Chester's Mentoring Initiative Health Survey

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This survey contains ten quick questions and should take about five minutes to complete. Feel free to complete a separate survey if you have different answers for different children in your family. Thank you!

Please visit https://cuys.org/mentoring to learn more about our good work bringing together Chester's services that benefit youth and their families. Founding partners include Amachi, Chester Upland Youth Soccer, Making a Change, Chester Eastside Inc., Boys & Girls Club of Chester and the Andrew L. Hicks Foundation.

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Since COVID restrictions took effect, have you become concerned that your child is not getting enough physical activity?

Yes

Clear selection

Has your child gained an unhealthy amount of weight during COVID restrictions?

Yes

Clear selection

Is your child less physically fit now compared with before the pandemic?

Yes

Clear selection

In a typical week BEFORE the pandemic started, how many hours did your child participate in sports/engage in physical activity, informal active play and organized sports?

Less than 1

1-5

6-10

10+

Clear selection

In a typical week DURING the pandemic, how many hours did your child participate in sports/engage in physical activity, informal active play and organized sports?

Less than 1

1-5

6-10

10+

Clear selection

How many hours per week do you think your child should engage in physical activity?

1-5

6-10

10+

Clear selection

Before the pandemic how important was it for your child to participate in organized sports for his/her health?

Not important

Very important

Clear selection

How important is it to you now that your child participates in organized sports for his/her health?

Not important

Very important

Clear selection

Please share any thoughts about these topics and what you’d like to see after the pandemic.

My child's age (check all that apply, if above answers relate to multiple children):

1-4 years

5-8 years

9-11 years

12-14 years

15+ years

(Optional) Children's names:

(Optional) Guardian's name:

(Optional) Guardian's email:

(Optional) Guardian's cell phone number:

Send me a copy of my responses.

Submit

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