Stipulation for Sole Parental Rights and Responsibilities with Parent-Child Contact - Vermont

STIPULATION FOR SOLE PARENTAL RIGHTS AND RESPONSIBILITIES

WITH PARENT-CHILD CONTACT ORDER

State of Vermont
Superior Court — Family Division

[________________________________] Unit

Docket No.: [________________________________]

Filed in connection with:
☐ Divorce (if applicable)
☐ Legal Separation
☐ Parentage Action
☐ Standalone PR&R Petition
☐ Civil Union Dissolution

[________________________________], Custodial Parent (Parent with sole PR&R)
[________________________________], Non-Custodial Parent (Parent with contact rights)

VERMONT TERMINOLOGY: Vermont uses "parental rights and responsibilities" (PR&R). Under 15 V.S.A. § 665(a), when parents cannot agree to share PR&R, the court shall award PR&R primarily or solely to one parent. This stipulation allocates sole legal and primary physical responsibility to one parent while establishing parent-child contact for the other parent. Vermont Judiciary materials also use “parent-time” and “visitation” for parent-child contact.

PART I — PARTIES AND CHILDREN

1.1 Parents

Custodial Parent (Sole PR&R):

• Full Name: [________________________________]
• Address: [________________________________], Vermont [____]
• County: [________________________________]
• Telephone: [________________________________]
• Email: [________________________________]

Non-Custodial Parent (Contact Rights):

• Full Name: [________________________________]
• Address: [________________________________]
• County/State: [________________________________]
• Telephone: [________________________________]
• Email: [________________________________]

1.2 Children

1.3 Basis for Sole PR&R

The parties agree, or the court has determined, that sole PR&R to the Custodial Parent serves the child(ren)'s best interests due to:

☐ Geographic distance between parents makes shared PR&R impracticable
☐ History of inability to cooperate and communicate effectively regarding the child(ren) (factor 8 under § 665(b))
☐ Concerns regarding the Non-Custodial Parent's ability to provide a safe environment
☐ History of domestic violence or abuse as defined in 15 V.S.A. § 1101
☐ Substance abuse concerns
☐ Non-Custodial Parent's prolonged absence or limited involvement
☐ Other: [________________________________]

1.4 Preparation

☐ The parties have reviewed the current Vermont Judiciary parenting-plan information and Form 400-00825.

☐ If this stipulation is part of a divorce involving the spouses' minor children or a parentage case, both parents have completed the Judiciary's Helping Children Cope With Separation and Divorce (COPE) parenting course. Completion dates: Parent A [__________]; Parent B [__________].
☐ The parties have completed any other course, mediation, or preparation required by the court or agreed by the parties: [________________________________]

PART II — SOLE LEGAL RESPONSIBILITY

2.1 Grant of Sole Legal Responsibility

The Custodial Parent shall have sole legal responsibility for the child(ren) under 15 V.S.A. § 664. The Custodial Parent has exclusive authority to make all major decisions concerning the child(ren)'s welfare, including:

(a) Education: School enrollment, school changes, homeschooling, special education services, tutoring, and college planning.

(b) Medical care: Selection of physicians, dentists, and specialists; authorization of medical procedures; medications; and vaccinations.

(c) Mental health: Counseling, therapy, and psychiatric services.

(d) Religious upbringing: Religious education, ceremonies, and practices.

(e) Extracurricular activities: Sports, arts, clubs, and other activities.

(f) Travel: Authorization for domestic and international travel.

(g) Legal matters: Representation in legal proceedings; passport applications; name changes.

2.2 Informing the Non-Custodial Parent

The Custodial Parent shall:

☐ Inform the Non-Custodial Parent of major decisions within [____] days after the decision is made. The Non-Custodial Parent may express concerns but does not have veto authority.

☐ Make reasonable efforts to consult with the Non-Custodial Parent before major decisions, though the Custodial Parent retains final authority.

☐ Not be required to consult or inform the Non-Custodial Parent regarding major decisions. (Use only in cases of domestic violence, abuse, or extreme circumstances.)

2.3 Emergency Decisions

Either parent may make emergency medical or safety decisions when the child(ren) are in that parent's care. The other parent shall be notified as soon as practicable, and in all events within 24 hours.

PART III — PRIMARY PHYSICAL RESPONSIBILITY

3.1 Primary Residence

The child(ren) shall reside primarily with the Custodial Parent at:

[________________________________]
[________________________________], Vermont [____]

The child(ren) shall be enrolled in [________________________________] (school/school district).

