2024 Summer STEAM Sign-Up Form           Faribault Public Schools
Fill out one sign-up form per child.

If you have any questions regarding the Summer STEAM program, feel free to call Community Education at 507-333-6070 or email mleichtnam@faribault.k12.mn.us.

Thank you for signing your child up for Summer STEAM! We are excited to offer this program and look forward to seeing your child this summer!

When:  June 17 - August 1, 2024  Monday - Thursday  8am - 3pm
Where:  Grades 1 - 4 at Jefferson Elementary  Grades 5 - 8 at Faribault High School
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Student Last Name *
Student First Name *
Student Middle Name
Date of Birth *
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Current School: *
Current Grade: *
Current Classroom Teacher *
Parent/Guardian Name: *
Parent/Guardian Phone Number: *
Emergency Contact Name: *
Emergency Contact Phone Number: *
Busing
Transportation is available to and from various pick-up and drop-off sites throughout Faribault. If your child needs transportation, forms must be submitted by March 15, 2024. Students registered after the March 2024 deadline WILL NOT be guaranteed transportation services. All current busing rules apply, including the one-mile transportation radius.
Morning Pick Up *
Afternoon Drop-Off *
Daycare/Not home Contact Name (if applicable):
Daycare/Not home Address (if applicable):
Daycare/Not home Phone Number (if applicable)
Required STEAM Transportation Expectations

It is Minnesota law that riding the bus is a privilege and not a right. If these expectations are not met, your student could lose their privilege to utilize transportation. 

The expectations on the bus include, but are not limited to: 

  • Respect and obey the bus driver at all times. 

  • Respect other students and their property at all times. Make room for others needing a seat. 

  • Cross 10 feet in front of the bus when crossing the roadway. 

  • Keep the aisle clear at all times. 

  • Keep your hands, head, and all other objects inside the bus at all times. 

  • Windows open to halfway point only, with driver permission. 

  • Remain seated facing forward at all times. 

  • Talk quietly and use appropriate language. 

  • Bus vandalism, such as cutting/ripping seats, is strictly prohibited.

  • No tampering with the bus radio, control equipment, or emergency exits.

  • Video or picture taking of any kind is strictly prohibited.

  • No fighting, harassment, intimidation, or horseplay. 

Actions found by the bus driver or school staff to be inappropriate, but not specifically listed above, may also result in disciplinary action.


Transportation Consequences

1st Offense: Verbal warning and phone call home to parent/guardian 

2nd Offense: Five-day suspension from transportation 

3rd Offense: Loss of transportation privileges for the remainder of STEAM 

Both the driver and school staff reserve the right to suspend a student from transportation and the program for the remainder of the school year upon one incident, should it be determined a major offense.

By typing your name below you have confirmed that you have read the transportation expectations and have reviewed them with your child. *
Please note the following criteria students must meet in order to enroll in the Summer STEAM program:

  • Able to follow verbal instructions and directions provided by STEAM staff and supervisors;

  • Demonstrate age-appropriate cooperative play and work behaviors (i.e., taking turns, sharing, etc.) in both small and large group activities with minimal adult supervision;

  • Able to work independently without disturbing others when assigned individual tasks;

  • Able to safely and successfully transition from one activity to another, and from one location to another with minimal adult supervision; and

  • Refrain from hitting, kicking, biting, and other forms of physical aggression toward other students and staff.

By typing your name below you have confirmed that you have read and agreed that you understand the criteria students must meet in order to attend the Summer STEAM program. *
By participating in Faribault Public Schools’ Summer STEAM program, students and parents agree to follow any and all rules and positive behavioral expectations established by Faribault Public Schools (FPS) and the Summer STEAM program. Failure to follow these rules may result in disciplinary action. The following are examples of positive behavioral expectations:

  • Respect FPS and Summer STEAM personnel (ex: program leaders, teachers, bus drivers, cafeteria workers, etc.) at all times.

  • Respect other students and their property at all times.

  • Use appropriate language at all times.

  • Follow all instructions or requests given by FPS and Summer STEAM staff at all times.

  • No fighting, harassment, intimidation, or bullying at any time.

Failure to meet any of the above rules and expectations will result in the following disciplinary actions:

  1. First offense – Verbal warning and conversation with parent/guardian.

  2. Second offense – Conversation with parent/guardian and student will be sent home for the remainder of the day or receive a one-day suspension from the STEAM program.

  3. Third offense – Conversation with parent/guardian and the student will be removed from the STEAM program.

This is a Minnesota Department of Education program in which students must meet (Minnesota Statutes, section 124D.68, Subdivision 2) criteria. By registering your child in the STEAM program, a Continual Learning Plan (CLP) will be created for your child based on academic or social-emotional goals.  Progress will be reviewed with you. By typing your name below, you give my permission to create a Continual Learning Plan (CLP) for my child if eligible. *
Students/Families may be included in photo, video, and online opportunities. Some of the photos/videos may be published or viewed in newspapers, television, or school and community publications. Student/Family photos and videos may also be included on the school district’s websites and social media sites. To opt out of these promotional opportunities, send a letter to Student Services Coordinator, Brenda Pittman, at the District Office, 710 17th St SW, PO Box 618, Faribault, MN 55021. *
Required
Goals: What goals do you have for your child in participating in Summer STEAM?  These will be included in the CLP. *
Medical: Please List any medical needs staff should be aware of about your child. *
Check the box below if you would like the nurse to contact you to discuss medical concerns regarding your child.  
Please type in your full name as an electronic signature to acknowledge and agree to the above information. Disclaimer: By typing your name into this registration form or giving your permission to a FPS staff member, you are hereby certifying that you are the legal parent or guardian of this child and this is recognized by Faribault Public Schools as a formal signature. *
If you had help completing this form, please type the name of the person below.  By typing their name, you are agreeing that all the information typed above is accurate.  
Email address for communications from Summer STEAM staff:
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