this is a draft of an agreement, also we agree that this draft cannot be enforced by either of us until the provisions have been ordered by the Court.

    1. Physical Custody and Access, determining where our child/child(ren) will live and spend time.


    A. Custody Option, please check below:
  • except during the times described/outlined in the Access Schedule session below.

  • 2. Access Schedule

  • during:
  • am/pm.

  • Weekends

  • Additional Times and Days, as Parents/Guardians, we agree that our child/child(ren) will be in the care of
  • at these additional times and days during the year.

  • Planning ahead and making sure the schedule accommodates, and works well for our child/child(ren):


    A. Parent/ Guardian have agreed between each other, giving a 48-hour notice of any change in the timeframe that the parent/guardian will pick-up, and return our child/child(ren). However, if an emergency should occur, as a parent/guardian, we both have agreed to contact the other parent/guardian immediate.

    B. As Parents/Guardians, if any changes must occur, we have agreed to talk to each other directly without sending messages thru our child/child(ren).

    C. As Parents/Guardians, we agreed upon picking our child/child(ren) up and returning them on time, implementing a twenty-minute grace period and will call ahead for an early arrival.

    D. We will both agree, as Parent/Guardian, to be respectful of each other’s time allowed with our child/child(ren). We will both agree to make a conscious effort not to schedule appointments, activities, or any other unknown events for our child/child(ren) during the other Parent/Guardian allowed time without an agreement in advance upon notification to the other Parent/Guardian.

    D. We will both agree, as Parent/Guardian, to be respectful of each other’s time allowed with our child/child(ren). We will both agree to make a conscious effort not to schedule appointments, activities, or any other unknown events for our child/child(ren) during the other Parent/Guardian allowed time without an agreement in advance upon notification to the other Parent/Guardian.

    F. As Parent/Guardian, we will both agree to be attentive to our child/child(ren) activities and interest, for example, sports, school activities, doctor’s appointments, cultural events, dancing lesson, music recitals, religious activities, extra-curricular activities, social events, club activities, and gatherings. Also, Parent/Guardian will both agree to attend these events when warranted.

    3. Legal Custody Decision:

  • As Parents/Guardians, we will discuss and implement all major issue concerning our child/child(ren), on education, health, religion, and all other important issue. If an issue cannot be solved, both Parents/Guardians have agreed to mediate in order to solve the issue, in the best interest in our child/child(ren).
  • However, if we are not able to reach a definitive agreement, the Parent/Guardian who has physical custody of our child/child(ren), on important matters such as, education, health, religion, recreation, will ultimately make that decision.
  • Parent/Guardian, he/she will make the final/conclusion, the concerns of our child/child(ren) on health, religion, education, recreation, and all other important matters. In addition, as a legal Parent/Guardian

  • has agreed to inform and discuss all concerning issue of our child/child(ren) to the other Parent/Guardian on a regular basic as time permits.

    4. Sharing informative Information, and decision about our child/child(ren) routinely.


    As a Parent/Guardian while the child/child(ren) is in our care, we both agreed that each Parent/Guardian has the authority, on deciding, on a daily routine but must inform each other Parent/Guardian, on minor health problems, injuries, television shows, rules, discipline, and bedtime

    Education, Childcare, and Daycare


    Both Parents/Guardians have agreed that all school, information should be sent to both Parents/Guardians, adding both Parents/Guardians have all information pertaining to schools or daycare such as reports, and activities would be shared between both Parents/Guardians.

    Emergency Contact


    Both Parents/Guardians have agreed to be on our child’s/child(ren’s) emergency contact information form pertaining to schools, and daycare. Both Parent/Guardian names should be signed and appear on all emergency contact information. If one Parent/Guardian receives emergency information on our child/child(ren), the other Parent/Guardian should be notified as soon as possible.

    Care coverage when a child/child(ren) is sick or injured


    In an occurrence, if our child/child(ren) is too sick to attend daycare or school, the Parent/Guardian who has present care for that child/child(ren) would be responsible in taking that child/child(ren) to seek medical attention and provide care for that child/child(ren). Once a sick schedule is determined, the other Parent/Guardian will be notified about the child/child(ren) illness. Also, if the child/child(ren) becomes sick or injured while attending daycare or school, the Parent/Guardian who picks that child/child(ren) up from school or daycare must provide care.

    Extra-Curricular Activities


    As Parents/Guardians, we have both agreed that our child/child(ren) will not participate in any extra-curricular activities that will interfere with the other Parents/Guardians schedule, unless in advance, with the agreement of the other Parent/Guardian, and with both agreeing that this extra-curricular activity is doable.

