Attachment 4A "Medium Distance Schedule (Basic Parenting Plan Form)" - Oregon

What Is Attachment 4A?

This is a legal form that was released by the Oregon Judicial Department - a government authority operating within Oregon. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on August 1, 2008;
  • The latest edition provided by the Oregon Judicial Department;
  • Easy to use and ready to print;
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  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Attachment 4A by clicking the link below or browse more documents and templates provided by the Oregon Judicial Department.

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ATTACHMENT 4A - MEDIUM DISTANCE SCHEDULE
This attachment is Part 2 of the Medium/Long Distance Parenting Plan. It is suggested for parents who live
at least 60 and not more than 180 miles or more apart from each other. You can decide what schedule is best for
you based on your family’s needs.
The goal of the schedule is to make sure that (1) children have enough contact with their home base and Parent A, (2)
children can participate in age-appropriate activities, and (3) children have as much time as possible with Parent B.
Unless you file another parenting plan with the court in the future, this plan will be in effect until each child is 18
years old. Please make sure you have selected an option in each age category.
If you have children of different ages, follow the schedule for the youngest child.
4.1 Routine Schedule
(CHECK OPTION 1 OR DESIGN YOUR OWN SCHEDULE IN OPTION 2)
OPTION 1
Birth up to age 18 months
Parent B shall have parenting time with the children every week as follows:
(CHECK ALL THAT APPLY)
From 9:00a.m. Saturday until 3:00 p.m. Saturday
From 9:00 a.m. Sunday until 3:00 p.m. Sunday
Three hours every ___________ (indicate day of the week)
Other: _________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
All parenting time shall take place at Parent A’s home or a familiar and consistent, child-related
environment, with Parent A nearby. Parent A shall have the option of having the children for
the entire weekend without scheduling make-up parenting time for Parent B one time every two
months.
Age 18 months up to age 36 months
Parent B shall have parenting time with the children on alternating weekends as follows:
(CHECK ONE)
Daytime Parenting Time: From 9 a.m. Saturday until 5 p.m. Saturday and 9 a.m. Sunday to
5 p.m. Sunday
Overnight Parenting Time: From 9 a.m. Saturday until 5 p.m. Sunday
Other: _________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Age 3 up to age 6
Routine Parenting Time
(CHECK ONE)
Parent B shall have parenting time with the children on alternating weekends from 6
p.m. on Friday until 6 p.m. on Sunday.
Other: _________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Page 1 of 5 ATTACHMENT 4A TO MEDIUM /LONG DISTANCE PARENTING PLAN (GUIDE) [Rev. 08/08]
Exhibit 1 – Part 2 of 2
ATTACHMENT 4A - MEDIUM DISTANCE SCHEDULE
This attachment is Part 2 of the Medium/Long Distance Parenting Plan. It is suggested for parents who live
at least 60 and not more than 180 miles or more apart from each other. You can decide what schedule is best for
you based on your family’s needs.
The goal of the schedule is to make sure that (1) children have enough contact with their home base and Parent A, (2)
children can participate in age-appropriate activities, and (3) children have as much time as possible with Parent B.
Unless you file another parenting plan with the court in the future, this plan will be in effect until each child is 18
years old. Please make sure you have selected an option in each age category.
If you have children of different ages, follow the schedule for the youngest child.
4.1 Routine Schedule
(CHECK OPTION 1 OR DESIGN YOUR OWN SCHEDULE IN OPTION 2)
OPTION 1
Birth up to age 18 months
Parent B shall have parenting time with the children every week as follows:
(CHECK ALL THAT APPLY)
From 9:00a.m. Saturday until 3:00 p.m. Saturday
From 9:00 a.m. Sunday until 3:00 p.m. Sunday
Three hours every ___________ (indicate day of the week)
Other: _________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
All parenting time shall take place at Parent A’s home or a familiar and consistent, child-related
environment, with Parent A nearby. Parent A shall have the option of having the children for
the entire weekend without scheduling make-up parenting time for Parent B one time every two
months.
Age 18 months up to age 36 months
Parent B shall have parenting time with the children on alternating weekends as follows:
(CHECK ONE)
Daytime Parenting Time: From 9 a.m. Saturday until 5 p.m. Saturday and 9 a.m. Sunday to
5 p.m. Sunday
Overnight Parenting Time: From 9 a.m. Saturday until 5 p.m. Sunday
Other: _________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Age 3 up to age 6
Routine Parenting Time
(CHECK ONE)
Parent B shall have parenting time with the children on alternating weekends from 6
p.m. on Friday until 6 p.m. on Sunday.
Other: _________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Page 1 of 5 ATTACHMENT 4A TO MEDIUM /LONG DISTANCE PARENTING PLAN (GUIDE) [Rev. 08/08]
Exhibit 1 – Part 2 of 2
Additional/Summer Parenting Time
(CHECK ONE)
Parent B shall have the children for the following additional parenting time periods which
may be exercised during the summer or other times during the year:
(CHECK ONE)
Up to three extended weekends of 3-4 days in length each year
Two 1-week blocks each year, separated by at least two weeks with Parent A
Three 1-week blocks each year, separated by at least two weeks with Parent A
Other: ________________________________________________________
_____________________________________________________________
_____________________________________________________________
We choose not to designate additional/summer parenting time
Age 6 up to age 16
(CHECK ONE)
Parent B shall have parenting time with the children on alternating weekends from 6 p.m.
on Friday until 6 p.m. on Sunday. If school is closed on the Monday following Parent B’s
