JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Proposed Regional Activity Center
Thank you for taking time to complete this survey. This is a preliminary survey available to citizens that will help us better understand the needs of our community and surrounding geographical areas. Results will help form a general needs-assessment in regards to a proposed community and activity center. All questions require a response. Additional information will published when information becomes available.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
On a scale of 1-5, how likely would you or a member of your household utilize an afterschool program (homework help, snack, safe environment)?
*
Very Unlikely
1
2
3
4
5
Very Likely
On a scale of 1-5, how likely would you or a member of your household utilize an indoor pool (swimming lessons, lap swim, water aerobics)?
*
Very Unlikely
1
2
3
4
5
Very Likely
On a scale of 1-5, how likely would you or a member of your household utilize gym or exercise equipment in a community center setting (cardio, free weights, etc.)?
*
Very Unlikely
1
2
3
4
5
Very Likely
On a scale of 1-5, how likely would your household or business utilize/rent meeting rooms (various sizes available)?
*
Very Unlikely
1
2
3
4
5
Very Likely
On a scale of 1-5, how likely would you or a member of your household utilize fitness classes (Zumba, cardio, aerobics, yoga, etc.)
*
Very Unlikely
1
2
3
4
5
Very Likely
On a scale of 1-5, how likely would you or a member of your household utilize the community center if youth sports were held there (basketball, volleyball, soccer etc.)?
*
Very Unlikely
1
2
3
4
5
Very Likely
On a scale of 1-5, how likely would you or a member of your household utilize a full sized basketball court for various activities (basketball, volleyball, indoor soccer, etc?)
*
Very Unlikely
1
2
3
4
5
Very Likely
On a scale of 1-5, how likely would you or a member of your household utilize an indoor walking track?
*
Very Unlikely
1
2
3
4
5
Very Likely
What kind of fitness classes would you be most interested in?
*
Dance (Zumba-style)
Senior (low-impact)
Yoga
Cardio/High intensity
Would the availability of a daycare/babysitter on site (while parent or guardian uses the facility) increase the likelihood of you joining the community center?
*
Yes
No
N/A
Would you be willing to support a county or sales tax to help in the funding of a community center?
*
Yes
No
Would you be willing to support the funding of a community center with some form of monthly donation?
*
Yes
No
Additional suggestions for proposed community center (class ideas, facility services, etc.)
Your answer
What is your age?
*
Under 18
18-24
25-34
35-44
45-54
55-64
65+
How many people currently live in your household?
*
1
2
3
4
5 or more
What is your 5-digit zip code?
*
Your answer
Submit
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