Name

Your name is OPTIONAL...

First Name

Last Name

Are you still participating in the program? *

Yes

No

Class Start Time *

Recently we needed to move the start times of practice by 15 minutes. How did this time change affect you?

The time change was Positive.

The time change was Negative

The time change was NOT relevant

IF you are NOT participating in the current session can you give us insight as to why?

Start times were too early

Start times were too late

Simply lost interest

Other Youth Activity conflicts

Upcoming travel conflicts

Too many participants

Other

Changes you would like to see in the program?

Choose all that apply.

Start sessions earlier.

Start sessions later.

More sessions in a week.

Add a weekend session.

Shorter sessions.

Longer sessions.

Last question

Would you participate in an adults only Self Defense/Martial Arts Exercise class?

Yes, in the evenings

Yes, in the mornings

Yes, on the weekend

No I would not participate