• 2026 Holiday Polar L Express Gift Drive Registration Form

    Saturday, December 5th 12:00 PM – 2:30 PM 1340 West Washington Blvd, Chicago, IL Who is Eligible? Immediate relatives of homicide victims are welcome to register their youth to receive gifts and celebrate the season with us. This event is designed to bring warmth, support, and a festive spirit to families impacted by loss. Gift distribution is available for siblings and children (ages 0-18) of homicide victims who are registered for the event. Please register up to 5 kids! We will open for more kids if we have openings later on, just to ensure ALL families get to participate. Any duplicate registrations will be DELETED so please do not do more than one.

  • Gaurdian Details

  • Format: (000) 000-0000.

  • Eligibility Details

  • Are you registering youth(s) who are the CHILD, SIBLING, or were under the primary care of the Homicide Victim?*

  • Youth & Gift Preferences

  • IF THIS SECTION IS NOT COMPLETED FULLY FOR EVERY CHILD, YOUR SUBMISSION WILL BE REJECTED.


    YOUTH INFORMATION:     List EACH YOUTH you are registeriong for a GIFT (must be 18yrs and under).

    GIFT REQUESTS: Please enter a few suggested gift items in the gift request field. Example of categories for gift inspiration:
    Sports, music, electronics (no tablets or IPads), arts&crafts, beauty, dolls, barbies, action figures, puzzles, or educational items and toys. Please be as specific as possible.

    Teens aging 10 + are able to recieve gift cards as well, but you must specify what for. For example: Roblox, PlayStation, game stop ect

    NOTICE: 5 kid max 

  • Rows

  • IF YOU MAKE AN ERROR ON THIS REGISTRATION, DO NOT COMPLETE A NEW FORM. PLEASE EMAIL JASMINE. JASMINE@CHICAGOSURVIVORS.ORG.

  • Photo/Video Release

    Photo/Video release: I understand that I will not be paid for these photographs and have no rights to them. I am participating as a volunteer. I hereby waive any right to inspect or approve the finished photograph or advertising copy or printed matter that may be used in conjunction therewith or to the eventual use that it might be applied.

    By submitting this form you agree to the photo release policy

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