3.2 Custodial Parent's Authority

The Custodial Parent has sole authority over the child(ren)'s day-to-day care, including routines, discipline, meals, bedtimes, homework supervision, childcare arrangements, and daily activities.

PART IV — NON-CUSTODIAL PARENT-CHILD CONTACT SCHEDULE

4.1 Type of Contact

☐ Standard unsupervised contact (Section 4.2)
☐ Expanded unsupervised contact (Section 4.3)
☐ Supervised contact (Section 4.4)
☐ Graduated/step-up contact (Section 4.5)

4.2 Standard Unsupervised Contact Schedule

Regular schedule:

• Alternating weekends: Friday at [____] through Sunday at [____]
• Midweek: [________________________________] (day) from [____] to [____]
  ☐ With overnight ☐ Without overnight

Approximate annual overnights: [____]

4.3 Expanded Unsupervised Contact Schedule

Regular schedule:

• Alternating weekends: Friday at [____] through Monday morning (school drop-off)
• Midweek: [________________________________] and [________________________________] (two evenings) from [____] to [____]
  ☐ With overnights ☐ Without overnights

Approximate annual overnights: [____]

4.4 Supervised Contact Schedule

(Applicable when the court or parties have determined supervision is necessary under 15 V.S.A. § 665a or based on safety concerns.)

Schedule:

• [________________________________] (day(s)) from [____] to [____]
• Frequency: ☐ Weekly ☐ Biweekly ☐ Other: [________________________________]
• Duration per visit: [____] hours

Supervision arrangements:

☐ Professional supervised visitation center: [________________________________]
☐ Approved individual supervisor: [________________________________]
Relationship to family: [________________________________]
Contact information: [________________________________]

☐ Therapeutic supervision by licensed clinician: [________________________________]

Conditions of supervised contact:

☐ If the court orders this condition under 15 V.S.A. § 665a(b)(4), the Non-Custodial Parent shall abstain from alcohol or controlled substances without a prescription during contact and for 24 hours before contact.
☐ The Non-Custodial Parent shall submit to random drug/alcohol testing: [________________________________]
☐ The supervisor shall have authority to terminate any visit if the child(ren)'s safety is at risk.
☐ The Non-Custodial Parent shall bear the cost of supervision.
☐ Other conditions: [________________________________]

Review of supervision: The parties agree to review the need for supervision every [____] months. Modification to unsupervised contact requires:
☐ Agreement of both parties filed with the court
☐ Court order following a motion and hearing
☐ Completion of the following conditions: [________________________________]

4.5 Graduated (Step-Up) Contact Schedule

(For situations where contact is being reintroduced or expanded gradually.)

Phase 1 (Weeks 1–[____]):
[________________________________]

Phase 2 (Weeks [____]–[____]):
[________________________________]

Phase 3 (Weeks [____]–[____]):
[________________________________]

Phase 4 — Ongoing:
[________________________________]

Progression to each phase requires: [________________________________]

4.6 Holiday Schedule

Holiday contact supersedes the regular schedule.

4.7 Summer Contact

The Non-Custodial Parent shall have [____] weeks of summer contact with at least [____] days' advance written notice to the Custodial Parent. Summer contact requests shall be submitted by [month/day] each year.

☐ Summer weeks may be consecutive.
☐ Summer weeks must be non-consecutive.
☐ Summer contact shall not conflict with the child(ren)'s enrolled summer programs: [________________________________]

4.8 Exchanges

• Exchange location: [________________________________]
  ☐ Custodial Parent's residence
  ☐ Neutral public location: [________________________________]
  ☐ School / childcare
  ☐ Other: [________________________________]

• Transportation: [________________________________]
  ☐ Non-Custodial Parent provides all transportation
  ☐ Custodial Parent provides all transportation
  ☐ Shared (Non-Custodial Parent picks up; Custodial Parent picks up for return)
  ☐ Other: [________________________________]

• Late policy: Notification required if more than 15 minutes late. If the Non-Custodial Parent is more than [____] minutes late without notice, the contact period is forfeited for that occasion.

PART V — COMMUNICATION

5.1 Parent-Child Contact During Custodial Parent's Time

The Custodial Parent shall facilitate reasonable telephone and/or video contact between the child(ren) and the Non-Custodial Parent:

• Schedule: [________________________________] (e.g., Tuesdays and Thursdays at 7:00 PM)
• Duration: Up to [____] minutes per call
• Method: ☐ Phone ☐ Video (FaceTime/Zoom) ☐ Both

The Custodial Parent shall ensure the child(ren) have access to a phone during scheduled contact times.

