Clone of Storytellers 2025 Summer Camp Registration

"Navigating the Universe Within"

Join us for our annual Storyteller's Summer Camp for youth ages 5-18! This year, camp will focus on helping our youth with "Navigating the Universe Within." The workshops and experiences have been designed to assist youth with exploring parts of themselves related to their emotions, thoughts, feelings, talents, and strengths.

Dates:

Tuesday, July 14th-Thursday, July 16th

Tuesday, July 21st-Thursday, July 23rd

Tuesday, July 28th-Thursday, July 30th

Times: 9:00am-2:00pm

Location: Augustana Lutheran Church of Hyde Park

Address: 5500 S. Woodlawn Avenue Chicago, IL 60637

If you have any issues with completing this form, please contact Samantha Vazquez at 630-294-3672 or samantha@chicagosurvivors.org

Parent/Caregiver Name

First NameLast Name

Parent/Caregiver Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Format: (000) 000-0000.

E-mail

example@example.com

Emergency Contact

First NameLast Name

Emergency Contact Phone Number

Format: (000) 000-0000.

List the safe adults allowed to pick up your camper at the end of the day.

Lost Loved One Name(s)

Angel/Death Date

Date

Youth Registration (if you need to register more than 4 youth, please complete an additional registration form)

Rows	Youth Name	Age	T-Shirt Size	Allergies
Youth #1
Youth #2
Youth #3
Youth #4

What weeks will your child(ren) attend camp?

Have you or your family been involved with Chicago Survivors in the past? If yes, which departments?

I will need support for Transportation Costs to and from camp. For Every 4 children, Chicago Survivors provides $100 for 3 days of transportation

Transportation Costs: Do you prefer Visa Gift Card or Uber Gift Card?

Are you interested in volunteering for field trips? (space may be limited)

Would you be interested in entering a raffle to win tickets to a Chicago Fire Soccer Game at Soldier Field on Thursday, July 16th at 7:30pm?

Are there any other concerns our team should know about your child to support them throughout the camp experience?

Makers Day is an opportunity for caregivers and children to create special items and memorabilia to honor lost loves ones. Makers Day is scheduled for Wednesday, July 29th 10am-2pm. Please use the box below to upload a photo for Maker's Day. (Note: If you submit multiple photos, they will be added to items as a collage)

Photo Release Form:

I grant Chicago Survivors, its representatives and employees, the right to take photographs of me, my child, and my property in connection with the above identified event. I authorize Chicago Survivors, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Chicago Survivors may use such photographs of me with or without my name or childs name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.

I have read and understand the above:

Signature for Photo Release (Please Sign OR Decline below)

Decline Photo Release Consent

Storytellers 2026 Summer Camp Registration