Healthy Beginnings Parent/Guardian Survey Question Title * 1. What grade is your child(ren) in? Kindergarten Grade 1 Grade 2 Grade 3 Grade 1/2 split Grade 2/3 split Other OK Question Title * 2. Please select the location of your child(ren)'s school? Cambridge Kitchener Waterloo Township of Wilmot Township of North Dumfries Township of Wellesley Township of Woolwich OK Question Title * 3. Is your child(ren) learning the Healthy Beginnings curriculum at school? If yes, please indicate the name of the school Yes No Name of school OK Question Title * 4. Does your child(ren) participate in any other Healthy Beginnings program(s) offered at the community centre? Please select all that apply. Physical Activity Session (multi week program) Family Fun Night (one time event) Summer Camp None OK Question Title * 5. Have you noticed your child connecting with what is being taught in the Healthy Beginnings program to other parts of their lives? Strongly Disagree Strongly Agree Clear i We adjusted the number you entered based on the slider’s scale. OK Question Title * 6. If your child is making connections between programs, can you give an example? OK Question Title * 7. Can your child(ren) remember what they learned in past Healthy Beginning sessions? Yes No I don't know Other (please specify) OK Question Title * 8. Did your child(ren) learn new information, skills or behaviour related to nutrition, health and/or physical activity? Please select all that apply. Try new healthy foods when offered Asks for fresh fruit or healthy snacks Eats less processed foods Plays outside more frequently Watches less TV Spends less time playing games on laptop, tablet or phone Drinks more water Demonstrates interest during grocery shopping and/or food preparation Other (please specify) OK Question Title * 9. Is your child more willing to try new foods and/or activities? Strongly Disagree Strongly Agree Clear i We adjusted the number you entered based on the slider’s scale. OK Question Title * 10. What would make the Healthy Beginnings program even better? Select all that apply. Lower cost of appropriate clothing or shoes (ie. athletic wear) Program does not match my child(ren)'s learning style or abilities Program could be offered at different times in the day and/or evening Program could be offered during different days of the week Program could be offered at different locations Program could be more culturally appropriate None Other (please specify) OK Question Title * 11. What would make the Healthy Beginnings program even better? Select all that apply. Lower cost of appropriate clothing or shoes (ie. athletic wear) Program does not match my child(ren)'s learning style or abilities Program could be offered at different times in the day and/or evening Program could be offered during different days of the week Program could be offered at different locations None Other (please specify) OK Question Title * 12. What is your favourite part of the Healthy Beginnings program? OK Question Title * 13. Do you have any additional feedback or comments about the Healthy Beginnings program? OK Question Title * 14. Name (optional) OK Question Title * 15. Contact information (optional) Name Email Address Phone Number OK DONE