5.2 Communication Between Parents

(a) Method: [________________________________] (e.g., OurFamilyWizard, email, text)
(b) Response time: Non-emergency messages within [____] hours.
(c) Emergency notification: The Custodial Parent shall notify the Non-Custodial Parent within 24 hours of any emergency, serious illness, injury, or hospitalization.

5.3 Non-Disparagement

Neither parent shall make negative, derogatory, or disparaging remarks about the other parent, that parent's family, or household members in the child(ren)'s presence or hearing.

5.4 Information Access

Subject to any court order limiting access in the child's best interests or to prevent detriment, the Non-Custodial Parent shall have access under 15 V.S.A. § 670 to:

• School records, report cards, and progress reports (directly from the school)
• Medical, dental, and mental health records (directly from providers)
• Notification of school events, parent-teacher conferences, and extracurricular activities

The Custodial Parent shall provide copies of report cards and significant medical information within [____] days of receipt.

PART VI — BEST-INTERESTS ANALYSIS UNDER 15 V.S.A. § 665(b)

The parties represent that this sole PR&R arrangement serves the child(ren)'s best interests under the nine statutory factors:

1. Love, affection, and guidance — [________________________________]

2. Material needs and safety — [________________________________]

3. Developmental needs — [________________________________]

4. Stability — [________________________________]

5. Co-parenting / fostering other-parent relationship — [________________________________]

6. Primary caregiver — [________________________________]

7. Significant relationships — [________________________________]

8. Communication and cooperation — [________________________________]

9. Domestic violence / abuse — ☐ No evidence of abuse. ☐ Evidence addressed in Part VII.

PART VII — DOMESTIC VIOLENCE PROVISIONS

☐ Not applicable.

☐ Applicable — If the circumstances described in 15 V.S.A. § 665a(a) apply, the court may award parent-child contact only if it finds that adequate safety provisions can be made. The following conditions may be proposed for the court's consideration:

☐ All exchanges supervised or at a public location
☐ Parent-child contact supervised by [________________________________]
☐ Completion of an intervention program ordered by the court: [________________________________]
☐ Abstention from alcohol/controlled substances during and 24 hours before contact
☐ No overnight contact until [________________________________]
☐ Completion of parenting classes: [________________________________]
☐ Completion of substance abuse evaluation and treatment: [________________________________]
☐ Mental health evaluation and compliance with recommendations: [________________________________]
☐ Random drug/alcohol testing
☐ Relief from Abuse Order currently in effect: Docket No. [________________________________]
☐ Other: [________________________________]

PART VIII — RELOCATION

8.1 Custodial Parent Relocation

(a) If the Custodial Parent plans to relocate in a way that affects the child(ren)'s school enrollment or materially increases the distance between the parents' homes, the Custodial Parent shall provide reasonable advance notice. The parties' agreed notice period is [____] days.

(b) Any relocation that affects this PR&R or parent-child-contact arrangement shall be addressed by written agreement or court order as applicable.

(c) The current contact schedule remains in effect until the court enters a new order.

8.2 Non-Custodial Parent Relocation

The Non-Custodial Parent shall provide reasonable advance notice of any change of address that affects the contact schedule and shall propose any needed schedule changes.

PART IX — DISPUTE RESOLUTION

9.1 Direct Communication

Parents shall first attempt to resolve disputes through direct communication within [____] days.

9.2 Mediation

If unsuccessful, parents shall participate in mediation before filing court motions.
☐ Vermont Family Mediation Program
☐ Private mediator: [________________________________]
Cost: [________________________________]

9.3 Guardian ad Litem

☐ The parties request appointment of a GAL under 15 V.S.A. § 669.
☐ A GAL is already appointed: [________________________________]
☐ Not applicable.

9.4 Court

Either parent may file a motion with the Vermont Superior Court, Family Division, [________________________________] Unit.

PART X — MODIFICATION

(a) To ask the court to modify an existing order by agreement, file the current Vermont Judiciary Form 400-00825 with the other modification papers. Both parents must sign the form. The filing fee for a stipulated motion is $35 if the court accepts the stipulation; if it does not, the higher non-stipulated motion fee applies.

(b) A contested motion to modify an existing order generally requires a real, substantial, and unanticipated change of circumstances under 15 V.S.A. § 668(a). Section 668(c) bars modification of a final order under § 665(f)(1) and requires an extraordinary, real, substantial, and unanticipated change to modify an order under § 665(f)(2). The Vermont Judiciary lists a $120 filing fee for a non-stipulated motion; check its current fee schedule and fee-waiver procedure before filing.

