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Please take a minute to respond to the questions below. Your responses to the items are confidential. To ensure your privacy, please do not write your name anywhere on the survey.

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* 1. Which school do you attend?

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* 2. Please mark the Sport Season.

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* 3. What sport are you currently playing?
Only choose one - the current season.

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* 4. Mark you grade level.

For each question below please check the box that best represents your opinion or experience.

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* 5. What percentage of your schools population bully or harass other students?
This includes cyberbullying, verbal/physical harassment, written harassment, or hazing type behavior.

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* 6. What percentage of your teammates bully or harass other students.
This includes cyberbullying, verbal/physical harassment, written harassment, or hazing type behavior.

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* 7. How many people on your team bully or harrass others?

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* 8. What percentage of upperclassmen (juniors or seniors) in your sport are willing to confront other athletes who are bullying or harrassing other students?

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* 9. What percentage of students in your school use alcohol and/or drugs during the school year?

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* 10. What percentage of athletes in your school use alcohol and/or drugs during their sport season?

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* 11. What percentage of your team uses alcohol and/or other drugs during their season?

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* 12. How many people on your team use alcohol and drugs during thier season?

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* 13. How easy is it to find parties where there is not alcohol and/or drugs available?

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* 14. What percentage of upperclassman (juniors or seniors) are willing to confront athletes who use alcohol and/or drugs during the season?

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* 15. There are negative effects on team morale when athletes on my team use alcohol and/or drugs.

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* 16. What percentage of athletes at your school use performance enhancing drugs?

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* 17. What percentage of athletes on your team use performance enhancing drugs?

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* 18. How many people on your team use performance enhancing drugs?

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* 19. Please check the type of performance enhancing drugs athletes or teammates are using.

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* 20. What percentage of athletes at your school use prescription drugs not prescribed to them by a doctor to get "high" or "stoned" (such as Vicodin, OxyContin, Percodan, Ritalin, Adderall)?

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* 21. What percentage of athletes on your team use prescription drugs not prescribed to them by a doctor to get "high" or "stoned" (such as Vicodin, OxyContin, Percodan, Ritalin, Adderall)?

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* 22. How many people on your team use prescription drugs not prescribed to them by a doctor to get "high" or "stoned" (such as Vicodin, OxyContin, Percodan, Ritalin, Adderall)?

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* 23. Please check the type of prescription drugs athletes or teammates are using.

Please rate you level of agreement about the following statement.

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* 24. Participation in athletics helps keep kids from using alcohol and/or drugs.

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* 25. The coach has talked to the team about the athletic code and alcohol and drug use by athletes.

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* 26. Signing a "code of conduct" in order to compete on a team helps prevent the use of alcohol and drugs.

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* 27. Most parents are aware of the use of alcohol and/or drugs by athletes, but choose to look the other way.

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* 28. The coach is aware that there are athletes on my team who use alcohol and/or drugs during the season, but choose to look the other way.

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* 29. Team Leaders/Co-captains use alcohol and/or drugs during the season.

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* 30. The consequences at my school for alcohol/drug use by athletes are not harsh enough.

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* 31. Team members should not attend a party where there is any alcohol and/or drug use.

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* 32. Although parents of athletes sign the code of conduct, they are willing to host the parties that include alcohol and/or drugs.

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* 33. If you know of a teammate who is using alcohol and/or drugs and reported it to your coach, the coach would address the student with appropriate consequences.

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* 34. If the code of conduct forbids students to be at a party where alcohol and/or other drugs is in use, should athletes who self report being at a party with alcohol and/or drugs face less consequences of reduced game miss.

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* 35. If digital pictures show an athlete engaged in alcohol and/or drug use, that athlete should face athletic code consequences.

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* 36. If team leaders/co-captains, who are to be a role model to the rest of the team, are caught hosting a party that has alcohol and/or drugs, their consequences should be double.

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* 37. As a result of what I have learned through the Athlete Committed Program, I have improved my athletic performance habits (sleep, nutrition, training/recovery, chemical health, etc.).

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* 38. Because of my participation in Athlete Committed, I feel more prepared to support my teammates through stressful and/or difficult times.

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* 39. Please rank the following Athlete Committed events.

  I don't really like this event/idea - Would not want to participate I sort of like this event/idea - Might participate I love this event/idea - Would definitely want to participate
Dodgeball Tournament
Capture the Flag
Movie Night
BBQ
Archery Tag
Scavenger Hunt
School Carnival
5K Run
Golf Tournament
Mud Run
Spike Ball Tournament
3 on 3 Basketball Tournament

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* 40. Do you participate in the Athlete Committed lunch time meetings?

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* 41. Is there anything you want your coach to focus on and/or address with your team this year?

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