    Emergency Medical Healthcare Decision


    As Parent/Guardian, we both agreed in an emergency, when necessary, that both Parents/Guardians give their permission for our child/child(ren) for emergency surgery or other necessary medical care as needed. Also, if one Parent/Guardian is unaware of the medical problem, the other Parent/Guardian must notify that Parent/Guardian as soon as possible, for all medical problem or problems. Both Parents/Guardians have agreed to follow all procedures required, for our child/child(ren) and notify the other Parent/Guardian as soon as possible from the hospital if that Parent/Guardian is not aware of the medical emergency problem. Both Parents/Guardians have agreed for our child/child(ren) to be provided with medical insurance for our child/child(ren)’s safety and health.

    Routine Medical Decision, and Agreements


    As Parent/Guardian, we both agreed to follow our child/child(ren)’s healthcare provider, pediatrician, doctor or providers, medical advice. As Parent/Guardian, we will both receive all medical documentation copies and medical records concerning our child/child(ren). We both have agreed to provide medical insurance for our child/child(ren) and absorb all medical cost pertaining to our child/child(ren)’s welfare.

    Extraordinary/Astounding Medical Decisions


    As Parents/Guardians, we both agreed to share all extraordinary/astounding medical decisions, from beginning, and continue medical treatment, of our child/child(ren) upon being gravely ill or injured, and all decision on a diagnosis will be discussed and shared, pertaining to all decisions, that will be made and concluded by both Parents/Guardian. Also, if we cannot agree, Parent/Guardian who has custody will make that decision, and if joint custody exist, the medical issue will be resolved in mediation.

    5. Family Communication and Conveying

    A. Communicated Verbally with each other


    Contact Information to be shared. As a Parent/Guardian, we both agreed to share our home phone, work phone, cell phone, as well as email address, pertaining to our child/child(ren)’s perspective. As Parents/Guardians, we will return all messages to the other Parent/Guardian as soon as possible, whether in person or via home phone, cell phones, and all other communication devices for our child/child(ren)’s welfare and safety.

    Parent/Guardian schedule conservation


    As Parent/Guardian, we have both agreed to have scheduled conservations on topics concerning our child/child(ren) with each other, on a scheduled regular basis. Engaging in a regular conservation as Parents/Guardians, we will agree upon a timeslot, in choosing an appropriate time where both Parents/Guardians are well rested and free from no interruptions, and our child/child(ren) will not overhear subjects of our discussion.

    Topics that are off limits


    As Parents/Guardians, we both agreed not to discuss our personal affairs, finance as well as any joint parenting decisions that have not been discuss with ourselves or within hearing range of our child/child(ren).

    Problem to resolve


    As Parents/Guardians, we have both agreed that we can end a conversation/discussion if and when a subject changes, involving our child/child(ren) within a disagreement that we cannot revolve.

    6. Communicating with our child/child(ren)

    Communication Encouragement


    As Parent/Guardian, we both agreed that our child/child(ren) will be able to call either Parent/Guardian at any time. We both encourage open communication between our child/child(ren), and Parents/Guardians on all subjects at any time. Also, we encourage extended family contact, visit, letters and phone calls to grandparents, relatives, and extended family members.

    Child/child(ren) Disciplining


    As Parents/Guardians, we have both agreed that our child/child(ren) will only be discipline or punish by us for misbehavior. If we do not agree on the punishment implemented by the other Parent/Guardian, we will try to discuss it with each other for an effective solution to improve the behavior of our child/child(ren). Upon not being able to resolve a solution in disciplinary action, we as Parents/Guardians will need a mediator or therapist in resolving the disciplinary problem.

    An agreement of both Parents/Guardians not to:


    Transport/Rely, as our child/child(ren) any and all messages either verbally or written or sent or delivered to the other Parent/Guardian.

    As Parents/Guardians, we have agreed not to advise our child/child(ren) to keep secrets from the other Parents/Guardians.

    As Parents/Guardians, we have agreed not to question our child/child(ren) about information pertaining to the other Parents/Guardians household or friends.

    As Parents/Guardians, we have both agreed not to persuade, encourage, or convince our child/child(ren) to dispute/challenge the authority of the other Parent/Guardian, in order to request a change of custody or to withstand/release spending their schedule time with the other Parent/Guardian.

    As Parents/Guardians, we have agreed verbally or motioning, that might reduce our child/child(ren)’s love affection, respect, and friendship for the other Parent/Guardian, nor we will allow friends, relative, or other outside entities to do so.

    7. Vacations and Holidays


    Holidays and Vacations may interrupt Parenting/Guardian schedules. Once holidays and vacations are done, the schedule will resume's from the point where it was interrupted.
  • We as Parents/Guardians have agreed to share holidays, special days, and vacations, taking into consideration the best interest of our child/child(ren). As Parents/Guardians, we understand this schedule is not formal, and can be unpredictable, but as Parents/Guardians, we believe that we can work the schedule out, to avoid unnecessary problems in the future

  • We have agreed to share vacations, all holidays, spring breaks, winter breaks, birthdays, Father’s Day, and Mother’s Day according to schedule that has been pre-arranged, according to the following schedules.

