Email Address *

Your age *

Gender *

Male

Female

ID *

Cell number *

Address *

Occupation *

Medical Aid information *

Contact person in case of an emergency *

Name and contact number please.

Where did you hear about Camp Escape? *

Have you ever been an eagle before? *

No

1 Year

2 Years

3 Years

4 Years

5 Years

Have you been a camper at CE? *

When would you like to come for your interview? *

Please note you have to be available for at least 1.5 hours however we are normally done within an hour. Please be at least 30 minutes early. Couples cannot come together.

T&C *

I read and understood the costs involved. I am also aware of the dates I need to be available for the eagles camp | meetings etc.

Yes

No

Did you pay your Admin fee and send through your proof of payment *

Yes

No

Eagles application

We look forward to meeting you. We will be in contact to confirm your interview appointment as soon as we have received your R70 admin fee and this application form.