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CHILD VISITATION

For weekends, please write:

Day:

Time:

FROM:

TO:

Day:

Time:

If you want to ALTERNATE WEEKENDS, please specify:

Starting Date:

FROM:

Day:

Time:

TO:

Day:

Time:

If you want to WEEKDAYS, please specify:

FROM:

Day:

Time:

Day:

Time:

TO:

Are there any Visitation days restrictions?

please specify:

Are you requesting SUPERVISED VISITATION?

You will need to provide PROOF OR A DECLARATION OF WHY

Would you like the Court to choose someone for Supervision?

If so, please specify and fill out the following

Name:

He/She is a:

Phone Number:

Cost paid by:

TRANSPORTATION FOR VISITATION

Begins by who:

Ends by who:

Begin Exchange Point Address:

End Exchange Point Address:

Would you like him/her to wait inside car so the child(ren) to go between the car and exchange point?

Would you like the other parent to get permission from you to get the child(ren) out of a place?

what place?:

Do you think there is a risk of Child Abduction (Kidnapping)?

Name the place he/she could take the Children:

Explain why:

Do you think he/she already kidnapped the children?

Explain why he/she would leave California:

Has he/she done any of the following?

He/she Has history of:

Please Explain:

Summons

Civil Restraining Orders

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