MARYLAND PARENTING PLAN TOOL MAPPT This form contains

MARYLAND PARENTING PLAN TOOL

☐ Parenting plan of ,

☐ J

oint parenting plan of:

Name Relationship to Child(ren)

Type of filing:

☐ Initi

al pleading

☐ Modification

☐ Relocation

Special circumstances: (choose all that apply)

☐ Allegation of domestic abuse (under Family Law Art., § 4-501)

☐ Supervised parenting time requested (abuse of a parent, child, or drug/alcohol addiction)

☐ Other: (describe)

BIOGRAPHICAL INFORMATION

Party 1

Name:

Address: ☐ Address unknown

☐ Address confidential due to:

☐ protective order that expires

☐ other court order: , entered

Street Address:

City, State, Zip:

Phone: E-mail:

CC-DR-109 (Rev. 01/2024) Page 1 of 9 MAPPT

Relationship to child(ren)

NOTES:

• Use this form to create a parenting plan for your child(ren). A parenting plan is a guide for

how parties will make decisions about the child(ren) and handle conflicts. Complete this form

separately, together, or with a mediator. Attach additional sheets if needed.

• If you and the other party/parties cannot agree on a comprehensive parenting plan, complete a

Joint Statement of the Parties Concerning Decision-Making Authority and Parenting Time

(form CC-DR-110).

• “Party”: A person seeking to establish or maintain a parent-child relationship with the

child(ren).

• MDEC counties only: You must file a Notice Regarding Restricted Information

Pursuant to Rule 20-201.1 (form MDJ-008) with this submission.

Name of party

Date

This form contains Restricted Information.

Party 2

Name:

Address: ☐ Address unknown

☐ Address confidential due to:

☐ protective order that expires

☐ other court order: , entered

Street Address:

City, State, Zip:

Phone: E-mail:

Party 3

Name:

Address: ☐ Address unknown

☐ Address confidential due to:

☐ protective order that expires

☐ other court order: , entered

Street Address:

City, State, Zip:

Phone: E-mail:

Child(ren)

This parenting plan is for the following minor child(ren) (add lines or attach additional sheets if needed):

Name Date of Birth

PARENTAL RESPONSI

BILITES

Choose from the general options below or make choices based on what is important to your family.

1. DECISION-MAKING AUTHORITY

Parental responsibility – Day-to-day decisions are the

responsibility of the party/parties the child(ren)

are with at the time, such as how the child(ren) dress(es), or their home routine. How will major

decisions such as medical and mental health care, education, religious training, extracurricular

activities, communication among the parties, and information sharing be made?

CC-DR-109 (Rev. 01/2024) Page 2 of 9 MAPPT

Date

(choose one)

☐ Shared parental responsibility

We will jointly make major decisions about the child(ren).

☐ Sole parenting responsibility

will make major decisions for the child(ren).

☐ Shared parental responsibility with decision-making authority

We will try to reach an agreement on issues. If we cannot agree, tie-breaking authority goes

to the following party:

Tie-breaking authority

Medical care ☐ No tie-breaking authority

Mental health ☐ No tie-breaking authority

Education ☐ No tie-breaking authority

Religious training ☐ No tie-breaking authority

Extracurricular activities ☐ No tie-breaking authority

Other: ☐ No tie-breaking authority

Communication between the parties – H

ow will you communicate with each other about the child(ren)?

Do not use the child(ren) as messengers to convey information, ask questions, or set up schedule changes.

We will communicate with each other: (choose all that apply)

☐ In person

☐ By telephone

☐ By text or similar method

☐ By e-mail

☐ Other:

Information sharing – How will you share and acc

ess information about the child(ren)’s health, mental

health, education, and welfare? Be listed as emergency contacts? Notify each other about changes to your

address or contact information?

(choose all that apply)

☐ Each of us will have access to

medical and school records and information about the child(ren) and

may consult with professionals.

☐ Each of us will share information about the health, mental health, education, and welfare of the

child(ren) and sign documentation ensuring that we each have access to records.

☐ We will give each other advance notice of medical appointments and appointments with the

child(ren)’s school.

☐ Each of us will get records and reports from the school and health care providers. Each of us have

equal rights to inspect and receive governmental agency and law enforcement records concerning

the child(ren).

