Heart & Soil Interest Form

1
Full Name* This field is required.Enter name of the young man (ages 12-18) attending.
First Name
Last Name
2
Parent/Guardian Name* This field is required.Enter name of the parent/guardian of young man attending.
First Name
Last Name
3
Parent/Guardian E-mail* This field is required.
4
Phone Number* This field is required.
Area Code
Phone Number
5
AgeEnter age of young man attending
6
Do you live in the Phoenix Metro area?* This field is required.
YESNO
7
Any Special Needs or ConcernsLET US KNOW ABOUT ANY SPECIAL CONSIDERATIONS (ALLERGIES, PHOBIAS, OR SPECIAL DIET)
8
Reservation SummaryDetails of the upcoming 2025 L.E.GA.C.Y. Camp
9
Registration Dues* This field is required.
prevnext( X )
My Bag
1
My Bag
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
ORDER SUMMARY
Total costUSD
3 Day 2 Night Retreat: May 24th - 26th, 2025What’s Included in Your Registration? ✔ 3 days of immersive mentorship, leadership training, and empowerment workshops ✔ Lodging and meals for the duration of the camp ✔ Outdoor and team-building activities ✔ Camp materials and exclusive L.E.G.A.C.Y. Camp gear ✔ A transformative experience that lasts a lifetime!
$300.00Edit
Back
Enter Coupon
Total cost $0.00
First Name
Last Name
10
Invoice ID
Should be Empty: