育儿计划 Parenting Plan 1您的信息2育儿计划3课外活动4时间安排5假期6寒假,暑假7旅行8教育 Unique IDHiddenAdmin InfoHiddenJudicial CircuitQueensKingsNew YorkHiddenCountyOrangeOsceolaLeonSanta RosaHiddenIndex Number HiddenIs client Plaintiff or Defendant?PlaintiffDefendant您的信息姓名Name* 名First name 中间名Middle name 姓Family name 电话Phone*邮箱Email* 地址(街道名和号码)Address (Street name and number)* 地址(城市,州,邮编号码)Address (City, state, zip)* 您配偶的信息姓名Name* 名First name 中间名Middle name 姓Family name 电话Phone*邮箱Email* 地址(街道名和号码)Address (Street name and number)* 地址(城市,州,邮编号码)Address (City, state, zip)* 孩子的信息此表格只争对其中一个孩子,如有其他孩子需要另外填写新的表格。名字Full name* 名First name 中间名Middle name 姓Family name 出生日期Date of Birth*月123456789101112日12345678910111213141516171819202122232425262728293031年202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920性别男女 Hidden育儿计划Parenting PlanHidden此育儿计划是:This parenting plan is:经各方同意提交给法院的育儿计划。A Parenting Plan submitted to the court with the agreement of the parties.由代表提交的草拟育儿计划。A proposed Parenting Plan submitted by or on behalf of:由法院制定的临时育儿计划。A temporary Parenting Plan established by the court.对之前的最终育儿计划或之前的最终命令的修改。A modification of a prior final Parenting Plan or prior final order.父母的名字Parent's Name 父母责任与决策权Parental Responsibility and Decision-Making父母对孩子的决策权请选择以下其中一个方案。父母责任Parental Responsibility 共同父母责任:为了子女的最大利益,父母双方应协商并共同做出所有影响子女福利的重大决定。重大决定包括但不限于有关子女教育、医疗和其他家庭特有责任的决定。父母中的任何一方都可以同意对子女进行心理健康治疗。Shared Parental Responsibility: It is in the best interests of the child(ren) that the parents confer and jointly make all major decisions affecting the welfare of the child(ren). Major decisions include, but are not limited to, decisions about the child(ren)’s education, healthcare, and other responsibilities unique to this family. Either parent may consent to mental health treatment for the child(ren). 带决策权的共同父母责任:为了子女的最大利益,在涉及子女的重大决定上,父母双方应进行协商并努力达成一致。如双方不能达成一致意见,有关子女的重大问题决策权如下:Shared Parental Responsibility with Decision Making Authority It is in the best interests 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: 独立父母责任:为了子女的最大利益,其中一方父母应享有为子女帮出重大决定的独立决策权。共同父母责任对子女来说是不利的。Sole Parental Responsibility: It is in the best interests of the child(ren) that only one Parent shall have sole authority to make major decisions for the child(ren.) It is detrimental to the child(ren) to have shared parental responsibility. 哪位父母将拥有决策权?Which parent will have sole authority?我Me我的配偶My spouse谁将决定教育/学术的问题?Who will decide on Education/Academic?我Me我的配偶My spouse谁将决定非紧急情况下的医疗保健?Who will decide on non-emergency health care?我Me我的配偶My spouse 课外活动 Extra-curricular Activities父母如何决定孩子参加的课外活动? 父母中的任何一方均可以为子女报名并允许他们参加子女所选择的活动。Either parent may register the child(ren) and allow them to participate in the activity of the child(ren)’s choice. 所有课外活动必须得到父母双方的同意。The parents must mutually agree to all extra-curricular activities. 其它 Other 课外活动的费用父母如何分享孩子课外活动的费用?我承担孩子课外活动100%的费用 I will pay 100% of the costs我的配偶承担孩子课外活动100%的费用 My spouse will pay 100% of the costs我们按照其它比例承担孩子课外活动的费用 We will share the costs你将支付多少百分比的课外活动费用?What percentage of the costs of the extra-curricular activities will you pay?*Please enter a number from 0 to 100.制服和设备课外活动所需制服和设备的支付方:The uniforms and equipment required for the extra-curricular activities shall be paid by:我承担孩子制服和设备100%的费用 I will pay 100% of the costs我的配偶承担孩子制服和设备100%的费用 My spouse will pay 100% of the costs我们按照其它比例承担孩子制服和设备的费用 We will share the costs你将支付课外活动所需的制服和设备费用的百分比是多少?What percentage of the costs of the uniforms and equipment required for extra-curricular activities will you pay?