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Board of Directors
Refer a Child
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Know of a Child Who Would
Be a Good Fit?
Fill Out the Form Below!
Please provide the names and ages of each child you would like to participate.
Please provide preliminary contact information (name, email, phone number, and physical address) of child's guardian(s).
Would you consider the referred child at-risk?
Please describe the circumstance or situation that you believe would classify the referred child as at-risk. Why do you believe that Camp Ezri would be beneficial to the child?
How did you hear about us?
Would you like your referral to remain anonymous?
Thanks! We'll be in touch with you soon.
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