Hoop of Learning Program About Program Registration Program Registration Student Information Name First Required Last Required Email Required Please provide a non-LPS email. Phone Required Please provide student phone number, not parent/guardian phone number. Address Address Required Address 2 City/Town Required State/Province Required - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code Required Tribal Affiliation Required Name of High School Required Grade Level Required Student must be in 11th or 12th grade to participate in this program. Parent/Guardian Information The University of Nebraska-Lincoln (UNL) has implemented a Youth Activity Safety Policy to provide a safe environment for youths participating in Nebraska sponsored activities, clinics or conferences. Our policy includes safe interaction guidelines as well as background and sex registry checks for Activity Workers. This policy will help to protect youth from potential misconduct incidents and provide a safe, educational and enjoyable activity/program experience. Youth Activity Safety Policy Requirements: All Activity Workers must successfully pass a sex offender registry search for Nebraska and the state(s) they reside. All Activity Workers driving activity vehicles must successfully pass a Driving Record Check. In the case of an emergency or accident involving your youth, Parents/Guardians will be notified, following notification of the appropriate emergency personnel. All Nebraska activities will comply with the University of Nebraska-Lincoln’s Youth Activities Safety Guidelines. As parent(s) or legal guardian(s) you give permission to this activity to use photos of your child in promotional media. Parent/Guardian Consent Required I, the parent/guardian, have read the above statement and agree to its terms. Parent/Guardian Name First Required Last Required Parent/Guardian Email Required Parent/Guardian Phone Required Leave this field blank