    Alternating schedules pertaining to our agreement.

  • the following day.
  • As Parents/Guardians, we both agreed, odd number years, the other Parent/Guardian will provide care on these holidays during this time.
    List Holidays that apply:

  • Vacations and Holidays continue

    In each even number year, the mother/father
  • will provide care for our child/child(ren) from
  • the following day. In odd numbered years, the other Parent/Guardian will provide care on these holidays during the times.

  • Schedule Split

  • Alternating schedules that have been split.

    As Parent/Guardian, we have theoretically workout a schedule as an agreement for sharing these holidays and alternating each year that allows Parent/Guardian to provide care for the child/child(ren) in the early part, and who provides care in the latter part.
  • Every year, as Parent/Guardian, we have worked out a schedule suitable for one Parent/Guardian to provide care during the following holidays every year, at the time listed below.
  • and the other half with
  • in the years ending with odd number our child/child(ren) will spend this time with, and be in care of
  • and ending at
  • starting at
  • and ending at
  • In years ending with an odd number, our child/child(ren) will spend time with and be in care of
  • starting December 31st at
  • ending New Year Day at
  • our child/child(ren) will then, be in care of
  • ending
  • in years ending with an odd number, our child/child(ren) will spend this time in care of
  • and the second half of winter break in care of with
  • In years ending with an odd number, our child/child(ren) will spend this time in care of with
  • starting at
  • and ending at
  • In years ending with an odd number, our child/child(ren) will be in care of and spending time with

  • Vacations


    As Parents/Guardians, we agreed that each of us may have our child/child(ren) in our care for up to
  • , non-consecutive or consecutive weeks of total uninterrupted vacation time, summer/year, according to this arrangement that has been implemented.
  • - As Parents/Guardians, we have agreed together to work out a solution for our child/child(ren) summer, and vacation plan including camps among other activities, no later than
  • - As Parents/Guardians, we will make a final decision about these plans no later than

  • - As Parents/Guardians, we have come to an agreement to provide each other with travel plans concerning our child/child(ren) on dates, times, carriers, phones numbers, and living arrangements such as hotels, as soon as plans and reservations are completed and become known to the traveling Parents/Guardians who has care of our child’s/child(ren)’s.

    - As Parents/Guardians, we have both agreed that the traveling Parent/Guardian, will phone or will have our child’s/child(ren)’s designated phone number, for communication purposes to the other Parent/Guardian upon the day of the arrival to that destination, as well as other times during, and throughout the vacation.

    Additional and other vacation arrangements


    As Parents/Guardians, if we have a disagreement on the vacations schedule, we both have agreed that the following rules implemented will apply.

    The Parents/Guardians
  • who may have first choice for the week of vacation with our child/child(ren) in the even number years, by giving a notice by
  • and the other Parents/Guardians may have priority in the odd numbered years by given this notice.

  • 8. Parent/Guardian, Re-Locating or Moving Outside the Area.


    If a Parent/Guardian is thinking about re-locating or moving outside the area where it would be impossible to maintain the current Parent/Guardian schedule as implemented, that Parent/Guardian must notify the other Parent/Guardian well in advance or within 50 days before a re-location or move has been implemented.

    As Parent/Guardian, an agreement, of consideration and changing our parenting agreement, so that both Parents/Guardians will spend quality-time with our child/child(ren) and participating in Parenting/Guardian decision.

    As Parents/Guardians, we have agreed that any new Parenting/Guardian schedule must support and maintain our relationship with our child/child(ren). We have agreed to use a trusted adult, family counselor or mediator to help us to re-construct any changes necessary in Parenting/Guardian agreement in meeting our new and present needs.

    9. Mediation Help and Follow-up.


    During custody of our child/child(ren), if within one year of the date of acknowledgement, custody/access order if a dispute or disagreement arrives concerning Parenting/Guardian issues, we may attend a mediation, follow-up through the Court’s, Custody/Access Mediation Program, (Under the following condition).

    - Both Parents/Guardians are willing to mediate.

    - There is mediation availability.

    - Mediation follow-up was discussed and agreed upon by both Parents/Guardians, in our original mediation session and was included in our Court-Order Parenting/Guardian plan.

    If these conditions have been implemented, we understand as Parents/Guardians, that we may attend mediation, that is conducted and scheduled by a Court Mediator at no charge. Also, we must understand that the availability of mediation follow-up is in the sole direction of the Lead Chief Custody/Access Mediator.
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