Adaptive Sports Survey

Athletes with Disabilities Network Northeast Chapter is a non-profit which promote a better quality of life for veterans and people with physical disabilities by creating awareness and opportunities to get involved with adaptive athletic, recreational, and educational activities. Our service is New Jersey, Philadelphia and surrounding counties. We would like to know what adaptive sports, clinics and events you would like in the region. Your input is very important for us to be able to understand the needs of the community and assist in providing these opportunities to you.

* 1. What are the days and times that you have the most availability? (Check three)

* 2. What are the best times for you to attend kayaking sessions? (you do not have to attend the whole time frame)

* 3. What is your level of disability?

* 4. Would you like to be notified when sports equipment grants and others are available?

* 5. Are there any activities that you have already participated in like, tennis or climbing that you would like to have more opportunities to do again?

* 6. If these recreational activities were available would you attend? Please check all that apply.

* 7. What county do you live in?

* 8. What age group best fits?

* 9. Please check all boxes that apply

* 10. Thank you for taking the time to complete the survey. If you would like to be on out email list and receive upcoming events please provide us with your email below in question 10.
Optional Contact information.  If you wish to not provide your contact information leave this section blank.
Brandon Holiday
Executive Director
Athletes with Disabilities Network North East Chapter
Bholiday@adnpage.org
267-242-4590
www.adnnec.org

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