☐ Each of us may consult with the child(ren)’s school, day care, health care providers, and other

programs about the child(ren)’s health, mental health, educational, emotional, and social progress.

☐ Each of us will be listed as “emergency contacts” for the child(ren) on all matters.

CC-DR-109 (Rev. 01/2024) Page 3 of 9 MAPPT

Name

☐ Each of us will gi

ve a residential, mailing, and contact address and telephone number to the other

party/parties and notify each other in writing (may be by text or email) within 24 hours of

changes.

☐ Other:

Schooling – What ty

pe of school

ing will the child(ren) have (for example, will the child(ren) attend

public or private schools or be homeschooled)? Which party’s address will be used to determine the

child(ren)’s school district?

We agree that the child(ren)

will:

☐ Attend public school. address will be designated for

school registration.

☐ Attend private school.

☐ Be homeschooled.

☐ Other:

Extracurricular activities – How will you manage activity calendars for practices, rehearsals, games

recitals, etc.? How will you handle conflicts with parenting time and exchange of activity calendars?

(choose all that apply)

☐ Each of us will ag

ree to extracurricular activities that may occur during each party’s scheduled

parenting time.

☐ Each of us will transport the child(ren) to and from all extracurricular activities during each

party’s scheduled parenting time.

☐ Each of us may register the child(ren) for an activity of the child(ren)’s choice, so long as it does

not interfere with the other party’s/parties’ parenting time.

☐ Each of us agrees as to the following extracurricular activities:

2. PARENTING TIME

What p

arenting time schedule will work best for your family?

Special considerations: (choose all that apply)

☐ We will not use drugs during our time with the child(ren).

☐ We will not drink alcohol during our time with the child(ren).

☐ We understand emergencies happen. We will accommodate reasonable changes that are timely

requested.

☐ Other:

CC-DR-109 (Rev. 01/2024) Page 4 of 9 MAPPT

Name’s

Regular weekda

y and weekend schedule-

☐ The following schedule begins on with

and continues as follows:

The child(ren) will be with :

☐ Weekends: ☐ ever

y ☐ every other ☐ other: (specify) from

to .

☐ Weekdays: (specify days) from

to .

☐ Other: (describe)

The child(ren)

will be with :

☐ Weekends: ☐ ever

y ☐ every other ☐ other: (specify) from

to .

☐ Weekdays: (specify days) from

to .

☐ Other: (describe)

The child(ren)

will be with :

☐ Weekends: ☐ every ☐ every other ☐ other: (specify) from

to .

☐ Weekdays: (specify days) from

to .

☐ Other: (describe)

☐ See attached cale

ndar for regular schedule.

☐ There is a different parenting time schedule for the following child(ren):

Holiday schedul

e- How will holidays be def

ined? Add special events or occasions important to your

family.

(choose one)

CC-DR-109 (Rev. 01/2024) P

age 5 of 9

MAPPT

Date

Name

☐ No holiday parenti

ng time will apply. The regular weekday and weekend schedule above will

apply.

☐ Holiday parenting time will be as we agree.

☐ Holiday parenting time will follow the schedule below. It will take priority over the regular

weekday, weekend, and summer schedules.

Fill in the blanks with your names to indicate where the child(ren) will be for the holidays.

Provide the beginning and ending times. If a holiday is not specified as even, odd, or every year

with one party, then the child(ren) will be with the party according to the regular schedule.

The following is not a complete list of holidays. Add holidays that apply to your family (other school

holidays, religious observances, Halloween, New Year’s Eve/day, etc.)

Holidays Even years Odd years Eve

ry year Begin/end time

Mother’s Day

Father’s Day

Martin Luther King Day

President’s Day

Memorial Day

Juneteenth

Fourth of July

Labor Day

Columbus Day

Thanksgiving

Veteran’s Day

Child(ren)’s Birthdays

Religious holidays (list):

Other (list):

Winter, spring, a

nd summer breaks are times when the child(ren) are out of school and you can

determine how those out-of-school times, including weekends, will be shared between you.

Winter break-

(choose one)

☐ We will follow the regular weekday and weekend schedule.

☐ We will alternate winter breaks. The child(ren) will stay with

in ☐ odd-numbered years ☐ even-numbered years, and with

in ☐ odd-numbered years ☐ even-numbered years.

