IN THE CIRCUIT COURT IN THE EIGHTEENTH JUDICIAL CIRCUIT IN AND FOR BREVARD COUNTY, FLORIDA. Case No.: , Petitioner and , Respondent Bar Code Label SUPERVISED/SAFETY-FOCUSED PARENTING PLAN This parenting plan is: (Choose only one) [ ] A Parenting Plan submitted to the court with the agreement of the parties. [ ] A proposed Parenting Plan submitted by or on behalf of: {Parent's Name} [ ] A Parenting Plan established by the court. This parenting plan is: (Choose only one) [ ] A final Parenting Plan established by the court. [ ] A temporary Parenting Plan established by the court. [ ] A modification of a prior final Parenting Plan or prior final order. I. PARENTS Mother Name: Address: Telephone Number: E-Mail: Father Name: Address: Telephone Number: E-Mail: Law 1112 - new 10-2009 American LegalNet, Inc. www.FormsWorkFlow.com Page 2 II. CHILDREN: This parenting plan is for the following child(ren) born to, or adopted by the parties: (add additional lines as needed) Name Date of Birth Sex III. JURISDICTION The United States is the country of habitual residence of the child(ren). The State of Florida is the child(ren)'s home state for the purposes of the Uniform Child Custody Jurisdiction and Enforcement Act. The Parenting Plan is a child custody determination for the purposes of the Uniform Child Custody Jurisdiction and Enforcement Act, the International Child Abduction Remedies Act, 42 U.S.C. Sections 11601 et seq., the Parental Kidnapping Prevention Act, and the Convention on the Civil Aspects of International Child Abduction enacted at the Hague on October 25, 1980, and for all other state and federal laws. Other: IV. PARENTAL RESPONSIBILITY AND DECISION MAKING [] [] It is in the best interests of the child(ren) that the [ ] Mother [ ] Father shall have sole authority to make major decisions for the child(ren). Shared Parental Responsibility with Decision Making Authority It is in the best interest of the child(ren) that the parents confer and attempt to agree on the major decisions involving the child(ren). If the parents are unable to agree, the authority for making major decisions regarding the child(ren) shall be as follows: Law 1112 - new 10-2009 American LegalNet, Inc. www.FormsWorkFlow.com Page 3 Education/Academic decisions Non-emergency health care [ [ [ [ [ ] Mother ] Mother ] Mother ] Mother ] Mother [ [ [ [ [ ] Father ] Father ] Father ] Father ] Father [] Other: (Explain) V. TIME-SHARING SCHEDULE [] No Time-Sharing: The [ ] Mother [ ] Father shall have no contact with the child(ren) until further order of the court. All parenting decisions shall be made by the other parent. Supervised Time-Sharing: Whenever the child(ren) are with the [ ] Mother [ ] Father, the supervisor shall be present. The [ ] Mother [ ] Father has the right to spend time with the child(ren) even though the other parent will be making most, if not all, of the parenting decisions which are made on the child(ren)'s behalf. The time-sharing schedule shall be mutually agreed to between the parents, but not less than the schedule set forth below: (Choose only one) Hours per week. The place(s), and time(s) shall be set by the [ ] Mother [ ] Father. From m. to m. on the following day(s) . [] VI. SUPERVISOR AND SUPERVISION (Choose only one) 1. Supervisor: The person supervising the time-sharing shall (Choose only one) Be selected by the [ ] Mother [ ] Father Be selected by the [ ] Mother [ ] Father, subject to the other parent's approval. Other: 2. Restrictions or Level of Supervisions: . . Law 1112 - new 10-2009 American LegalNet, Inc. www.FormsWorkFlow.com Page 4 3. Costs of Supervision The costs of supervision shall be paid by the [ ] Mother [ ] Father Other: VII. LOCATION: (Choose only one) The [ ] Mother [ ] Father shall spend his/her time-sharing with the child(ren) at the following locations: Supervised visitation center (name of facility) . (location) or other location designated by the [ ] Mother [ ] Father Any location designated by the [ ] Mother [ ] Father with the approval of the supervisor. Other: VIII. DESIGNATION FOR OTHER LEGAL PURPOSES 1. The child(ren) named in this Supervised/Safety-Focused Parenting Plan are scheduled to reside the majority of the time with the [ ] Mother [ ] Father. This majority designation is SOLELY for purposes of all other state and federal statutes which require such a designation. This designation does not affect either parent's rights and responsibilities under this parenting plan. For purposes of school boundary determination and registration, the [ ] Mother's [ ] Father's address shall be designated. . . 2. IX. TRANSPORTATION AND EXCHANGE OF CHILD(REN) 1. Transportation The child(ren) shall not be driven in a car unless the driver has a valid driver's license, automobile insurance, seat belts, and child safety seats as required by Florida Law. Law 1112 - new 10-2009 American LegalNet, Inc. www.FormsWorkFlow.com Page 5 The [ ] Mother [ ] Father or a mutually agreed upon person shall be responsible for transporting the child(ren) to the exchange point. The child(ren) shall be picked up and/or returned to the exchange point by (Choose only one): [] [] [] [] 2. The [ ] Mother [ ] Father with the supervisor present. The supervisor alone. A monitored exchange location (specify) Other: . . Exchange The exchange of the child(ren) shall occur at: (Choose all that apply) [] [] [] The site of the supervised visit. Other: The [ ] Mother [ ] Father may not come to the exchange point. . IX. COMMUNICATION 1. Between Parents (Choose only one) [] All communications regarding the child(ren) shall be between the parents. The parents shall not use the child(ren) as messengers to convey information, ask questions, or set up schedule changes. [] The parents shall communicate with each other by (Choose all that apply) [ [ [ [ [ 2. ] ] ] ] ] in person by telephone by letter by e-mail Other: . Between Parent and Child(ren) The [ ] Mother [ ] Father (Choose all that apply) [] Shall not telephone, write, or e-mail the child(ren) unless the contact is agreed to in advance by the other parent. Law 1112 - new 10-2009 American LegalNet, Inc. www.FormsWorkFlow.com Page 6 [] May write or e-mail the child(ren) at any time. Each parent shall provide a contact address (and e-mail address if appropriate) to the other parent, unless otherwise prohibited by court order. May call the child(ren) on the telephone times per week. The call minutes and shall take place between shall last no more