Enrollment Form

STEM & Vine is coming back to North East Elementary!

STEM & Vine will provide contextualized computer science and S.T.E.M. after school learning in the North East community with a particular focus on agriculture, ecology, and industry.

Programming will run from 3:45-5:30pm on Tuesdays for 1-2 learners and Thursdays for grade 3-4 learners.

The program is free with after school snack provided. Bus transportation is no longer provided.

STEM & Vine will offer three sessions, each centered around a unique theme and held once a week over a four-week period.
Students may choose to enroll in individual sessions or for all three at once.
- Session 1: Agriculture – Begins in October
- Session 2: Coding & Computer Science – Begins in February
- Session 3: Watersheds – Begins in April

Behavior Policy: To preserve the learning experience for all students, STEM & Vine has a two strike behavior policy. If a student's behavior is disrupting learning, the first strike will be a call home. If additional infractions occur, the student will be unenrolled from STEM & Vine.

Repeated Absence Policy: STEM & Vine is operating on a long waitlist. If your child is consecutively absent, we will contact you to discuss options for continual enrollment in the program. After 4 consecutive absences, your child may be moved the to the waitlist.

WAIVER AND RELEASE FROM LIABILITY CONTRACT

In consideration of the minor identified in the enrollment form being allowed to participate in the activities provided by or in conjunction with the Mercyhurst University STEM & Vine program (“MSV”), and any related events and activities, and further intending to be legally bound, the undersigned/authorizing guardian:

Agrees that, prior to allowing the minor to participate, they have the right to inspect the facilities and equipment to be used, if any, and if they believe anything is unsafe, they will immediately so advise the supervisor in charge of such facilities and equipment and refuse to participate.
Acknowledges and fully understands that the minor may engage in activities that involve risk of injury, which might result not only from their own actions or inactions, but also from the actions, inactions or negligence of others, or the condition of the premises or of any equipment used. The undersigned/authorizing guardian further acknowledges that there may be other risks not known to MSV or not reasonably foreseeable at this time.
Assumes all the foregoing risks and accepts personal responsibility for the damages following such injury, in the event it occurs.
Releases, waives, discharges and covenants not to sue MSV, Mercyhurst University, any of their affiliate entities, or any of their respective directors, officers, shareholders, agents, or employees; other participants; or the owners of the premises and/or equipment used to conduct MSV, to all of whom the benefits of this waiver and release from liability shall inure, from demands, losses or damages on account of injury, including damage to property, caused or alleged to be caused in whole or in part by negligence of the releases or otherwise.

BY CLICKING "I AGREE TO THE WAIVER" BELOW, YOU ARE AFFIRMING THAT YOU HAVE READ THE ABOVE WAIVER AND RELEASE FROM LIABILITY, UNDERSTAND THAT YOU HAVE GIVEN UP RIGHTS BY SIGNING IT, AND AGREE YOU ARE SIGNING IT VOLUNTARILY. YOU REPRESENT THAT YOU ARE THE PARENT OR GUARDIAN OF THE MINOR, AND ACKNOWLEDGE AND AGREE TO THE ABOVE ON BEHALF OF THE MINOR PARTICIPANT, IN YOUR INDIVIDUAL CAPACITY, AND IN YOUR CAPACITY AS PARENT OR GUARDIAN OF THE MINOR PARTICIPANT.

I, the undersigned/authorizing guardian give my permission for:

My child to participate in MSV
My child to participate in MSV field trips throughout the School Year
My child to be photographed, recorded, and have their work showcased in the MSV Newsletter, reports, and other publicity
MSV to exchange information regarding my child with the Pennsylvania Department of Education and/or the School District for program evaluation and statistical purposes. This information may include: test scores, grades, behavior reports, and attendance.

Student Enrollment Form

WAIVER AND RELEASE FROM LIABILITY CONTRACT