Adaptive & Inclusive Recreation Program Suggestions

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* 1. What are the age(s) of the family members who would be enrolling in AR programs?

Pre-K (2 - 4 yrs)

Youth (5 - 12yrs)

Teen (13 - 17yrs)

Adult (18+ yrs)

Active Adult (55+ yrs)

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* 2. Which of the following of AR activities or programs would you be most likely to enroll in this fall?

Martial Arts

Lacrosse

Baseball/Teeball

Cheerleading

Sitting Volleyball

Boccia

Soccer

Basketball

Pickleball

Sensory Exploration

Craft Classes

Social Outings

Fitness Classes

Special Events (Dances, Seasonal Events, Bingo, etc.)

Outdoor Experiences (Walks, Hikes, etc.)

Game Nights

Other (please specify)

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* 3. What times are you most likely to attend a class?

	Morning	Afternoon	Evening
Monday	Monday Morning	Monday Afternoon	Monday Evening
Tuesday	Tuesday Morning	Tuesday Afternoon	Tuesday Evening
Wednesday	Wednesday Morning	Wednesday Afternoon	Wednesday Evening
Thursday	Thursday Morning	Thursday Afternoon	Thursday Evening
Friday	Friday Morning	Friday Afternoon	Friday Evening
Saturday	Saturday Morning	Saturday Afternoon	Saturday Evening
Sunday	Sunday Morning	Sunday Afternoon	Sunday Evening

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* 4. Which activity format are you most likely to attend?

Consecutive, multi-week programs/classes

A one-time program/class

Drop-in programs

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* 5. Do you have any other comments or suggestions?

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* 6. How did you find out FCPR's AIR Programs?

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* 7. Would you like to be included in a mailing list about upcoming AIR offerings?

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address