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Northlands Bee Club is a free weekly program for junior high and high school students in the Edmonton area who want to learn about keeping  honey bees in an urban context. 

If you have any questions about this survey, contact Northlands Agriculture at 780-471-7300.

Applicant name. (If just one person in your family is applying, use only the field for Applicant 1; if more than one person in your family is applying, use Applicant 2 and 3 fields as needed). 

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* 1. Applicant name. (If just one person in your family is applying, use only the field for Applicant 1; if more than one person in your family is applying, use Applicant 2 and 3 fields as needed). 

Applicant's birth date.

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* 2. Applicant's birth date.

Applicant's current school.

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* 3. Applicant's current school.

Applicant's current grade.

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* 4. Applicant's current grade.

Bee Club communicates primarily by email. What is the best email address to use? 

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* 5. Bee Club communicates primarily by email. What is the best email address to use? 

Bee Club occasionally communicates by phone/text. What is the best phone number to use? 

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* 6. Bee Club occasionally communicates by phone/text. What is the best phone number to use? 

Bee Club runs Thursdays from 6-8 pm for 24 weeks from May-November. Is there any reason you might not be able to attend? If yes, please explain.

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* 7. Bee Club runs Thursdays from 6-8 pm for 24 weeks from May-November. Is there any reason you might not be able to attend? If yes, please explain.

Bee Club meets at Northlands Park, 7410 Borden Park Road. How will you get to and from Bee Club?

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* 8. Bee Club meets at Northlands Park, 7410 Borden Park Road. How will you get to and from Bee Club?

Occasionally, the time, location, and format of Bee Club meetings change. We'll give you advance notice. Click on any of the circumstances that might be hard for you to manage.

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* 9. Occasionally, the time, location, and format of Bee Club meetings change. We'll give you advance notice. Click on any of the circumstances that might be hard for you to manage.

Indicate your preference for signing in and out at each Bee Club meeting. 

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* 10. Indicate your preference for signing in and out at each Bee Club meeting. 

Beekeeping comes with a risk of stings. Have you ever been stung by a honeybee?

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* 11. Beekeeping comes with a risk of stings. Have you ever been stung by a honeybee?

Are you allergic to bees? If yes, do you carry an EpiPen?

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* 12. Are you allergic to bees? If yes, do you carry an EpiPen?

Have you ever been around bee hives or handled bees? If yes, tell us about your experience.

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* 13. Have you ever been around bee hives or handled bees? If yes, tell us about your experience.

Do you have any physical barriers to lifting or carrying heavy objects?

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* 14. Do you have any physical barriers to lifting or carrying heavy objects?

Do you have any other medical conditions that Bee Club should know about?

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* 15. Do you have any other medical conditions that Bee Club should know about?

Please provide two emergency contacts; one may be a parent/guardian. 

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* 16. Please provide two emergency contacts; one may be a parent/guardian. 

Please provide your Alberta Healthcare Number.

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* 17. Please provide your Alberta Healthcare Number.

Please provide the name and number of your family doctor.

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* 18. Please provide the name and number of your family doctor.

Bee Club occasionally shares snacks or a meal. Do you have any dietary stipulations?

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* 19. Bee Club occasionally shares snacks or a meal. Do you have any dietary stipulations?

Why do you want to join Northlands Bee Club?

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* 20. Why do you want to join Northlands Bee Club?

How did you hear about Northlands Bee Club?

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* 21. How did you hear about Northlands Bee Club?

Northlands Youth Beekeeping Project Liability Waiver. 
By checking each box, I indicate my willingness for my child/children to participate in the Activity and my acceptance of the terms and conditions contained herein.

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* 22. Northlands Youth Beekeeping Project Liability Waiver. 
By checking each box, I indicate my willingness for my child/children to participate in the Activity and my acceptance of the terms and conditions contained herein.

Parent/guardian information.

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* 23. Parent/guardian information.

Do you have any questions or comments to share?

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* 24. Do you have any questions or comments to share?

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