STEAM Summer Program | Philadelphia Arts In Education Partnership

The Philadelphia Arts in Education Partnership’s work is in service to the field of arts in education. PAEP advances best practices through the design and implementation of arts in education programs building the capacity of teachers and artists to integrate the arts across the curriculum.

The program runs June 28-August 4, Tuesday, Wednesdays and Thursdays from 9 AM to 3 PM.

The program will run in-person at Grover Washington Middle School (201 E Olney Ave, Philadelphia, PA 19120) and William H. Ziegler Elementary School (5935 Saul St, Philadelphia, PA 19149)

The program provides students in grades 5-8 with the unique opportunity to strengthen academic competencies through visual and performing arts practices. Students participate in fun and engaging science, math, literacy, and social emotional learning activities as well as experience learning through different art forms (visual arts, music, dance, and theater). Participants will also receive PAEP FREE art supplies, breakfast and lunch!

Covid-19: PAEP will follow the policies and procedures set in place by the School District of Philadelphia regarding Covid-19 safety.

Child’s Information

School*

First Name*

Last Name*

Gender*

Male
Female

Grade*

5
6
7
8

Address

Street Address Address Line 2 City State ZIP Code

Home Phone

Cell Phone*

Teacher's Name*

Date of Birth*

Student ID# / Lunch ID#*

Parent / Legal Guardian Information

First Name*

Last Name*

Relationship*

Email Address*

Home Phone

Cell Phone

Work Phone

Emergency and Medical Information

**The people listed below should be responsible individuals who can: 1) give permission to administer health care; and 2) have the authority to speak on behalf of the parent or legal guardian**

Full Name

Relationship

Home Number

Cell/Work Number

Full Name

Relationship

Home Number

Cell/Work Number

Family Physician

Physician Phone Number

My child has allergies

Yes
No

Please explain

My child has medical concerns or special needs

Yes
No

Please explain

My child takes medication(s)

Yes
No

Please explain

Desired Major

The program would like to gain a better sense of what art forms the students would like to participate in. We ask that you fill out your child’s desired major is while they attend our program. Please fill in Visual Art, Dance, Music or Theater.

Desired Major

I, hereby give permission for my child to attend the STEAM Summer Enrichment Program. I give permission for my child to be dismissed in the following way:

My child has permission to walk home from the STEAM Summer Program.
My child will ride public transportation from the STEAM Summer Program.
I will pick up my child from the STEAM Summer Program.

My child has permission to be picked up by:

How did you hear about the program?

Billy Penn/WHYY Website
Cap4Kids Website
Family Focus Website
Mommy Poppins Website
My Student's Classmates
PAEP's Facebook Page
PAEP's Website
Prinicipal, Administrator or Teacher at School
Other

Enrollment Agreements

Please indicate*

Release Agreement: I understand that the school building closes promptly after the Virtual STEAM Summer Program ends each day. I also understand that, if I elect to pick up my child, I am responsible for my child leaving the program on time. If I am late more than three times to pick up my child, I understand that the program and school staff has the right to remove my child from the program.

Emergency Care Release: In the event of an emergency in which I cannot be reached, I authorize emergency medical personnel to Photography Release: provide the necessary first aid and/or hospitalization. I understand that my child may be photographed, videotaped, and/or interviewed for the purpose of PAEP promotional use. If I do not want my child photographed, videotaped, and/or interviewed, I must notify PAEP in writing.

Enrollment Agreement: I understand that this enrollment form must be filled out completely. Missing sections may prevent my child from attending the program.

Code of Conduct: I understand my child is required to follow The School District of Philadelphia’s Student Code of Conduct. I understand that all parents and children are expected to respect the program and school staff. If my child exhibits inappropriate behavior during the program a behavior report will be issued. After three behavior reports, my child may be suspended or removed from the program.

Parent / Guardian Name*

Parent / Guardian Signature*