Walking and Biking to School - Parent Survey

Dear Parents and Caregivers,

Your child's school wants to learn more about the walking and bicycling to school habits of Paradise children in order to help improve safety. This survey will take about 5-10 minutes to complete.

Please complete one survey per school (example: if you have one child in elementary and one in intermediate fill out one survey for the elementary and one survey for the intermediate). If more than one child attends the same school, please fill out the survey for the child with the next birthday from today's date.

Your responses will be kept confidential and neither your name or your child's name will be associated with any results. Thank you for participating in this survey!

* 1. School name:

* 2. What is the grade of the child you are filling out this survey for?

* 3. How far does your child live from school?

* 4. On most days, how does your child arrive to school?

* 5. On most days, how does your child leave school for home?

* 6. Which of the following issues affect your decision to allow, or not allow your child to walk or bike to/from school?

* 7. Which of the following items would increase the likelihood that your child would walk or bike to school?

* 8. How much FUN is walking or biking to/from school for your child?

* 9. How HEALTHY is walking or biking to/from school for your child?

* 10. OPTIONAL: Would you be interested in any of the following activities?

* 11. OPTIONAL: Contact Information: Name and Email Address

* 12. OPTIONAL: Please provide any additional comments below: