Boys & Girls Clubs Big Brothers Big Sisters of Edmonton & Area

Please take a few minutes to complete this survey. It is private and isn't shared with anyone other than the staff. It is used to help us make sure we are doing our best. You can choose not to fill it out or to stop at any time.

* 1. Date Survey Completed

* 2. The Club I go to is:

* 3. Gender

* 4. What is your age?

* 5. How long have you been coming to the Club?

* 6. How often do you come to the Club?

* 7. Being Healthy, Active & Safe

  Yes Not Sure No
I feel safe at the Club
I can talk to staff at the Club if something is bothering me
The Club feeds me healthy food
I get to run and play at the Club
Since you started coming to the Club, have you  met new people here that you could turn to for help if needed

* 8. Being Connected

  Yes Not Sure No
I like being at the Club
The staff at the Club treat me fairly
Staff ask me what I want to do at the Club
Staff at the Club care about me
Staff at the Club help me to do my best
Have you made new friends here that the Club
I have friends to do things with at the Club
Since coming to the Club, do you have friends that help you make good choices

* 9. Learning New Things

  Yes Not Sure No
I get to try new things at the Club, like arts, crafts and sports
I like the things we get to do at the Club

* 10. Being Confident

  Yes Not Sure No
Since coming to the Club, are you able to disagree with your friends if they are doing/saying things that make you feel uncomfortable
Staff at the Club help me to get along with other kids
I like myself

* 11. Can you name two or three adults that you can talk to or spend time with besides your family?

* 12. Why do you participate in the Club (check all that apply)

* 13. What is your favorite part about the Club?

* 14. Do you have any ideas to make the Club better?

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