Summer 2023 Camp Order Request
After you fill out this order request, we will contact you to go over details and availability before the order is completed.
Sign in to Google to save your progress. Learn more
Email *
Details
Timings:  10am-3pm at St Benedict’s playing fields, Perivale Lane, UB6 8TL:

#    Individual days: £50 per day (£55 non-EHC members)
#    Two days: £90 (£100 non-EHC members)
#    Three days: £120 (£135 non-EHC members)
#    Four days: £160 (£180 non EHC members) 
#    All five days: £200 (£225 for non-EHC members)
To secure your booking (payment details)
Ealing Hockey Ltd (CASC)
Account Number: 30117875
Sort Code: 23-05-80

Quoting particpant's Surname with Initial and age (eg Blogg.F.10)
Are you an existing Ealing HC member? *
What days are you booking? *
Required
Guardian / Parent's name *
Your E-mail *
Phone number *
Full Residential Address *
Participants Name *
Participants Date of Birth
MM
/
DD
/
YYYY
Gender
Clear selection
Ethnicity
Preferred contact method *
Required
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Ealing Hockey. Report Abuse