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2. Program Name*
   This is the title of the program you are evaluating.
4. Program Location*
6. Program Date*
   Program Date
10. Would you recommend this program to a friend?*

    1. Yes
    2. No
12. How did you learn about this program?

    1. City Staff
    2. Flyer Postings
    3. Friend
    4. Newspaper
    5. Social Media
    6. Website
    7. Other
13. If "Other", please explain:
15. Why did you register for this program?

    1. Attended previously
    2. Interested
    3. Location (convenient, close to home)
    4. Needed childcare during that time
    5. Recommended by someone
    6. Registration fees were reasonable
    7. Reputation of program
    8. Other
16. If "Other", please explain:
18. How satisfied were you with the program's activities?

    1. 0 - Not Sure
    2. 1 - Not At All Satisfied
    3. 2 - Not Very Satisfied
    4. 3 - Somewhat Satisfied
    5. 4 - Very Satisfied
19. How satisfied were you with the suitability of the program's location?

    1. 0 - Not Sure
    2. 1 - Not At All Satisfied
    3. 2 - Not Very Satisfied
    4. 3 - Somewhat Satisfied
    5. 4 - Very Satisfied
21. How satisfied were you with the program leaders or instructors?

    1. 0 - Not Sure
    2. 1 - Not At All Satisfied
    3. 2 - Not Very Satisfied
    4. 3 - Somewhat Satisfied
    5. 4 - Very Satisfied
22. How satisfied were you with the cleanliness and condition of the facility?

    1. 0 - Not Sure
    2. 1 - Not At All Satisfied
    3. 2 - Not Very Satisfied
    4. 3 - Somewhat Satisfied
    5. 4 - Very Satisfied
24. How satisfied were you with the safety and supervision measures?

    1. 0 - Not Sure
    2. 1 - Not At All Satisfied
    3. 2 - Not Very Satisfied
    4. 3 - Somewhat Satisfied
    5. 4 - Very Satisfied
25. How satisfied were you with the registration process?

    1. 0 - Not Sure
    2. 1 - Not At All Satisfied
    3. 2 - Not Very Satisfied
    4. 3 - Somewhat Satisfied
    5. 4 - Very Satisfied
27. How satisfied were you with the approachability and courteousness of the program staff?

    1. 0 - Not Sure
    2. 1 - Not At All Satisfied
    3. 2 - Not Very Satisfied
    4. 3 - Somewhat Satisfied
    5. 4 - Very Satisfied
28. How satisfied were you with the cost of the program?

    1. 0 - Not Sure
    2. 1 - Not At All Satisfied
    3. 2 - Not Very Satisfied
    4. 3 - Somewhat Satisfied
    5. 4 - Very Satisfied
30. How satisfied were you with the program's hours?

    1. 0 - Not Sure
    2. 1 - Not At All Satisfied
    3. 2 - Not Very Satisfied
    4. 3 - Somewhat Satisfied
    5. 4 - Very Satisfied
32. Please provide any comments and suggestions you may have regarding this program:
36. Please let us know if you wish to be contacted by our staff.
38. Name
40. Email
41. Phone
43. Consent

    By completing this form you are consenting to the voluntary collection and use of your personal information in accordance with Section 26(d) of the Freedom of Information and Protection of Privacy Act. This information provided by you will be used solely for the purpose of contacting you for further follow-up as per your request. Your information will not be used for any other purpose. If you have any questions about the collection, storage, correction and/or use of your personal information, please contact Jennifer Keefe, Manager of Community Recreation and Culture Services, at 604-927-3599.

    1. I consent
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45. 1. Receive an email copy of this form.
46. Email address

    This field is not part of the form submission.

47. Submit

* indicates a required field