CC-DR-109 (Rev. 01/2024) Page 6 of 9 MAPPT

Name

If a holiday designated above doesn’t fall within a party’s winter break time, the holiday schedule

will take precedent.

☐ We will divide winter break as follows:

Spring break-

(choose one)

☐ We will follow the regular weekday and weekend schedule.

☐ We will alternate spring breaks. The child(ren) will stay with

in ☐ odd-numbered years ☐ even-numbered years, and with

in ☐ odd-numbered years ☐ even-numbered years.

If a holiday designated above doesn’t fall within a party’s spring break time, the holiday schedule

will take precedent.

☐ We will divide spring break as follows:

Summer break-

(choose one)

☐ We will follow the regular weekday and weekend schedule.

☐ Each of us will have weeks with the child(ren) during the summer. These weeks may

be ☐ consecutive ☐ non-consectutive and start and end on . We will

request the week(s) by of each year. If there is a conflict,

will get first pick of the date in odd-numbered years and

will get first pick of the date in even-numbered years.

☐ We will divide summer break as follows:

Out-of-state travel

(choose all that apply)

☐ Each of us may travel within the United States with the child(ren) during our parenting

time/vacation. The party traveling with the child(ren) will give the other party/parties at least

days written notice before traveling out-of-state unless there is an emergency, and

will include an itinerary, with locations and telephone numbers where the child(ren) and that

party can be reached.

☐ Each of us may travel out of the country with the child(ren) during our parenting time/vacation.

The party traveling with the child(ren) will give the other party/parties at least days

written notice before traveling out of the country and will include an itinerary, with locations

and telephone numbers where the child(ren) and that party can be reached. We agree to provide

documentation necessary for the other party/parties to take the child(ren) out of the country.

CC-DR-109 (Rev. 01/2024) Page 7 of 9 MAPPT

Name

Day of week

Date

Name

☐ Other:

3. TRANSPORTATION AND EXCHANGE OF CHILD(REN)

Transportation

(choose one)

☐ The party beginning their parenting time will provide transportation for the child(ren).

☐ The party ending their parenting time will provide transportation for the child(ren).

☐ will provide all transportation.

☐ Other:

Exchanges of the child(ren)

Each of us will have the child(ren) ready and on time with proper clothing, medications, homework,

extracurricular activity uniforms or equipment, etc., at the time of exchange. The receiving party will

be notified if the child(ren) took any medications within 24 hours of the transition.

(choose one)

☐ Exchanges will be at each party’s home.

☐ Exchanges will occur at unless we agree

in advance to a different meeting place.

☐ Other:

4. COMMUNICATION BETWEEN PARENTS AND CHILD(REN)

Each of us will keep contact information current.

The child(ren) may have ☐ telephone ☐ e-mail ☐ other electronic communication in the form of

with the other party/parties: (choose one)

☐ Anytime

☐ Every day during the hours of to

☐ On the following days: during the hours of

☐ Other:

5. CHILD CARE

(choose all that apply)

☐ Each of us may select child care providers.

☐ We must agree on child care providers.

☐ Each of us must offer the other party/parties the opportunity to care for the child(ren) before

using a child care provider for any period exceeding hours.

☐ Other:

CC-DR-109 (Rev. 01/2024) Page 8 of 9

MAPPT

Name

6. DISPUTES

How will you resolve disputes relating to the parenting plan?

(select one)

☐ We agree to attend at least mediation session(s) before asking the court to intervene.

☐ Other: (describe)

7. OTHER ISSUES

For example, the child(ren)’s name(s), names used to refer to step-parents or other adults,

circumstances requiring parental consent (driving, marriage, military service, employment, etc.),

restrictions on what the child(ren) are exposed to (entertainment, firearms, all-terrain vehicles, etc.),

and discipline.

NOTE: You have the right to consult with a lawyer to review this document before you sign it.

I/We enter this parenting plan voluntarily. I/We believe this plan is in the best interest of the

child(ren) at this time. I am/We are satisfied with this plan and intend to be bound by it.

Signature

Printed Name

Street Address

City, State, Zip

Telephone Number

E-mail

Fax

E-mail

Fax

Telephone Number

City, State, Zip

Street Address

Printed Name

Signature

Date

Signature

Printed Name

Street Address

City, State, Zip

Telephone Number

E-mail

Fax

Date

CC-DR-109

(Rev. 01/2024) Page 9 of 9

MAPPT

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