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   Bloomfield Fire Youth Camp

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   “Girls on Fire” Two Day Camp 

   Wednesday 8/16 and Thursday 8/17 9 AM to 1 PM

   
   

   Bloomfield Fire House Station 3 located at 124 East Passaic Avenue Eligible for Bloomfield female residents, entering 4^th or 5^th grade.

9. Name:*
11. Address:*
13. School:*
14. Entering Grade:

    1. 4th
    2. 5th
16. Parent / Guardian Name:*
18. Phone Number:*
19. Email Address:
21. Emergency Contact (Name and Number)*
23. T-Shir Size (Choose one):
    -- Select One --Youth SmallYouth MediumYouth LargeYouth Extra LargeSmallMediumLarge

25. Applications must be submitted to Fire Headquarters by August 1, 2023. (Limited Availability)

    
    

    Bloomfield Fire Department

    375 Franklin Street Bloomfield, New Jersey 07003 Attention: Fire Youth Camp

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27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

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