Check all that apply
a. Every
from
am/pm to
am/pm.
b.
Each weekend or
Alternating weekends.
Friday at __________ am/pm to Saturday at __________ am/pm
Friday at __________ am/pm to Sunday at _________ am/pm
Saturday at ________ am/pm to Sunday at __________ am/pm
Saturday at ________ am/pm to Saturday at ________ am/pm
Sunday at _________ am/pm to Sunday at ________ am/pm
c. Major holidays shall be divided as follows:
Major holidays
Even-numbered years
Odd-numbered years
New Years Day
Easter
Memorial Day
4th of July
Labor Day
Thanksgiving Day
Christmas Eve
Christmas Day
Other:
_
(including other special days, holidays and
/or religious observances)
d. Extended school vacation periods such as summer vacation, spring break, winter break and
Thanksgiving weekend (be specific as to start and end times):
e. When there is a conflict between holiday visitation and other visitation periods, the provision for
holiday visitation shall control with no requirement for makeup visitation. Unless otherwise
Specified, holiday visitation shall begin on the holiday at: ____ am/pm and end at ____ am/pm.
f. Mother’s Day shall always be with mother and Father’s Day shall always be with father.
g. Other
___.
3. This visitation agreement commences on: _________________
(date)
4. Visitation Transportation
Each parent shall provide transportation one-way for visitation, or
shall provide all transportation for visitation, or
Other arrangements
.
Part C. Custody and Visitation Rules
General
1. Each parent shall promptly give to the other parent any information received concerning the
child(ren)’s education, including but not limited to parent/teacher conferences, school club meetings,
school programs, athletic schedules, and other school activities in which the child(ren) is/are engaged.
2. Each parent shall refrain from discussing the conduct of the other parent in the presence of the
child(ren).
3. Under no circumstances shall the question of child support, either as to the amount or as to the
manner of transmission of payment, be raised in the presence of the child(ren).
4. Each parent shall advise the other as soon as possible if he or she is unable to keep the planned
visitation with the child(ren).
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174-CSR202 (R04-06)