JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Fall Parent Survey
Hello 6th - 12th Grade Parents,
This survey is meant to gather information from parents to best serve your children during these unusual times.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Parent's Name (optional)
Your answer
What grade is your child/children entering? (Select all that apply).
*
6th
7th
8th
9th
10th
11th
12th
Required
What school does your child/children attend? (Select all that apply)
*
Blue Mountain Middle School
Copper Beech Middle School
Pierre Van Cortlandt Middle School
Croton Harmon High School
Hendrick Hudson High School
Lakeland High School
Walter Panas High School
Other:
Required
Are you opting for your child/children to do virtual learning through the end of 2020?
*
Yes
No
Unsure at time
At this time, where will you be working from this fall? (Select all that apply for your household.)
*
At home
Locally (less than 20 minutes from the YC)
Non-locally (more than 20 minutes from the YC)
Traveling (my job takes me to a different location daily/frequently)
Other:
Required
At this time do you feel comfortable sending your child to the YC?
*
Yes
No
Unsure at this time
Please select all of the locations you would let your child AND they would want to attend a program at.
*
Indoor at the YC
Outdoor at the YC
Online via Zoom with YC staff
Other Town Locations with YC staff
None of the above
Required
Which type of program are you most comfortable with?
*
Structured (group lead)
Unstructured (free play)
Both
Neither
Would you prefer weekdays or weekend hours?
*
Weekdays ( Monday - Friday)
Weekend (Friday - Sunday)
Both
Neither
Please select all of the weekdays and times your child would use the YC.
3 PM
4 PM
5 PM
6 PM
7 PM
8 PM
Monday
Tuesday
Wednesday
Thursday
Friday
3 PM
4 PM
5 PM
6 PM
7 PM
8 PM
Monday
Tuesday
Wednesday
Thursday
Friday
Please select all the weekend days and times your child would use the YC.
1 PM
2 PM
3 PM
4 PM
5 PM
6 PM
7 PM
8 PM
9 PM
10 PM
Friday
Saturday
Sunday
1 PM
2 PM
3 PM
4 PM
5 PM
6 PM
7 PM
8 PM
9 PM
10 PM
Friday
Saturday
Sunday
How would your child arrive to the YC? (Select all that apply.)
*
Parent/Adult Drop-off
Public Transportation (uber, bus, train, etc.)
Walk/Ride Bike
My child does not have a ride
Other:
Required
Would you allow AND would your child be interested in a Community Clean-Up program (picking up litter at various locations)?
*
Yes
No
Unsure at this time
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms