Walking and Biking to School - Parent Survey

Survey About Walking and Biking to School for Parents

Dear Parent or Caregiver,

Your child's school wants to learn more about children walking and biking to school. This survey will take about 5-10 minutes to complete. We ask that each family complete only one survey per school your children attend. If more than one child attends the same school, please fill out the survey for the child with the next birthday from today's date. Your responses will be kept confidential and neither your name or your child's name will be associated with any results. Thank you for participating in this survey!

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* 1. School Name:

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* 2. What is the grade of the child you are filling out this survey for?

1st

2nd

3rd

4th

5th

6th

7th

8th

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* 3. How far does your child live from school?

Less than 1/4 mile

1/4 mile up to 1/2 mile

1/2 mile up to 1 mile

1 mile up to 2 miles

More than 2 miles

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* 4. On most days, how does your child arrive to school?

	Walk	Bike	School Bus	Family Vehicle
Arrive at School	Arrive at School Walk	Arrive at School Bike	Arrive at School School Bus	Arrive at School Family Vehicle
Leave for Home	Leave for Home Walk	Leave for Home Bike	Leave for Home School Bus	Leave for Home Family Vehicle

Other (please specify)

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* 5. Which of the following issues affected your decision to allow, or not to allow your child to walk or bike to/from school?

Distance

Convenience of driving

Time

Child's before or after-school activities

Speed of traffic along route

Amount of traffic along route

Adults to walk or bike with

Sidewalks or pathways

Safety of intersection and crossings

Crossing guards

Violence or crime

Weather or climate

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* 6. Which of the following items would increase the likelihood that your child would walk or bike to school?

Knowing other kids are walking/biking

A regular "walking school bus" for groups of students to walk or bike together

A planned walking/biking day such as National Walk to School Day

Pedestrian/Bike safety education

Crosswalks

Crossing Guards

Sidewalks

Police presence

Other_________________________________

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* 7. How much FUN is walking or biking to/from school for your child?

Very Fun

Fun

Neutral

Boring

Very Boring

Very Fun

Fun

Neutral

Boring

Very Boring

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* 8. Would you be interested in any of the following activities?

Trying to establish a safe route for your child to walk

Allowing your child to participate in walk-to-school and bike-to-school events

Chaperoning students walking/biking to school on walk/bike-to- school event days

Walking and Biking to School - Parent Survey

Survey About Walking and Biking to School for Parents

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* 1. School Name:

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* 2. What is the grade of the child you are filling out this survey for?

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* 3. How far does your child live from school?

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* 4. On most days, how does your child arrive to school?

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* 5. Which of the following issues affected your decision to allow, or not to allow your child to walk or bike to/from school?

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* 6. Which of the following items would increase the likelihood that your child would walk or bike to school?

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* 7. How much FUN is walking or biking to/from school for your child?

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* 8. Would you be interested in any of the following activities?

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* 9. Contact Information: Name and Email Address

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* 10. Please provide any additional comments below: