Youth Development
Healthy Living
Social Responsibility

Youth Program Survey

Name of Class:*
Day of the Week:
Month That Child Took The Class:
Instructor/Coach Name:
Is Child a Male or Female?
    
Your Name (Completely Optional):
Please indicate your satisfaction with the following areas. The scale is 1 to 5.
'1' is Poor;  '3' is Average;  '5' is Excellent.
Instructor Quality/Knowledge:
   
   
Value of Program for the Price:
   
   
Schedule/Location Convenience:
   
   
Improvement in Participant's Skills:
   
   
Emphasis Placed on Sportsmanship:
   
   
Social Environment (Peer to Peer):
   
   
Safety of the Program:
   
   
Level of Fun Your Child Had:
   
   
Instructor Communication with Parent:
   
   
Cleanliness of Space:
   
   
Was Facility Appropriate for Class Activity:
   
   
Condition/Availability of Equipment
   
   

Do you have any additional Comments? Please let us know if you would like to be contacted by our Executive Director or a member of our Program Committee by including your contact name, phone number and/or email address below. Thank you for your additional comments.

Additional Comments:
This is a captcha-picture. It is used to prevent mass-access by robots. (see: www.captcha.net)

Please confirm that you are not a script by entering the letters from the image.