Provide details for membership registration.
Provide details for membership
registration.
Your Name
*
Your Partner’s Name
Mobile Number
Email
Current City of Residence
Your Gender *
Male
Female
Others
Why are you looking for couple companionship? *
Have you ever tried couple companionship before? *
Rate your experience if you tried it. *
What do you want on Regnum? *
Activities with Other Couples *
Can you afford the $100
monthly membership fee?
Yes, this is exciting!
No, I don’t like fun
Cannot commit at this time
Acceptance of Terms and Conditions*
Privacy Policy Agreement*
Consent for Background Check*
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Complete the form to apply