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Queens to be Academy (4).jpg

Columbus Ohio - Register Today

First name*

Last name*

Parent Full Name *

Email*

Phone*

Grade Level *

4th Grade

5th Grade

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 workshop. This optional donation helps QTBA continue to provide a quality program.

$10

$20

$30

Let Me Know About Upcoming Opportunities with QTBA!

Youth Name

Parent Name

Parent Email

Parent Phone

How did you find out about us?

Youth Age Group

K-3rd

4th-5th

6th-8th

9th-12th

What Kind of Opportunites are you interested in?

Conferences

Individual Workshops

Small Group Cohorts

1 on 1 Mentoring

What is your monthly budget for QTBA Partcipation?

Free Opportunities Only

$10 - $25

$30 - $75

$100 - $250

Questions?

We'll get back to you soon!

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