Mystery Date Activity Survey * 1. Your Contact Information Name E-mail Address Phone Number * 2. Who is the Mystery Date for? Boyfriend or Husband Girlfriend or Wife Friend(s) * 3. On which day would you prefer to go on your Mystery Date (please select date at least 2 weeks from today's date)? Preferred Day #1 MM / DD / YYYY Preferred Day #2 MM / DD / YYYY Preferred Day #3 MM / DD / YYYY * 4. Level of Activeness for Your Date None A little Medium A lot Skydiving Level of Activeness for Your Date Level of Activeness for Your Date None Level of Activeness for Your Date A little Level of Activeness for Your Date Medium Level of Activeness for Your Date A lot Level of Activeness for Your Date Skydiving * 5. Specific Interests Brunch Tourism Indoor sports Vegetarian Wine bars Seasonal activities Cooking classes Yoga Tours Sporting events Rage Fitness classes Coffee/tea Craft beer Spa Scenic/nature Shopping Best lunch Museums & fine arts Concerts Best dinner Comedy clubs Best breakfast Movies Chill Meditation Outdoor sports Fine dining Unusual activities FULL-ON SURPRISE (surprise for both of you) Other (please specify) * 6. Price range (per couple) Less than $50 $50-100 $100-200 $200+ * 7. Duration Half day (morning) Half day (evening) Full day * 8. What has been your favorite DC activity in the past 3 months? * 9. Are you celebrating anything specific? * 10. Is there anything else you want to let us know (i.e. dietary restrictions, time constraints, severe dislikes, etc.)? READY FOR ADVENTURE!