Long Distance Parenting Plan (Page 12 of 32) in pdf

 The parent with the minor child(ren) shall transport the minor child(ren) to and/or from all mutually

agreed upon extra-curricular activities, providing all necessary uniforms and equipment are within the

parent’s possession.

 The costs of the extra-curricular activities shall be

 Mother _____ %

 Father _____%

Paid by:

 The uniforms and equipment required for extra-curricular activities shall be

 Mother _____ %

 Father _____%

Paid by:

 Other: ______________________________________________________________________

 No changes can occur without the written consent of both parents or court order.

 If the child(ren) attend summer camps, the costs and efforts shall be:

 Parent scheduled to have the child(ren) during that time period; or

Paid by:

 Mother _____ %

 Father _____%

6. MEDICAL

Parents shall discuss all medical, psychological, counseling, therapeutic, optical, orthodontic, dental or

other health related care and needs of the child(ren).

In the event of serious illness, accident or hospitalization affecting the health of the child(ren), the

parent with the knowledge of such event shall immediately notify the other parent.

 A parent scheduling a routine appointment for the child(ren) shall notify the other parent within 7

days, in writing, that the appointment occurred. The notice shall include the health care provider’s name

and contact information.

√ Check all that apply

 A parent scheduling a routine appointment for the child(ren) will give the other parent ____ days

notice in advance of the appointment to allow the other parent to attend.

 Uncovered medical expenses of the child(ren) shall be

 Mother _____ %

 Father _____%

Paid by:

 Uncovered dental and/or orthodontic expenses of the child(ren) shall be

 Mother _____ %

 Father _____%

Paid by:

 Uncovered psychological, counseling, therapeutic or other health related needs of the child(ren)

expenses shall be

 Mother _____ %

 Father _____%

Paid by:

√ Check all that apply

7. RELIGION

 Each parent may provide religious instruction in the faith they so desire.

 The parents have agreed that the child(ren)’s religious training shall be in the faith of :

__________________________________________________________

A. The costs of such training shall be

 Mother _____ %

 Father _____%

Paid by:

B. The efforts and transportation needed for training shall be

 Mother _____ %

 Father _____%

Paid by:

_______

______

Basic LDPP

Page 4 of 24

Mother

Father

Rev. 9/09/08

Long Distance Parenting Plan Page 12

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