Dear Family Members/Care providers:

Thank you for completing this brief survey. Your input is vital to AbilityFirst Camp Paivika. Your camper has already completed his/her own survey while at camp, so we would like this survey to be from your perspective.

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* 1. What is your relationship to the camper?

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* 2. How long has your camper been attending Camp Paivika?

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* 3. My camper's age is:

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* 4. Does your camper attend another program at AbilityFirst in addition to Camp Paivika?

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* 5. If you answered no to Question 4, please check all the barriers that apply to preventing your camper in attending  another program at AbilityFirst in addition to Camp Paivika? (Check all that apply)

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* 6. What do you value most about your camper's experiences at Camp Paivika? (Check all that apply)

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* 7. What were the key factors that led you to come to Camp Paivika? (Check all that apply)

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* 8. Attending Camp Paivika has impacted my campers independence:

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* 9. When your camper came home, did your camper gain the confidence to try new things?

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* 10. When your camper came home did your camper gain increased confidence to meet/make new friends?

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* 11. The staff at Camp Paivika:

  Yes No Don't know
Were friendly
Were well trained
Were good listeners during check in
Were respectful
Were helpful
Made a good first impression of camp
Met the needs of my camper
Were able to adapt activities appropriately so that my camper could participate

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* 12. Having my camper attend Camp Paivika provides a valuable rest for me for my family.

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* 13. When my camper returned home, I felt recharged and better able to meet the demands of care giving.

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* 14. Overall, do you feel that having your camper attend camp has made a positive difference in your life?

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* 15. I can tell my camper had fun at camp.

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* 16. What do you feel sets Camp Paivika apart from other camps that your camper could attend?

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* 17. How would you rate the quality of the program provided for your camper's overall experience at Camp Paivika?

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* 18. How would you rate the over all safety at Camp Paivika?

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* 19. How likely is it that you would recommend Camp Paivika to a friend or colleague?

Not at all likely
Extremely likely

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* 20. The facilities at Camp Paivika:

  Strongly Agree Agree Disagree Stongly Disagree
Have adequate space
Are well maintained
Are in good repair
Are in a safe and desirable location
Are accessible

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* 21. On-line registration was (check all that apply)

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* 22. How far did you travel from your home to come to Camp Paivika?

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* 23. Does your camper want to return to Camp Paivika next year?

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* 24. What suggestions do you have to improve our program at Camp Paivika?

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* 25. Does your camper attend any other summer activities or programs? If yes, please provide name of activities or programs they attend?

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* 26. Other comments:

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