The Bee Hive Club Booking Form

The Bee Hive Club Booking/Consent Form

If you have any questions please do not hesitate to email us beewelltogether@outlook.com Thank you Helen and Becky. If you would like to see details of our GDPR/Privacy statements or cancellation policy we can provide these via email.
Child's Name*

First NameLast Name
Date of birth*

MonthDayYear
Child's age
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Carer Name*
Parent/Carer Contact Email*
Emergency Contact Telephone No.*
All sessions will take place at The Mary Stevens Centre, 221 Hagley Road, Stourbridge DY8 2JR. Drop off from 9am (930am start) - 12pm.*

Friday 8th August 2025
All sessions are £25 per morning. Your child will need a snack/s and water bottle. Along with appropriate clothing for outside play (weather permitting activity). Please make payment via bank transfer to: Bee Well Together CIC. Account Number 69904556 Sort Code 60-83-71*

I confirm I will make payment ASAP to secure my child's space
I consent for photographs of my child to be used by Bee Well. *
Additional information: Please provide us with any relevant information in regard to your child's presentation, that will support them while attending the Bee Hive Club i.e. sensory preferences. mobility issues, communication needs etc. Is your child on any medication, please also include any food intolerances or allergies.*
How did you hear about Bee Well?

FacebookInstagramFriend/FamilyFlyerSchoolOther
By submitting this form I give consent for my child, named above to attend The Bee Hive Club.

I agree that I give consent for my child to attend the above sessions offered by Bee Well Together
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The Bee Hive Club Booking/Consent Form