*Please enter a number from 0 to 100.Hidden信息共享Information Sharing除非法院另有说明或命令。 除非法律另有禁止,否则父母双方都应能接触到与孩子有关的医疗和学校记录及信息,并应被允许独立咨询与孩子有关的任何和所有专业人士。父母应相互合作,分享与孩子的健康、教育和福利有关的信息,他们应签署任何必要的文件,确保父母双方都能查阅上述记录。 每位家长应负责直接从学校和医疗机构获取记录和报告。 父母双方都有平等的权利来检查和接受政府机构和执法部门关于孩子的记录。 父母双方应具有平等和独立的权力,与孩子的学校、日托、保健提供者和其他项目就孩子的教育、情感和社会进步进行协商。 父母双方都应被列为孩子的 “紧急联系人”。 父母双方都有持续的责任向另一方提供居住、邮寄和联系地址以及联系电话。如果有任何变化,父母双方应在24小时内以书面形式通知对方。父母双方应在七(7)天内以书面形式通知法院任何变化。 Unless otherwise indicated or ordered by the Court: Unless otherwise prohibited by law, each parent shall have access to medical and school records and information pertaining to the child(ren) and shall be permitted to independently consult with any and all professionals involved with the child(ren). The parents shall cooperate with each other in sharing information related to the health, education, and welfare of the child(ren) and they shall sign any necessary documentation ensuring that both parents have access to said records. Each parent shall be responsible for obtaining records and reports directly from the school and health care providers. Both parents have equal rights to inspect and receive governmental agency and law enforcement records concerning the child(ren). Both parents shall have equal and independent authority to confer with the child(ren)’s school, day care, health care providers, and other programs with regard to the child(ren)’s educational, emotional, and social progress. Both parents shall be listed as “emergency contacts” for the child(ren). Each parent has a continuing responsibility to provide a residential, mailing, and contact address and contact telephone number to the other parent. Hidden其他Other: 孩子跟你在一起的时间双方可以决定孩子与每个父母在一起的时间,在以下只用说明你希望与孩子在一起的时间,余下的时间就归于你的配偶。哪几个工作日孩子应该与你在一起?The time period that child shall spend time with you on weekdays 周一Monday 周二Tuesday 周三Wednesday 周四Thursday 周五Friday 哪几个周末孩子应该与你在一起?The time period that child shall spend time with you on weekends每周末跟我在一起Every Weekend每隔一周末 Every Other Weekend每周末和我的配偶在一起 Every weekend with my spouseHidden孩子跟你的配偶在一起的时间 假期时间父母可以选择对孩子的假期有任何特殊的安排。假期时间表Holiday Schedule 假日分时应按照以下时间表进行。假日时间表将优先于正常工作日、周末和暑期时间表。在空白处填写相应家长的姓名或称号,以表明孩子在假期将在哪里。提供开始和结束时间。如果节假日没有指定为偶数、奇数或每年,孩子将按照父母一方的安排留在父母身边,那么正常的日程安排Holiday time-sharing shall be in accordance with the following schedule. The Holiday schedule will take priority over the regular weekday, weekend, and summer schedules. Fill in the blanks with the name or designation of the appropriate parent 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 child(ren) will remain with the parent in accordance with the with one parent, then the regular schedule 不应适用假日时间分享。应适用上述正常的时间共享时间表。No holiday time sharing shall apply. The regular time-sharing schedule set forth above shall apply. 假日分时应按照以下时间表进行Holiday time-sharing shall be in accordance with the following schedule.请选择以下哪些年的节日孩子应该和你在一起。