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Your Child Survey
Please fill out this short survey related to your child and their time spent outdoors. Please fill out a different survey for each child. Thank you!
Also, please sign up to participate in future community discussions related to our children and their health and wellbeing:
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* Indicates required question
Email
*
Your email
Parent/Guardian First Name
Your answer
Parent/Guardian Last Name
Your answer
Which neighborhood does your child live or learn in?
Acres Homes
Third Ward
Other:
Clear selection
Age of child
0 - 2
3 - Pre-K
Primary/Elementary School
Middle/Junior High School
High School
Out of High School - 22 years
Clear selection
How much time does your child spend in front of a screen each day? (phone, tablet, computer, tv, video games, etc.)
None
Less than an hour
1 - 2 hours
over 2 hours to 4 hours
over 4 hours
I'm not sure
Clear selection
How much recess or outdoor time does your child get at school each day?
None
Less than an hour
1 - 2 hours
over 2 hours to 4 hours
over 4 hours
I'm not sure
Clear selection
How much recess or outdoor time does your child get outside of school each day?
None
Less than an hour
1 - 2 hours
over 2 hours to 4 hours
over 4 hours
I'm not sure
Clear selection
How many days per week does your family participate in outdoor activities together?
None
1
2
3
4
5
6
7
Clear selection
Is there any additional information you would like us to know?
Your answer
Send me a copy of my responses.
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