weekend, parenting time shall continue to Monday until 6 p.m. and if school is closed on the
Friday before Parent B’s weekend, parenting time shall begin at 6 p.m. on Thursday.
Other: ___________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Parent B shall have the children for school break, holiday and summer parenting time as listed
in paragraph 4.2 and 4.3 below.
Age 16 up to age 18
(CHECK ONE)
Parent B shall have parenting time with the children on weekends as follows:
(CHECK ONE)
Every other weekend from 6:00 p.m. Friday until 6:00 p.m. Sunday
One weekend every month from 6:00 p.m. Friday until 6:00 p.m. Sunday
Other: _________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
OPTION 2 (Routine Schedule developed by parents)
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
4.2 School Breaks and Holiday Schedule
(CHECK OPTION 1 OR DESIGN YOUR OWN
SCHEDULE IN OPTION 2)
OPTION 1
Winter Break
Under Age 6
(CHECK ONE)
Parent B shall have parenting time with the child according to the Routine Schedule in
4.1 above
Parent B shall have parenting time with the child up to four hours on Christmas Day
Other: _________________________________________________________________
_______________________________________________________________________
Page 2 of 5 ATTACHMENT 4A TO MEDIUM /LONG DISTANCE PARENTING PLAN (GUIDE) [Rev. 08/08]
Exhibit 1 – Part 2 of 2
Age 6 and Older
(CHECK ONE)
Parent B shall have parenting time for one week of school Winter Break every year
(OPTIONAL)
with the week including Christmas Day in
(CHECK ONE)
Odd-numbered years
Even-numbered years
Parent B shall have parenting time for two weeks of school Winter Break in
(CHECK ONE)
Odd-numbered years
Even-numbered years
Other: _________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Spring Break
Under Age 6
Parent B shall have parenting time with the children according to the Routine Schedule in
4.1 above.
Age 6 and Older
(CHECK ONE)
Parent B shall have parenting time for Spring Break every year.
Parent B shall have parenting time for Spring Break in
(CHECK ONE)
Odd-numbered years
Even-numbered years
Other: _________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Thanksgiving Break. Thanksgiving break begins 6:00 p.m. Wednesday and ends 6:00 p.m.
Sunday unless otherwise indicated in “Other” below.
Under Age 6
(CHECK ONE)
Parent B shall have parenting time with the children according to the Routine Schedule
in 4.1 above
Parent B shall have up to four hours of parenting time on Thanksgiving Day.
Other: _________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Age 6 and Older
(CHECK ONE)
Parent B shall have parenting time for Thanksgiving Break every year.
Parent B shall have parenting time for Thanksgiving Break in
(CHECK ONE)
Odd-numbered years
Even-numbered years
Other: _________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Holiday Weekends
Birth up to age 36 Months
Parent B shall have weekend parenting time with the child according to the Routine
Schedule in 4.1 above.
Page 3 of 5 ATTACHMENT 4A TO MEDIUM /LONG DISTANCE PARENTING PLAN (GUIDE) [Rev. 08/08]
Exhibit 1 – Part 2 of 2
Age 3 and Older
(CHECK ONE)
Parent B shall have parenting time from 6:00 PM on Friday until 6:00 PM on Monday on
the following holidays:
(CHECK ALL THAT APPLY)
Martin Luther King Jr. Birthday,
President’s Day,
Memorial Day,
Labor Day
Other Monday holidays:________________________________________________
We will follow the Routine Schedule in 4.1 above for these holidays.
OPTION 2 (School Break and Holiday Schedule developed by parents)
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
4.3 Summer Schedule
(CHECK OPTION 1 OR DESIGN YOUR OWN SCHEDULE IN OPTION 2)
OPTION 1
Under Age 6
Parent B’ shall have summer parenting time according to the Routine and Additional/
Summer Schedule in 4.1 above.
Age 6 up to age 9
Parent B shall have parenting time with the children for
(CHECK ONE)
Three weeks, exercised in
(CHECK ONE)
One-week blocks separated by at least one week with Parent A
Two 10-day periods separated by at least one week with Parent A
Four weeks, exercised in
(CHECK ONE)
One-week blocks separated by at least one week with Parent A
Two-week blocks separated by at least one week with Parent A
Other: _________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Age 9 up to age 16
Parent B shall have parenting time with the children for
(CHECK ONE)
Three weeks, exercised in
(CHECK ONE)
One-week blocks separated by at least one week with Parent A
One 3-week block with Parent A having the option to visit the children one
weekend during the parenting time
Four weeks, exercised in
(CHECK ONE)
Two-week blocks separated by at least one week with Parent A
One 4-week block with Parent A having the option to visit the children on
alternate weekends
Six weeks, exercised in
(CHECK ONE)
Three 2-week blocks
One 6-week block with Parent A having the option to visit the children on
alternate weekends
Other: _________________________________________________________________
_______________________________________________________________________
Page 4 of 5 ATTACHMENT 4A TO MEDIUM /LONG DISTANCE PARENTING PLAN (GUIDE) [Rev. 08/08]
Exhibit 1 – Part 2 of 2
Age 16 up to age 18
Parent B shall have parenting time with the children for
(CHECK ONE)
Two 1-week blocks
One 3-week block
One 4-week block
Other: _________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
OPTION 2 (Summer Schedule developed by parents)
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
4.3.1 Notice for Summer Scheduling
(CHECK ONE)
Before May 1 of each year, Parent B shall notify Parent A, in writing, of the dates chosen
for summer parenting time. Parent A has the right to choose the dates for Parent B’s
summer parenting time if Parent B does not give notice before May 1. Parent B’s summer
parenting time shall end at least seven days before the children’s first day of school. This
notice provision shall apply to any additional parenting time chosen in 4.1 above.
Other: _________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Page 5 of 5 ATTACHMENT 4A TO MEDIUM /LONG DISTANCE PARENTING PLAN (GUIDE) [Rev. 08/08]
Exhibit 1 – Part 2 of 2