STAR Youth Application Form

Thank you for your interest in STAR (Supported, Thriving, Authentic & Resilient) Youth, 
The STAR youth program works to bring youth currently or previously in foster care together with a focus on Social Emotional Learning (SEL), through affirming activities that help them create a positive sense of self and their identity, and create a peer network with other youth with shared life experiences. 
The STAR youth program is grounded in the belief that youth who have experienced foster care deserve a safe, inclusive, affirming, and youth-friendly place where they can build healthy relationships and be supported in positive identity development.  Research shows that youth that forge friendships and other relationships with positive features report having greater involvement in school and higher self-perceived social acceptance. These are protective factors our program works to reinforce:  

• establish physical and psychological safety;  
• establish appropriate structures that promote healthy bonding;  
• support youth in cultivating supportive intimate (non-romantic) relationships;  
• create opportunities for belonging; promote positive social norms;  
• support self-efficacy/empowerment/age-appropriate autonomy; and  
• create opportunities for skill building.   

STAR Youth Summer Application Form Lunch will be served daily. STAR is completely free for qualifying youth. King County: 9:00am - 2:00pm, Monday-Friday 5907 Martin Luther King Jr. Way S, 98118 North Star (Week 1) will cover general social-emotional learning topics like emotional regulation and coping with stress.  Constellation (Week 2) will focus on family separation-specific subject matter, including telling your story (or choosing not to) and honoring important milestones.  Youth are welcome to join us for both weeks or just one. *Update: as of July 3, all sessions are full except for July 17-21 and August 21-25 Pierce County: 9:00am - 2:00pm, Monday, August 21st - Friday, August 25th 3501 104th St E, Tacoma, 98446 Monday, August 21st - We get to know each other and participate in team-building activities Tuesday, August 22nd - We talk about the importance of communication Wednesday, August 23rd - We discuss the ripple effects of acting with kindness Thursday, August 24th - We explore listening skills Friday, August 25th - We identify stressors and strategies to cope with them Please indicate which session(s) you are planning to attend by checking the box below. King County Sessions Constellation (week 2): July 17th - July 21st   Pierce County Sessions Monday, August 21st - Friday, August 25th   Before and After Care Please check here if your youth will need to be dropped off earlier than 9am or picked up later than 2pm Basic Information & Demographics Youth First Name* Youth Last Name* Preferred First Name (if different from legal) Pronouns She/Her He/Him They/Them Other (list below)   if other, list here: Gender Female Male Genderfluid Transgender Female Agender Gender non-conforming Non-Binary Other Transgender Male Transmasculine Two-spirit   If Other, list here Birth Date Race/Ethnicity Arab, Iranian or Middle Eastern Asian Black/African American Hispanic or Latino Multi-Racial Native American or Alaska Native Other Pacific Islander or Native Hawaiian Unknown White   if other, list here Tribal affiliation, if applicable Primary Language Is this youth Formerly in care; adopted Formerly in care; reunified In a guardianship In foster care   Information for Amara Staff If you are able, please tell us more information about the youth attending camp to help our staff with planning. If you prefer, you can leave these fields blank and we will follow up at a later date.   Description of Youth’s Strengths: Description of Youth’s Interests: Description of “What Works” (i.e., routine, fidget toys, incentives, etc.) to support your youth to regulate emotions and feel safe Description of “What Doesn’t Work” (i.e., timed tasks, transitions, etc.) to support your youth to regulate emotions and feel safe Are there any triggers for this youth that staff/volunteers should be aware of? What might it look like for this youth when they are feeling triggered or dysregulated? What are some things that help when they are feeling this way? What do you hope that your youth will get out of the STAR Program experience? Any other information you would like our staff to know: Does your youth have any dietary restrictions? Does your youth have any medical needs that might affect participation in our programming? If yes, please let us know how we can support them in order to be successful, safe and comfortable in our program. Does your youth have a disability or learning needs that you would like us to know about? If yes, please let us know how we can support them in order to be successful, safe and comfortable in our program. Parent/Caregiver Caregiver name* Caregiver phone ()-ext Enter Int'l Number Caregiver Email* Zip code (where youth lives currently) What is your relationship to this youth? Preferred method of communication (check all that apply) Email In-Person Phone   Ok to leave a message? Primary language How did you hear about STAR? Total # of adults in household Total # of youth in household Acknowledgement and Waiver Submission of this form does not guarantee enrollment in the program. Amara staff will contact you to confirm your enrollment as soon as possible I affirm that I have the authority to enroll the above-named youth in the STAR Youth program*

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