STARR 2026 Student Application

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STARR
STARR: Students Talking About Race + Racism is a 2-day, non-residential program for students interested in learning about the current and past manifestations of race and racism in our country. Click here to learn more about STARR. Any high school student that lives or attends school in North Carolina is eligible for STARR. Applicants are expected to attend both days of STARR. 
Students in middle school and students that have recently graduated are encourage to apply and will be admitted as space allows. 

Should you need assistance completing this application, contact Kelly Dawson at kdawson@nccjtriad.org or 336-272-0359 x 210.

This application is for the STARR session taking place January 24 and 26, 2025. This session is being hosted at West Market Street United Methodist Church in Greensboro.  

Applicant Information















(Ex: man, woman, transgender man, transgender woman, etc.)







By checking the text opt-in box you are agreeing to receive periodic SMS and/or MMS message from this organization. Message and data rates may apply. Text HELP for more information. Text STOP to stop receiving messages



Parent/Guardian Information
Parent /Guardian #1












By checking the text opt-in box you are agreeing to receive periodic SMS and/or MMS message from this organization. Message and data rates may apply. Text HELP for more information. Text STOP to stop receiving messages

Parent /Guardian #2












By checking the text opt-in box you are agreeing to receive periodic SMS and/or MMS message from this organization. Message and data rates may apply. Text HELP for more information. Text STOP to stop receiving messages

Additional Emergency Contact
In the event of an emergency, NCCJ will contact the parent/guardians listed above. If you would like to provide an additional emergency contact, please list that information below. 





Additional Information

Demographic Information
To ensure diversity at STARR, we ask that you please check any/all of the following that apply to you:  (This information is confidential and will be viewed by NCCJ staff only.  It will not be used or disclosed for any other purposes.)







Health History and Medical Release Form

All medical information will be kept strictly confidential and will only be viewed by NCCJ staff. 


This section should be completed by a parent or guardian.










Medical Conditions








Parent/Guardian Authorization
This health history is correct and complete as far as I know, and my child/the child in my care has permission to participate in the program activities except as noted.  I also understand that North Carolina for Community and Justice (NCCJ), its officers, board members, volunteers, agents, employees and licensees cannot be held liable for any health complications or problems that resulted from or were caused by my child's/the child in my care's negligent regard for his/her own health and safety.


Student Agreement to Abide by Health Restrictions
I understand and agree to abide by the restrictions placed on my activities during this program. I agree not to infringe on the safety of or knowingly cause bodily harm to the others in attendance at STARR.  I also understand that North Carolina for Community and Justice (NCCJ), its officers, board members, volunteers, agents, employees and licensees cannot be held liable for any health complications or problems that resulted from or were caused by my negligent regard for my own health and safety.


Photo Release
I am the parent/legal guardian of this applicant who will be participating in activities sponsored by North Carolina for Community and Justice (NCCJ), including STARR. I understand that my child/the child in my care, alone or with other participants and/or NCCJ staff, volunteers or representatives, may be interviewed, photographed, recorded on film, audio tape, video, or other visual and sound computerized, telephonic, voice-mail or tape media ("photographs and/or sound/image recordings") and/or may provide written or oral statements to NCCJ and/or others approved by NCCJ.

I hereby consent to the foregoing and grant permission, without reservation, to NCCJ and/or those approved by NCCJ to generate, prepare, advertise, describe, and/or publicize NCCJ and its work, good will, public education and/or fundraising activities, disseminate, otherwise use and comment upon the photographs and/or sound/image recordings as they may determine, without review by me or my child/the child in my care and without financial or other obligation of any nature to me or my child/the child in my care.  I consent that my child/the child in my care may be identified by name, age, race, school of attendance, city of residence, or program of participation as these companies and/or those approved by these companies may determine. Uses may include, but are not limited to, promotional videos, fundraising appeals, website content, and news coverage.

I release NCCJ, its officers, Board of Directors, volunteers, agents, employees and licensees from all claims that I or my child/the child in my care may have, or might have, for any cause of action arising out of the taking and/or use of the photographs and/or sound/image recordings as set forth herein. This consent and release shall continue in effect, without a limitation of time.



Important Note About Photos:
Photos and videos are an important way NCCJ shares the STARR experience, especially through social media and printed materials. Most of our photos capture group activities rather than individual portraits. We are mindful to use images in ways that reflect the positive, respectful, and inclusive spirit of our programs. 

We will never use a student’s image in a major marketing campaign (such as billboards or TV ads) without getting additional permission from parents/guardians. We do not publish students' full names alongside their images. 
If your student cannot be photographed or recorded, please contact Kelly Dawson at kdawson@nccjtriad.org or 336.272.0359 x 210 before the program begins. We will work directly with you to make accommodations and set expectations prior to your student’s arrival.
Bullying Policy
At North Carolina for Community and Justice (NCCJ), we have a firm policy against all types of bullying. Everyone in the program is expected to treat each other with respect. This includes students, volunteers, and NCCJ staff members. Our STARR staff has been trained to recognize all incidents of bullying and take them seriously. We promote respectful communication between staff and delegates and work together as a team to ensure that each delegates has a wonderful and safe experience at STARR. 
What is bullying? 

