Hidden Bee Learning Fall Enrollment Form

Hidden Bee Learning

Enrollment and Depost Form
Applicant Information
Child #1 Name*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Gender*
Mobile Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Child #2 Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender
Mobile Phone Number
Please enter a valid phone number.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Child #3 Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender
Mobile Phone Number
Please enter a valid phone number.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Application Details
Enrollment Status
Student No.
Health and Safty
Gathering health information about each child participating in our program is crucial for ensuring their safety and well-being during all activities. This information allows us to accommodate any specific health needs, allergies, or medical conditions your child may have, ensuring that we provide a safe and supportive environment for everyone. If certain health details are not applicable to your child, please indicate this by writing "N/A" in the relevant sections. This will help us understand that there are no specific health concerns to consider for your child's participation in our program. For families enrolling more than one child in our program, it's important to provide health information for each child individually. Please specify the name of each child alongside their respective health details to ensure we can accurately accommodate their unique needs and conditions.
Please specify any allergies your child has (for example: bees, pollen, peanuts, dairy).*
Are there any activities that your child should avoid or be restricted from participating in?*
Are there any dietary requirements for your child that we should be aware of? Please note that children are expected to bring their own lunches and snacks, although we may occasionally provide additional snacks or treats.*
Although we are not equipped to administer medication, it's crucial for us to be informed about any medications your child is taking, including prescription or over-the-counter drugs. This information is vital in providing appropriate emergency services if needed. Is your child currently on any medication that would be relevant during the program?*
We are committed to accommodating children with diverse needs. Please let us know if your child has any physical, mental, or other conditions requiring special attention during the program.*

Contact In case of Emergency
Name*

First NameMiddle NameLast Name
Mobile Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Relationship*

Parental Information
Name of Mother / Legal Guardian'*

First NameMiddle NameLast Name
Mobile Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of Father / Legal Guardian

First NameMiddle NameLast Name
Mobile Phone Number
Please enter a valid phone number.
Email
example@example.com
Address of Father / Legal Guardian (if not the same as above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Hidden Bee Learning

Applicant Information

Application Details

Health and Safty

Contact In case of Emergency

Parental Information

Enrichment Program Participation Disclaimer and Photo Release for Hidden Bee Farm

Program Days