母亲节Mother's Day偶数年Even Years奇数年Odd Years每年跟我在一起Every Year每年跟我配偶在一起Every year with my spouseHidden开始/结束时间 Begin/End Time 父亲节Father's Day偶数年Even Years奇数年Odd Years每年跟我在一起Every Year每年跟我的配偶在一起Every year with my spouseHidden开始/结束时间 Begin/End Time 总统节 President's Day偶数年Even Years奇数年Odd Years每年跟我在一起Every Year每年跟我配偶在一起 Every year with my spouseHidden开始/结束时间 Begin/End Time 马丁·路德·金纪念日 Martin Luther King Jr. Day偶数年Even Years奇数年Odd Years每年跟我在一起Every Year每年跟我配偶在一起Every year with my spouseHidden开始/结束时间 Begin/End Time 复活节Easter偶数年Even Years奇数年Odd Years每年跟我在一起Every Year每年跟我配偶在一起Every year with my spouseHidden开始/结束时间 Begin/End Time 逾越节Passover偶数年Even Years奇数年Odd Years每年跟我在一起Every Year每年跟我配偶在一起Every year with my spouseHidden开始/结束时间 Begin/End Time 亡兵纪念日 Memorial Day Weekend偶数年Even Years奇数年Odd Years每年跟我在一起Every Year每年跟我配偶在一起Every year with my spouseHidden开始/结束时间 Begin/End Time 国庆节 4th of July偶数年Even Years奇数年Odd Years每年跟我在一起Every Year每年跟我配偶在一起Every year with my spouseHidden开始/结束时间 Begin/End Time 劳工节 Labor Day Weekend偶数年 Even Years奇数年 Odd Years每年跟我在一起 Every Year每年跟我配偶在一起Every year with my spouseHidden开始/结束时间 Begin/End Time 哥伦布日 Columbus Day Weekend偶数年 Even Years奇数年 Odd Years每年跟我在一起 Every Year每年跟我配偶在一起Every year with my spouseHidden开始/结束时间 Begin/End Time 万圣节 Halloween偶数年 Even Years奇数年 Odd Years每年跟我在一起 Every Year每年跟我配偶在一起Every year with my spouseHidden开始/结束时间 Begin/End Time 感恩节 Thanksgiving偶数年 Even Years奇数年 Odd Years每年跟我在一起 Every Year每年跟我配偶在一起Every year with my spouseHidden开始/结束时间 Begin/End Time 退伍军人节 Veteran's Day偶数年Even Years奇数年Odd Years每年跟我在一起Every Year每年跟我配偶在一起Every year with my spouseHidden开始/结束时间 Begin/End Time 光明节 Hanukkah偶数年 Even Years奇数年 Odd Years每年跟我在一起 Every Year每年跟我配偶在一起Every year with my spouseHidden开始/结束时间 Begin/End Time 赎罪日 Yom Kippur偶数年 Even Years奇数年 Odd Years每年跟我在一起 Every Year每年跟我配偶在一起Every year with my spouseHidden开始/结束时间 Begin/End Time Rosh Hashanah 罗什哈沙那节偶数年 Even Years奇数年 Odd Years每年跟我在一起 Every Year每年跟我配偶在一起Every year with my spouseHidden开始/结束时间 Begin/End Time 孩子生日 Child Birthday偶数年 Even Years奇数年 Odd Years每年跟我在一起 Every Year每年跟我配偶在一起Every year with my spouseHidden开始/结束时间 Begin/End Time Hidden这个假期安排可能会影响到正常的时间共享时间表。父母可能希望指定以下任一或两个选项:This holiday schedule may affect the regular Time-Sharing Schedule. Parents may wish to specify either or both of the following options: 当父母采用隔周计划,而假期安排会导致父母中的一方连续三个周末拥有孩子时,父母将交换下一个周末,这样在恢复常规的隔周模式之前,双方都有连续两个周末。When the parents are using an alternating weekend plan and the holiday schedule would result in one parent having the child(ren) for three weekends in a row, the parents will exchange the following weekend, so that each has two weekends in a row before the regular alternating weekend pattern resumes. 如果父母在未指定的假日或非上课日之前或之后的周末带孩子,他们应在该假日或非上课日带孩子。If a parent has the child(ren) on a weekend immediately before or after an unspecified holiday or non-school day, they shall have the child(ren) for the holiday or non-school day. 寒假Winter Break寒假安排Winter Break Schedule 父母应按照正常的日程安排度过寒假。The parents shall follow the regular schedule through the Winter. 父母应在不同年份的寒假期间交替进行。The parents shall alternate the entire Winter Break. 我们中的一个人应在每年的整个寒假期间拥有这个孩子。One of us shall have the child for the entire Winter Break. 寒假将被平均分配。寒假的前半部分将归属于其中一方父母,后半部分将归属于另一方父母。The Winter Break will be evenly divided. The first half of the Winter Break will go to the parent whose regularly scheduled weekend falls on the first half and the second half going to the parent whose weekend falls during the second half. 寒假的前部分将属于哪一方父母?我Me我的配偶My spouseHidden12月的哪一天?What day of December?*Please enter a number from 1 to 31.每一年的寒假孩子和谁在一起?Who shall have the child for the entire Winter Break?