Home Educators Workshop Booking Form

Little Bee Big Feelings Booking/Consent Form

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

First NameLast Name
Child Name*
Parent/carer Contact Number*

Area CodePhone Number
Email Address*
example@example.com
Child's Age*
Children will need to attend all 5 weeks and full payment (£100) will be required by Monday 1st June 2026 to secure your child's space. 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 to secure our space ASAP*

Yes
All sessions will take place 4-5pm at The Mary Stevens Centre, 221 Hagley Road, Stourbridge DY8 2JR.

Week one - Parent/Carer and Child Tuesday 9th June 2026

Week two - Child only Tuesday 16th June 2026

Week three - Child only Tuesday 23rd June 2026

Week four - Child only Tuesday 30th June 2026

Week five - Child only Tuesday 7th July 2026
I consent for photographs to be used by Bee Well. Images used do not show faces to protect identities.*

YesNo
Additional information: Please provide us with any relevant information in regard to your child's presentation, that will support them while attending the group sessions i.e. sensory preferences. mobility issues, communication needs etc. Is your child on any medication, please also include any food intolerances or allergies*
By submitting this form I give consent for my child, named above to attend Little Bee Big Feelings 5 week group intervention.*

I agree that I give consent for the above names child to attend all Little Bee Big Feelings group sessions
Should be Empty:

Little Bee Big Feelings Booking/Consent Form