PEACE, LIBERATION & THE ARTS SUMMER ADVENTURE

Welcome to the PLA Summer Adventure sponsored by 4 Circles Beyond

We’re so glad you’re interested in joining this year’s Peace, Liberation & Arts Summer Adventure: Roots of Resistance – The Art and Alchemy of Becoming. This 10-day immersive journey brings together youth from Chester to travel, reflect, create, and grow as visionary leaders and agents of change.

This summer, we’ll explore the living legacy of resistance—how it moves through history, culture, the body, and everyday acts of care. Together, we’ll visit sacred lands, historic sites, and community spaces where liberation struggles have shaped generations. Through these experiences, we’ll uncover how resistance lives in storytelling, in movement and music, in food and memory, and in the ways we build connection and collective power.

The PLA Summer Adventure is more than just a trip. It is a transformative journey rooted in creativity, community, and healing. Whether we are learning capoeira, creating protest art, sharing meals, or walking the paths of those who came before us, we will be grounding ourselves in truth, imagination, and justice.

This program is open to youth ages 13 to 16 who are ready to lead, collaborate, and co-create a powerful experience. Space is limited, and we are forming a balanced and intentional group of participants. All applicants will be notified of their selection by June 15, 2025.

Thank you for your interest in the PLA Summer Adventure. We look forward to traveling, learning, and becoming together.

In peace and solidarity,

Victor A. Cabral, LSW
PLA Summer Adventure Director

For questions, contact:
victor@4CirclesBeyond.org or jill@4CirclesBeyond.org

As part of our selection process, we would love to learn more about how you express yourself creatively. If you would like, you can submit an example of your artwork or creativity to help us better understand your style, interests, and potential. This can be anything that feels true to you, such as a photo of visual art, a voice recording or song, a short video, a saved TikTok, a poem, story, journal entry, or any other form of creative expression. Submitting something is completely optional, but we welcome anything you would like to share. If you choose to include a submission, you can upload it or provide a link along with your application.

Please List Names of Individuals Authorized to Act On Your Behalf If You Are Unavailable

I understand that in case of any emergency requiring medical treatment, every effort will be made to contact one of the people listed above. If none of these people can be contacted, I authorize the 4 Circles Beyond staff to act on my behalf and give consent to treatment as deemed necessary by emergency responders.

Peace, Liberation & The Arts Summer Adventure 2025
Student and Parent/Caretaker Commitment Form

Participation in the PLA Summer Adventure is a powerful and immersive experience designed to promote learning, reflection, creativity, and leadership. Over the course of 10 days, youth and staff will travel, share space, and engage in workshops, creative projects, and community-building.

This form outlines the commitments and responsibilities that all participants—and their families—must agree to in order to ensure a safe, respectful, and transformative experience for everyone involved.

SECTION 1: STUDENT COMMITMENT
To be completed and signed by the youth applicant.

As a participant in the 2025 PLA Summer Adventure, I agree to the following:

1. I will actively participate in all scheduled activities from July 18–27, 2025, including travel, workshops, creative sessions, reflections, and team-building.
   
   
2. I will treat all fellow participants, staff, and people we meet with kindness, care, and respect.
   
   
3. I will work with others to create and follow a group agreement that supports safety, honesty, and accountability.
   
   
4. I will check in my cell phone daily, as part of building an intentional and connected group environment.
   
   
5. I will dress appropriately for all activities, including cultural site visits, outdoor time, and community events.
   
   
6. I will not engage in fighting, bullying, harassment, or use offensive language.
   
   
7. I will not use or possess tobacco, alcohol, or any illegal or controlled substances. I understand that breaking this rule will result in being sent home early, and my parent or caretaker will be contacted.
   
   
8. I understand that serious violations of expectations may result in my removal from activities or dismissal from the program. If that happens, I may be sent home early at my family’s expense.
   
   
9. I will show up with a positive attitude, take responsibility for my actions, and be open to learning and growth.
   
   
10. I understand that my parent or guardian may be held financially responsible for damages I cause to lodging, vehicles, or program property.

 

SECTION 2: PARENT OR GUARDIAN COMMITMENT

To be completed and signed by the parent or legal guardian.

