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* 1. Why did you come today? (check all that apply)

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* 2. How did you find out about this program or session? (check all that apply)

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* 3. For the next questions think about how surfing makes you feel compared to other activities.
Compared to other activities I have done, surfing...

  Strongly Disagree Disagree Not sure Agree Strongly agree
... makes me happy
...makes me nervous
....makes me calm
... makes me want to keep doing it

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* 4. I feel like an important part of my (check all that apply)

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* 5. How do you feel…

  Very Unsafe Unsafe Not sure Safe Very Safe
....at the beach
...in the ocean
...talking with a mentor or coach
...away from the program

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* 6. Think about how you feel after surfing (right now). When you compare your current feeling to how you felt before surfing, how do you feel?

  Much Less Less No change More Much more
I am confident about my week
I can concentrate
I am lonely
I have friends I can talk to
I am sad
I am happy with my physical fitness

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* 7. Using 3 words, describe your feelings when you surf.

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* 8. How could today’s program could be improved.

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* 9. Using 3 words, describe what parts of today’s program you enjoyed
the most.

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* 10. Is there anything else you'd like to tell us about your experience with this program?

These questions are for the data loggers and do NOT need to be asked of the participant directly

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* 12. Participant GENDER

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* 14. (For data loggers) Is there anything else you want to say  (or space for participant # or site information)?

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