Young History Detectives Registration
Fall + Spring 2023
A Program of The House of Afros, Capes & Curls
Additional documents for registration
• Student Contract (separate form students receive)
Young History Detectives
The Young History Detectives is an educational program and curriculum of The House of Afros, Capes & Curls. Students learn Black History, both regional, national, and across the African Diaspora along with historical research methods to better understand US History. Research and documentation skills critical thinking, problem-solving, cultural enrichment, and historical knowledge with our ongoing Spatial Memory Project, are all supported through this program.
Fall 2023 + Spring 2024
Our main project will be researching and recording history discovered at individual properties on 24th, 16th, and 30th Streets in North Omaha. It's a multi-year project that they started last summer and will continue until we can create a VR experience mapping North Omaha, which is the big picture. This is a multi-year project where we document the history of buildings and spaces on 24th, 30th, and 16th Streets, and learn the history of Omaha, to create a VR exhibition and tour for the community.
Student Information
Name
*
First Name
Last Name
Birth Date
*
-
Month
-
Day
Year
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Pronouns
*
Please Select
He/Him
She /Her
They/Them
Other (please share)
Ethnicity
*
Please Select
African American
Hispanic/Latino
Asian
Caucasian
Native American/Alaskan
Hawaiian/Pacific Islander
Middle Eastern
Prefer not to answer
Other
Student Email Address
*
Phone Number
Please enter a valid phone number.
Age
*
Please Select
11
12
13
14
15
16
17
Grade Level
*
Please Select
6th
7th
8th
9th
10th
11th
12th
Have you previously attended Young History Detective workshop, program or summer camp?
*
Yes
No
If yes, what year?
Student Residence Information
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student Phone Number
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Area Code
Phone Number
Parent/Guardian Information
Name
*
First Name
Last Name
Parent/Guardian Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Name
First Name
Last Name
Parent/Guardian Email Address
example@example.com
Phone Number
Please enter a valid phone number.
Parent/Guardian Residence Information (if different from above)
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Emergency Contact 1
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Emergency Contact 2
Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Medical Information
Please list any of the following: Current medications, Medication allergies, Food allergies, Chronic health concerns.
Social or Emotional Needs
Let us know anything we may need to know to support the best learning experience possible.
Accessibilty Needs
Please list any accessibility needs student may need
Notes
Anything else you think we should know. All information is private and confidential.
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Media Release
I hereby give permission for images of my child, captured during The Young History Detectives Program through video, photo and digital camera, to be used solely for the purposes of The House of Afros, Capes & Curls Inc. promotional material and publications, and waive any rights of compensation or ownership thereto.
Parent/Guardian Signature
*
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Transportation Authorization
(Our primary transportation is provided by ENCAP) I authorize The House of Afros, Capes & Curls to transport my minor child on a public bus or van operated by ENCAP (Eastern Nebraska Community Action Partnership), Metro Area Transit or in a bus or van, driven by an individual authorized by The House of Afros, Capes & Curls, Inc. I understand my child is expected to follow all applicable laws regarding riding in a motor vehicle and is expected to follow the directions provided by the driver and/or staff or volunteer.
Parent/Guardian Signature
*
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Field Trip Authorization
I give permission for my child (named above) to attend field trips associated with The Young History Detectives Program, as a part of The House of Afros, Capes & Curls. I further give permission for The House of Afros, Capes & Curls to transport my child on a public bus or van operated by by ENCAP (Eastern Nebraska Community Action Partnership), Metro Area Transit or in a bus or van, driven by an individual authorized by The House of Afros, Capes & Curls, Inc. I understand my child is expected to follow all applicable laws regarding riding in a motor vehicle and is expected to follow the directions provided by the driver and/or staff or volunteer.
Parent/Guardian Signature
*
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Pick Up Authorization
Please list all individuals authorized to pick-up students. All students must be signed in and signed out at the The Barbara Weitz Center for Community for Engagement (CEC)
Name, Phone Number, Relationship
*
Lana Toon, 402-867-5309, Aunt
YHD Camp Payment
I will make payment/payments online
I am requesting a scholarship
I am as a parent/guardian available to volunteer
My Products
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2023 Summer Camp Fee
Young History Detectives History Summer Camp Monday-Friday | July 24 - August 4 | 10:00 AM - 5:30 PM UNO | Barbara Weitz Community Engagement Center
$
150.00
Quantity
0
1
2
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4
Payment Methods
Credit Card
Apple Pay
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Google Pay
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Cash App Pay
After submitting the form, you will be redirected to Cash App Pay to complete the payment.
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