LAFD Youth FIRE Program
Youth FIRE Program intake form. Participants must be 14-18 years old AND in High School.

Next programs start date:
Harbor- Spring 2020
Metro- Sept 28 - Nov 16
Valley- Oct 5 - Nov 23

Email address *
Which FIRE Program Location are you interested in?
If you are a returning participant of this program, which phase did you participate in last? *
Last Name *
Your answer
First Name *
Your answer
Date of Birth (mm/dd/yyyy) *
Your answer
Gender *
Ethnicity *
Phone Number (For example: xxx-xxx-xxxx) *
Your answer
Parent Name *
Your answer
Parent Phone Number (For example: xxx-xxx-xxxx) *
Your answer
Zip Code *
Your answer
Medical Concerns (allergies, asthma, medications, etc.)
Your answer
High School currently attending?
Your answer
School ID Number
Your answer
Shirt Size
Have you attended any other LAFD youth programs? (Check all that apply) *
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