Ezra Junior Girls Winter Camp 2018
Years 4, 5 & 6

Sleep-away Camp:
Phasels Wood, Hertfordshire
Fri 16th - Sun 18th February

Please fill in this form and send payment by online transfer to reserve a place on Ezra Winter Camp 2018.

THE FULL PRICE OF WINTER CAMP 2018 IS £65

A place will not be reserved unless the balance is received. Spaces are limited, please book early to avoid disappointment.

For more information please contact Sarah: 07432126170

Completing an application does not mean you have been accepted at camp. We will send out acceptance emails at a later date to all successful applicants.
Ezra UK reserves the right to refuse any application at their discretion.

First Name *
Your answer
Surname *
Your answer
Age *
Your answer
Date of Birth *
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Name of School *
Your answer
School Year *
Home Address *
Your answer
Post Code *
Your answer
Home Phone Number *
Your answer
Parent name *
Your answer
Parent email address *
Your answer
Parent contact number *
Your answer
Alternative emergency contact number *
Your answer
Medical Information / Allergies *
GP Name and Number *
Your answer
I would like to book for Ezra Winter Camp for JUNIOR GIRLS. A place is not reserved until the balance is received. *
Please pay by online transfer, the details are: Account Name: Ezra Youth Movement, Account Number:00006407, Sort Code:30 93 50. Please use reference code first name, surname, WCJG e.g. NameNameWCJG
Required
I give my permission for Ezra Youth Movement to take pictures of my child during this trip to use for promotional purposes. *
I give my child permission to partake in this activity. I grant permission for any Madricha to take any necessary action should there be any unforeseen occurrences be it medical or other. *
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