(c) Under 15 V.S.A. § 668(b), whenever physical responsibility is modified, the court shall set a child support modification hearing and give notice to the parties.

(d) The Non-Custodial Parent may petition for expanded contact or shared PR&R upon demonstrating changed circumstances and that the modification serves the child(ren)'s best interests.

PART XI — CHILD SUPPORT

☐ The Non-Custodial Parent shall pay child support of $[________________________________] per month, calculated under the current Vermont Child Support Guidelines adopted under 15 V.S.A. §§ 654–657. Any deviation shall be addressed under 15 V.S.A. § 659.

☐ A separate child support order is being filed concurrently.

☐ Child support has been addressed in a prior order dated [__/__/____].

Health insurance: [________________________________] (parent) shall maintain health insurance.

Unreimbursed medical expenses: ☐ Split equally ☐ Proportional to income: [____]% / [____]% ☐ Other: [________________________________]

PART XII — ADDITIONAL PROVISIONS

12.1 Substance Use

The parties agree to the following substance-use condition during parenting time: [________________________________]. If the court orders a condition under 15 V.S.A. § 665a(b)(4), the order may require abstinence during parent-child contact and for 24 hours preceding contact when alcohol or drugs were involved in the domestic abuse.

12.2 Firearms Safety

All firearms shall be stored unloaded in a locked container with ammunition stored separately, inaccessible to the child(ren).

12.3 Return of Child(ren)

The Non-Custodial Parent shall return the child(ren) to the designated exchange location at the scheduled time. A failure to follow the parent-child-contact order may be addressed through court enforcement, including remedies under 15 V.S.A. § 668a where applicable.

12.4 Child's Preference

The parties may record the child(ren)'s views and needs for counsel or the court to address under the governing best-interest law.

PART XIII — GENERAL PROVISIONS

(a) Governing law. 15 V.S.A. Chapter 11, Subchapter 3A.
(b) Jurisdiction. This agreement is subject to the UCCJEA. Before filing, identify the court with jurisdiction under 15 V.S.A. §§ 1061 and 1071 and complete the court's current forms.
(c) Severability. Unenforceable provisions do not affect the remainder.
(d) Integration. This is the complete agreement regarding PR&R.
(e) Counterparts. May be executed in counterparts.

SIGNATURES

Custodial Parent:

Signature: [________________________________]
Printed Name: [________________________________]
Date: [__/__/____]

Non-Custodial Parent:

Signature: [________________________________]
Printed Name: [________________________________]
Date: [__/__/____]

Attorney for Custodial Parent (if applicable):

Signature: [________________________________]
Printed Name: [________________________________]
Vermont Bar No.: [________________________________]

Attorney for Non-Custodial Parent (if applicable):

Signature: [________________________________]
Printed Name: [________________________________]
Vermont Bar No.: [________________________________]

ORDER OF THE COURT

The Court has reviewed this Stipulation and, finding that sole parental rights and responsibilities to the Custodial Parent with parent-child contact for the Non-Custodial Parent serves the best interests of the child(ren) under 15 V.S.A. § 665(b), hereby:

☐ APPROVES this Stipulation and enters it as a court order.

☐ APPROVES WITH MODIFICATIONS: [________________________________]

☐ ORDERS a hearing on [__/__/____] at [____].

☐ ORDERS a child support hearing on [__/__/____] at [____].

IT IS SO ORDERED.

Date: [__/__/____]

[________________________________]
Judge, Vermont Superior Court — Family Division
[________________________________] Unit

Sources and References

• 15 V.S.A. § 664 — Definitions (legal responsibility, physical responsibility)
• 15 V.S.A. § 665 — Rights and responsibilities order; best interests of the child (nine factors)
• 15 V.S.A. § 665(a) — Sole or primary PR&R when parents cannot agree to share
• 15 V.S.A. § 665a — Conditions of parent-child contact (domestic violence)
• 15 V.S.A. § 668 — Modification of order
• 15 V.S.A. § 668a — Enforcement of visitation
• 15 V.S.A. § 659 — Child support order and guideline deviation factors
• 15 V.S.A. § 669 — Guardian ad litem
• 15 V.S.A. § 1101 — Abuse definition used by the custody statutes
• 15 V.S.A. §§ 1061, 1071 — UCCJEA definitions and initial jurisdiction
• Vermont Judiciary Form 400-00825 — Agreement on Parental Rights and Responsibilities
• Vermont Judiciary — Family Division: https://www.vermontjudiciary.org/family