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QTBA
Summer Registration: Ohio Program
First name
*
Last name
*
Parent Full Name
*
Email
*
Phone
*
Grade Level
*
Middle School (6th - 8th)
High School (9th-12th)
Please list any allergies or health limitations
Emergency contact Name
*
Emergency Contact Phone
*
"By completing this registration form, you consent to the use of photos, videos, and other media taken during Queens To Be Academy events for promotional and educational purposes."
*
I Understand
This is a FREE summer program. This optional donation helps QTBA continue to provide a quality program.
$10
$20
$30
Register
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