Bullying is aggressive behavior that is intentional, is repeated over time, and involves an imbalance of power or strength. Bullying can take on various forms, including:
  • Physical Bullying- when one person engages in physical force against another person, such as hitting, punching, pushing, kicking, pinching, or restraining another. 
  • Verbal Bullying- when someone uses their words to hurt another, such as belittling or calling another a hurtful name
  • Nonverbal or relational bullying- when one person manipulates a relationship or desired relationship to harm another person. This can include social exclusion, friendship manipulation, or gossip. This type of bullying also includes intimidating another person by using gestures. 
  • Hazing- an activity expected of someone joining or participating in a group that humiliates, degrades, abuses, or endangers that person regardless of that person's willingness to participate. 
  • Sexualized bullying- when bullying involves behaviors that are sexual in nature. Examples of sexualized bullying include sexting, exposures or private body parts, and verbal bullying involving sexualized language or innuendos. 
Anyone who sees and act of bullying and/or who then encourages it is engaging in bullying. This policy applies to all employees, contractors, and volunteers. 

Bullying may show up as:
  • teasing
  • name calling 
  • excluding others
  • rumors
  • ganging up
  • intentionally disrupting programs and activities
  • mocking or taunting
What's the impact?
The bullying behavior has a negative impact emotionally, spiritually, or physically on the victim. 

Discipline Procedures
If a student does not follow the community agreements, we will take the following action steps as behavior problems progress:
  1. Staff will redirect the student to more appropriate behavior. 
  2. If inappropriate behavior continues, the student will be reminded of the first warning they received. NCCJ staff will work with the student to decide on appropriate action steps. A phone call home may occur at this point if staff and/or student feel like this is necessary or could be helpful. 
  3. If a student's behavior continues, the student's parent/guardian will be notified, or the student may be dismissed from STARR.
Bullying incidents and action steps will be documented by NCCJ staff. 

If a delegate is participating in bullying activities, the delegate's parent/guardian can be called and asked to pick up their child immediately, regardless of the time of day or day of the week. 

By signing below I acknowledge that I have read, understood, and agree to the bullying policy above. 




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Students will walk (with adult supervision) from West Market Street United Methodist Church to the International Civil Rights Center and Museum (ICRCM). The 0.5 mile walk takes 5-10 minutes to complete.
Students will only be transported in vehicles in the event of inclement weather (rain, snow, temperatures below freezing).
If your student has a mobility issue that prevents them from walking, contact Kelly Dawson at kdawson@nccjtriad.org or 336.272.0359 x 210 so that we can make accommodations. 
Transportation Waiver
I am the parent or legal guardian of the named minor child who is participating in NCCJ's STARR program. 

I, the undersigned, give permission for my child/the child in my care to be transported in a private vehicle. I hereby release North Carolina for Community and Justice (NCCJ) and its employees, including its board members, and program volunteers, from any and all liability, damages, claims, and judgments, of every kind and nature arising out of, or in any way relating to, any injury or death to my child/the child in my care, or for property damage, occurring during, or on account of transportation of my child/the child in my care by the Transporting Party. 

Notwithstanding this general release, the actual Transporting Party, even if an employee of the North Carolina for Community and Justice (NCCJ) is not released from liability for his/her operation of his/her vehicle, but only to the extent that Transporting Party is covered with liability insurance. Further, the undersigned agrees to indemnify and save harmless North Carolina for Community and Justice (NCCJ) and its employees, including its board members, and program volunteers, from all claims demands, liabilities, or judgments for personal injury or death to my child/the child in my care, or others, or property damage; except, however, if the Transporting Party is an employee of North Carolina for Community and Justice (NCCJ) and acting within the course and scope of his/her duties, this indemnity shall not apply to claims and liabilities against the actual Transporting Party for his/her operation of his/her vehicle, but only to the extent of the limits of liability insurance insuring the Transporting Party.





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Tuition and Tuition Assistance

  • The full cost of attending STARR is $200. 
  • A refund of tuition will be made upon written request when a cancellation is made at least 2 weeks before a session. 
  • To receive a refund, submit your request to Alison Jones at ajones@nccjtriad.org. 
  • No refunds will be given for a student who leaves a session early. 
Tuition Assistance
  • NCCJ works hard to ensure STARR students include a diverse population. This includes socio-economic diversity. Generous, need-based tuition assistance is available to all applicants. Please do not let your need for assistance discourage you from applying to Anytown. 
  • NCCJ will do our best to work with your family to cover the fees that you cannot. We ask that you please only request what you truly need so that we can provide aid to everyone who needs assistance. 
  • Please indicate below whether you are applying for tuition assistance and how much of the full cost of attending STARR ($200) you can pay. 
  • All information provided will be kept confidential.
  • All tuition assistance applicants will receive a statement from NCCJ indicating whether their request for tuition assistance has been accepted or declined.


If you have requested tuition assistance, you will receive an email confirmation within 5 business days. 
By signing below, I verify that I have thoroughly read the information listed in the tuition, fees and tuition assistance section of this application. I give my permission for the young person named above to apply as a participant in NCCJ's STARR program.