Blaze - Discovering My Purpose
Please complete this form to register your 7th or 8th grade daughter by September 20th. Parents will be reminded of our first meeting by email. There is a registration fee of $10. Please send it to the school office or rectory in an envelope labeled Blaze-Janet Fiatoa by September 30th.

Participant's Name
Participant's Grade In School *
Parent's Name *
Parent's Cell Phone Number *
Parent's Email Address *
Participant's Cell Phone Number *
Do Blaze Leaders have parental permission to communicate with participant by phone? *
Can your daughter's image be published on St. Jerome's Parish social media sites and website? *
Emergency Contact Name and Cell Number *
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