Queen In Me online registration

You must fill out the form below. When the form is submitted it will take you to the payment page for you to pay your registration fee and first two weeks of tuition.

Queen In Me Registration Form

* Indicates required field

Parent's Name *

First

Last

Name of Child *

Date of Birth | Age *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Cell Phone *

Business Phone *

Will you need before/after care - Yes or No *

Will your queen be able to complete the entire 8 weeks - June 10th - August 2? *

Will you be providing lunch or Will you child eat the lunch provided by the program? (additional charges for lunch provided by the program)? *

Submit