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* 1. Rate the following questions about you and your child/ partner:

  Very Poor Poor Neutral Good Very Good
Communication with your child/ partner
Relationship with your child/ partner

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* 2. How many hours do you spend per week with your child/ partner?

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* 3. Rate the following about the time spent with your child/ partner:

  Very Unlikely Unlikely Neutral Likely Very Likely
The time spent with your child/ partner is intentional
You and your child/ partner are both present and engaged in your time spent together
You find new and creative ways to spend time with your child/ partner

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* 4. Rate the following questions about the likelihood of your child/ partner to do the following:

  Very Unlikely Somewhat Unlikely Neutral  Somewhat Likely Very Likely
Learn a new skill
Try new/ difficult tasks
Do a task that requires working with others- cooperation
Say they are confident in facing challenges

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* 5. At this time, how many hours per week are you likely to spend engaging in an activity outdoors?

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* 6. What do you look forward to most during the CORE program?

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* 7. Have you participated in CYO's Core Program before? If so, how many semesters?

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