我Me我的配偶My spouse哪些年的寒假孩子和你在一起?Year Periods奇数年的寒假由我来照顾孩子 odd-numbered years偶数年的寒假由我来照顾孩子 even-numbered yearsHidden特定寒假日 Specific Winter Holidays如果上面没有涉及,具体的冬季节日,如圣诞节、除夕、光明节、宽扎节等应按以下方式分享If not addressed above, the specific Winter Holidays such as Christmas, New Year’s Eve, Hanukkah, Kwanzaa, etc. shall be shared as follows 暑假Summer Break暑假时间表Summer Break Schedule 父母应按照正常的日程安排度过暑假。The parents shall follow the regular schedule through the summer. 父母应在不同年份的暑假期间交替进行。The parents shall alternate the entire Summer Break. 其中一位父母应在每年的整个暑假期间拥有孩子。One parent shall have the child(ren) for the entire Summer Break every year. 暑假将被平均分配。暑假的前半部分将归属于其中一方父母,后半部分将归属于另一方父母。The Summer Break will be evenly divided. The first half of the Summer Break will go to the parent whose regularly scheduled weekend falls on the first half and the second half going to the parent whose weekend falls during the second half. Hidden在奇数年中,谁应拥有这个孩子?Who shall have the child during the odd-numbered years?我Me我的配偶My spouse哪些年的暑假孩子应该和你在一起?Who shall have the child during the even numbered years?奇数年偶数年暑假的前部分将属于哪一方父母?我Me我的配偶 My spouse每一年的暑假孩子应该和哪一位父母在一起?Who shall have the child during the summer break?我Me我的配偶My spouseHidden其他:{具体说明} Other: {Specify} 春假Spring Break春假安排 Spring Break Schedule 父母应遵循正常的时间表。The parents shall follow the regular schedule. 父母应在不同年份的春假期间交替进行。The parents shall alternate the entire Spring Break. 其中一位父母应在每年的整个春假期间拥有孩子。One parent shall have the child(ren) for the entire Spring Break every year. 父母应平均分配春假时间。除非另有约定,否则父母应交替使用每年的第一个和第二个季度。The parents shall equally divide the Spring Break. The parents shall alternate the first and second one-halves each year unless otherwise agreed. Hidden从放假后的特定时间到开学前的特定时间,谁应享有整个暑假?Who shall have the entire Summer Break from a specific time after school is out until a specific time before school starts?我Me我的配偶My spouse每年的整个春假孩子应该和哪一位父母在一起?Who shall have the child during the Spring break?我 Me我的配偶 My SpouseHidden放假后从什么时候开始?From what time after school is out? Hidden直到开学前的什么时候?Until what time before school starts? 哪些年的春假孩子应该和你在一起?Year Periods奇数年odd-numbered years偶数年even-numbered years春假的前部分将属于哪一方父母?我Me我的配偶My spouseHidden从放假后什么时候开始?From what time after school is out? Hidden直到开学前什么时候?Until what time before school starts? Hidden在延长的分担时间内,解释另一方父母何时应拥有孩子。During the extended periods of time-sharing, explain when the other parent shall have the child Hidden其他{具体说明} Other: {Specify} Hidden过夜天数 Number of OvernightsThe two numbers must equal 365.Hidden根据时间分享计划,你每年将与孩子有多少天在一起过夜?Based upon the time-sharing schedule, how many overnights per year will you have with the child?Hidden根据时间分享计划,你的配偶每年会有多少天与孩子在一起过夜?Based upon the time-sharing schedule, how many overnights per year will your spouse have with the child?Hidden指定不同的时间表 Specify Different ScheduleHidden解释 Explain Hidden交换孩子 Exchange of ChildHidden如果父母一方迟到而不与另一方联系作出其他安排,带孩子的一方有多少分钟可以继续进行其他计划和活动?How many minutes if a parent is late without contacting the other parent to make other arrangements, the parent with the child may proceed with other plans and activities?Hidden交换Exchnage 交换孩子应在父母家中进行,除非父母双方同意在不同的地点见面。Exchanges shall be at the parents’ homes unless both parents agree to a different meeting place. 交换孩子每次应在不同的地点进行,除非双方事先同意在不同的地点见面。Exchanges shall occur at a different place unless both parties agree in advance to a different meeting place.. 