The purpose of this survey is to give you the opportunity to provide feedback to the athletic director about your experiences and feelings about your child’s team. This form will remain confidential unless permission to the contrary is granted. Please mark your answers by filling in the appropriate box.

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* 1. What sport is being evaluated?

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* 2. What level?

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* 3. What grade is your child in?

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* 4. What is your child’s gender?

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* 5. What is the coach’s gender?

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* 6. Did you participate in sports during high school or college?

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* 7. If yes to the previous question, in what role(s):

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* 8. Do you want your survey to be seen by your son/daughter’s coach?

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* 9. What percentage of games/matches/meets did you attend?

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* 10. Did you attend a pre-season event (meeting, Meet the Teams, etc.)?

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* 11. Have you communicated directly with the coach about matters pertaining to your child?

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* 12. Please respond to the following questions by filling in the box that most closely reflects your opinion.

  Strongly Agree Agree Neutral Disagree Disagree Strongly No basis for judgement
The coach is approachable.
The coach is concerned about my child’s academic progress.
The coach is a positive role model for my child.
The coach has good knowledge of the sport.
The coach defines success by more than the win/loss record.
The coach allows injured players to recover from injuries.
The coach respects my child.
The coach treats all members with respect.
The coach uses reasonable judgement when dealing with student/athlete scheduling conflicts.
Facilities for sports are clean and well-maintained.
Playing facilities are adequate and safe.

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* 13. What do you think about:

  Excellent Very Good Good Fair Poor No basis for judgement
your child’s level of communication with the coach?
the intensity of the competitions?
your child’s improvement since the season began?
your child’s overall experience with this team?

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* 14. I have been informed about the:

  Very informed Moderately informed Not informed No basis for judgement
coach’s philosophy.
practice times.
Athletic Handbook policies.
team rules.
travel procedures (i.e. itinerary, food, dress code).
rationale used to determine my child’s participation during competitions.

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* 15. Being a part of this team has helped my child to:

  Strongly agree Agree Neutral Disagree Strongly disagree No basis for judgement
have a balanced lifestyle.
have higher aspirations.
be more dedicated.
think more clearly under stressful situations.
overcome adversity (injuries, less playing time, conflicts).
respect school and team rules.
be productively involved in the school and community
set personal goals.
become a positive role model.
make good decisions.
have a positive attitude.
develop leadership skills.
work cooperatively with others.
recognize contributions of others.
be a better student.
accept criticism without taking it personally.
manage his/her time better.
communicate his/her ideas.
be responsible for his/her actions (including body language).

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* 16. What information did you consider when answering these questions? (Indicate all that apply)

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* 17. Please use the space below for comments about your child’s overall experience (attach separate sheet if needed).

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