Project BLOOM – Interest & Registration Form

We Rise. We Grow. We BLOOM.

Program Schedule: 1st & 3rd Saturdays | 11:00 AM – 1:00 PM

Note: Submitting this form indicates your interest in joining Project BLOOM. Completion of this form does not guarantee acceptance. All applications are reviewed to ensure the program is the right fit for each participant.

Student Information

Parent/Guardian Information

Emergency Contact (other than parent/guardian)

Getting to Know You

Student Interests & Goals

Health & Wellness

Consent & Acknowledgment

I understand that submitting this form does not guarantee acceptance into Project BLOOM. I give permission for my child to participate if selected, understanding that the program focuses on wellness, healthy relationships, communication, boundaries, and sisterhood.