其他 Other Hidden交换孩子应在哪里进行?Where shall exchanges occur at? Hidden其他:Other: Hidden交通费用 Transportation Costs 交通费用应包括在儿童抚养工作表和/或儿童抚养令中,不应包括在这里。Transportation costs are included in the Child Support Worksheets and/or the Order for Child Support and should not be included here. 交通费用将被分摊。Transportation costs will be shared. 其他。Other 你将负责多大比例的交通费用?What percentage of transportation costs will you be responsible for?Please enter a number from 0 to 100.你的配偶将负责多大比例的交通费用?What percentage of transportation costs will your spouse be responsible for?Please enter a number from 0 to 100.其他:Other: 国外和外州旅行 Foreign and Out-Of-State Travel国外和外州旅行 {请注明所有适用的项目}。Foreign and Out-Of-State Travel {Indicate all that apply} 父母中的任何一方都可以在他/她分管期间与孩子在美国境内旅行。与孩子一起旅行的一方应在去外州旅行前至少给另一方一定数量的书面通知,除非有紧急情况,并应在旅行前至少给另一方提供详细的行程,包括可以联系到孩子和父母的地点和电话号码。Either parent may travel within the United States with the child during his/her time-sharing. The parent traveling with the child shall give the other parent at least a specific amount of days written notice before traveling out of state unless there is an emergency, and shall provide the other parent with a detailed itinerary, including locations and telephone numbers where the child and parent can be reached at least a specific amount of days before traveling. 父母中的任何一方都可以在其分担期间与孩子一起出国旅行。至少在旅行前的特定天数,父母应提供一份详细的行程,包括地点,以及旅行期间可以联系到孩子和父母的电话号码。父母双方都同意提供任何必要的文件,以便另一方带孩子出国。Either parent may travel out of the country with the child during his/her time-sharing. At least a specific amount of days prior to traveling, the parent shall provide a detailed itinerary, including locations, and telephone numbers where the child and parent may be reached during the trip. Each parent agrees to provide whatever documentation is necessary for the other parent to take the child out of the country. 旅行前的通知天数 Number of days to notice before traveling至少在旅行前多少天应该联系父母?At least how many days before traveling the parent can be reached?应提供以下送回孩子时的保障: The following security for the return of the child shall be provided: 其他 Other 教育 Education为了确定学校边界和注册,应使用哪位家长的地址?For purposes of school boundary determination and registration, which parent's address shall be used?我 Me我的配偶 My spouse是否有关于私立学校或家庭教育的规定?Is there any provision made regarding private or home schooling?是 Yes否 No关于私立学校或家庭教育,有以下规定:The following provisions are made regarding private or home schooling: Hidden其他 Other Hidden为其他法律目的的指定 Designation For Other Legal Purposes这种多数人的指定仅仅是为了所有其他需要这种指定的州和联邦法律。这一指定并不影响父母任何一方在本养育计划下的权利和责任。This majority designation is SOLELY for purposes of all other state and federal laws which require such a designation. This designation does not affect either parent’s rights and responsibilities under this Parenting Plan.Hidden本养育计划中提到的孩子大部分时间与谁居住?Whom the child named in this Parenting Plan are scheduled to reside the majority of the time with?我 Me我的配偶 My spouse从From 到To 其他Other Hidden电子通信的费用应按以下方式处理:Costs of Electronic Communication shall be addressed as follows: 孩子保健 Child Care孩子保健 Child Care {Choose only one} 每位家长可以选择合适的儿童护理机构。Each parent may select appropriate child care providers. 所有护理机构都必须经父母双方同意。All child care providers must be agreed upon by both parents. 在使用儿童护理机构超过特定时间之前,父母双方必须先为另一方提供照顾孩子的机会。Each parent must offer the other parent the opportunity to care for the child before using a child care provider for any period exceeding specific hours. 多少个小时?How many hours?其他:{具体说明} Other:{Specify}