Passed Thru Fire
Our 2026 date for the Western Cape is 9 - 12 APRIL we do need a minimum number of 10 Dads and Sons to make this event happen.
Dad's Name
First Name
Last Name
Email
example@example.com
Mobile Number
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Back
Next
Mom's Name
First Name
Last Name
Mobile Number
Please enter a valid phone number.
Format: (000) 000-0000.
Son's Name
First Name
Last Name
Son's Age
Dad’s or Son's Allergies or conditions
Medical Aid
Medical Aid Number
Back
Next
Additional Detail:Is there anything that you would like to share with us about your child that will help them, their Event Leaders or ourselves? (aspirations, behavioral problems or anything else)
Are You or your Son / dependent on any medication which we should be aware of?
May we, via email, keep you informed regarding additional HEARTLAND SA experiences and events in the future?
No
Yes
Cost for Dad and Son team, all inclusive for on-site duration. Snacks, luxury refreshments etc. not included.
prev
next
( X )
ZAR
PTF
Please upload POP
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Signature
Newsletter
Yes, subscribe me to this newsletter.
Newsletter
Yes, subscribe me to this newsletter.
Submit
Should be Empty: