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* 1. Do you live in City limits?

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* 2. Zip Code:

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* 3. Do you live within a 1/2 mile of a public park or recreational facility?

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* 4. What is the greatest household barrier to more regular use of a park or recreational facility?

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* 5. Ethnicity origin (or Race): Please specify your ethnicity

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* 6. Select the number of persons in your household including yourself who are in the age brackets below:

  1 2 3 4 5 6
14 and under
15-19 years old
20-35 years old
36-45 years old
46-60 years old
61 and over

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* 7. Check below how frequently you or others in your household have visited the following facilities in the past year.

  Regularly Occasionally Rarely Never
Alvin C. Cavines Park
Franklin Square Park
Keziah Park
Kingsley Street Park
Waterfront Park
Lowe-White Memorial Park
Jaycee Building
Marsh Walk
Southport Community Building

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* 8. Overall, how would you rate the existing recreational facilities in Southport?

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* 9. Overall, how would you rate the recreational programs offered in Southport?

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* 10. In which of the following City recreation programs and special events do you or others in your household participate on a regular basis?

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* 11. Check below improvements that could be made to EXISTING parks and list facilities

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* 12. The following is a list of recreation activities that you could do at a public park or recreation facility.  Rank the importance of each activity with 1 being most important and 5 being least important.  Please consider other members of your household.

  Most Important Least Important
Jogging/Walking Trails
Soccer Fields
Bicycle Trails
Skateboard Park
Splash Pad
Bocce Courts
Baseball/Softball Fields
Outdoor Basketball Courts
Community Center
Indoor Swimming Pool
Shuffleboard Courts
Outdoor/Indoor Swimming Pool
Football Field
Tennis Courts
Open Space/Natural Areas
Outdoor Track
Picnic Areas
Mountain Biking
Horseshoe Pits
Sand Volleyball Courts
Outdoor Playground
Indoor Gymnasium
Dog Park
Outdoor Performance Area
Multi-Sports Complex
Teen Center
Fitness Facility
Disc Golf
Environmental Center
Hiking Trails

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* 13. Please list below, any recreation programs or special events that you would like to see offered within Southport:

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* 14. Do you use any school or private facilities for recreation or leisure activities?

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* 15. Within the last year have you traveled out of Southport to use a recreation facility or program?

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* 16. Would you favor or oppose expanding recreational opportunities in the Southport?

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* 17. What, if any, sources of funding are you willing to support in order to make improvements, build new facilities, and create programs?  Check all that apply.

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* 18. Would you be willing to pay a nominal fee to attend an event or use a special facility?

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* 19. Additional Comments:

T