As the parent or guardian of the applicant, I agree to the following:

1. I support my child’s participation in the PLA Summer Adventure and understand the full commitment requiredfor a 10-day travel-based experience.
   
   
2. I have reviewed this form with my child and will help reinforce the importance of group agreements, respect, accountability, and participation.
   
   
3. I understand that if my child violates major program rules (such as substance use or harassment), I may be contacted immediately and asked to make travel arrangements for their early return at my expense.
   
   
4. I understand that group lodging, transportation, and shared space require my child to act responsibly. I agree to be financially responsible for any damages caused by my child.

SECTION 3: MEDICAL AUTHORIZATION AND SELF-ADMINISTRATION POLICY
By signing below, we give permission for the following:

In the event of an accident, illness, or emergency requiring medical treatment during the program, every reasonable effort will be made to contact the parent or guardian, or the emergency contact listed on this form. If no one can be reached, I authorize the staff of 4 Circles Beyond to act on my behalf and give consent for any treatment deemed necessary by emergency medical personnel, including transportation, hospitalization, and medical procedures.

We understand that program staff are not medical professionals and will not administer prescription medications. If my child takes medication, I confirm that they are able to safely and independently self-administer their prescribed medication and that I have provided all necessary information in their health form.

I also authorize staff to provide basic over-the-counter medications (such as Tylenol, ibuprofen, allergy medicine, or antacids) as needed during the trip, unless otherwise indicated in writing.

We understand that all medical information must be provided in advance of the program. Failure to disclose relevant details may impact the safety or participation of my child.

PHOTO / MEDIA RELEASE PERMISSION

I, the undersigned parent or legal guardian of [Youth Name], give permission to 4 Circles Beyond Inc., including its staff, volunteers, and approved media partners, to photograph, film, or record my child during the Peace, Liberation, and Arts Summer Adventure 2025.

I understand that these images, videos, or recordings may be used by 4 Circles Beyond for purposes such as sharing the program’s impact, celebrating youth participation, and promoting the organization’s mission. This may include use in print materials, brochures, social media, websites, or press coverage.

I understand that:

• My child’s full name will not be used without additional permission.
• These materials may be edited for clarity or formatting.
• All media will be handled with care and respect for youth safety and privacy.
• I will not receive compensation for the use of these materials.
• I waive the right to review or approve the final products.

I release 4 Circles Beyond Inc. and its partners from any liability related to the use of media taken during the program, and I understand this permission is given voluntarily.

By signing below, I confirm that I understand and agree to the terms of this media release.

 

PLA Summer Adventure
Parent or Caretaker Field Trip Permission Form

• I, [Parent or Caretaker's Name], hereby give permission for my youth, [Youth's Name], to participate in the PLA Summer Adventure organized by 4 Circles Beyond.
• I understand that this program includes travel to multiple locations over the course of 10 days, from July 18 to July 27, 2025. Activities may include but are not limited to cultural site visits, physical activities such as ropes courses or movement-based workshops, and participation in overnight group lodging. I recognize that the group will be traveling together across state lines and staying in various locations under the supervision of trained adult staff.
• I understand that there are certain risks involved with participation in a travel-based program, including the potential for physical injury, property loss, or unexpected events that may arise while in new or unfamiliar environments. I acknowledge that 4 Circles Beyond will take all reasonable steps to ensure my youth’s safety and well-being throughout the program, including supervision by experienced staff, adherence to safety protocols, and coordination with trusted partners and hosts.
• I authorize 4 Circles Beyond, its staff, and any designated transportation providers to transport my youth during the full course of the PLA Summer Adventure. I understand that all transportation will be arranged in accordance with applicable safety guidelines and legal requirements.
• I release 4 Circles Beyond, its staff, volunteers, and any associated partners from any liability or claims related to my youth’s participation in this program, including any injuries, accidents, or other incidents that may occur during the course of travel and activities.
• I understand that I am responsible for ensuring my youth is prepared for the trip. This includes submitting emergency contact information, health details, required medications, and any important instructions that may support their safety and participation.
• I understand that program costs such as travel, meals, and lodging are being covered or subsidized through the program, and that I may be responsible for costs related to personal items, special needs, or damages caused by my youth.
• By signing below, I confirm that I have read and understood the terms of this permission form and that I voluntarily grant permission for my youth to participate in the PLA Summer Adventure.