Short Breaks Activity Feedback Question Title * 1. What is your nearest town? Question Title * 2. How many children/young people do you have registered with 'All In'? 0 1 2 3 4 5+ Question Title * 3. Which provider ran the acivity you are rating? Action for Children playscheme Action for Children activity service Action for Children - The Willows residential Barnados Connect Barnardos Short Breaks Service Childminding Home-Start Hope House Hydrotherapy Kidzfirst playscheme Kidzfirst residential Kidzfirst weekends and other London Road gym London Road trampolining London Road fun and games Maurice Chandler fund and games Mencap Bradbury residential Oswestry family fun sessions Pacc Face2Face Perry Riding School Quarry swimming lessons Scrappies Short Breaks community nursing/palliative care Sports Village cycling Sports Village football Sports Village gym Sports Village saturday club Taking Part Art Start/Art Cart Tickwood Farm Whitchurch fun and games Youth club Other (please specify) Question Title * 4. How easy was it to book onto the activity? Very easy Easy OK Difficult Very difficult Question Title * 5. Please rate the following questions: Very poor Poor Ok Good Excellent Was the activity well run? Was the activity well run? Very poor Was the activity well run? Poor Was the activity well run? Ok Was the activity well run? Good Was the activity well run? Excellent Do you feel staff related well to your child/young person? Do you feel staff related well to your child/young person? Very poor Do you feel staff related well to your child/young person? Poor Do you feel staff related well to your child/young person? Ok Do you feel staff related well to your child/young person? Good Do you feel staff related well to your child/young person? Excellent What did your child/young person think of the activity? What did your child/young person think of the activity? Very poor What did your child/young person think of the activity? Poor What did your child/young person think of the activity? Ok What did your child/young person think of the activity? Good What did your child/young person think of the activity? Excellent What did you think of the activity? What did you think of the activity? Very poor What did you think of the activity? Poor What did you think of the activity? Ok What did you think of the activity? Good What did you think of the activity? Excellent Question Title * 6. Would your child/young person attend this activity again? Yes Maybe No If you answered no, please use this space below to explain why? Question Title * 7. If this activity is currently free would you be willing to make a contribution to the cost of the activity if this were required in the future? Yes Maybe No Question Title * 8. Please use the space below to detail any other activities you might like to see offered: Done