Exit Taylor Street Park Improvements Question Title * 1. Do you currently visit any of the playgrounds within the Town of Wake Forest Parks System? Yes No If you chose no, is there a specific reason you do not currently visit the playgrounds in Wake Forest? Question Title * 2. Who do you usually go to playgrounds with? Check all that apply. I take my child I take my grandchild or other family member I am a caregiver who takes a child I meet family or friends there Rarely Other (please specify) Question Title * 3. Would you or someone in your household benefit from a playground and accessible features? Yes No Question Title * 4. What are important aspects of a playground to you and/or the child(ren) in your household? Question Title * 5. Of the playgrounds you haven’t enjoyed, what didn’t you and/or you child(ren) like about them? Question Title * 6. Rate the importance of the following facilities in a playground. Using a scale of 1 to 5; 1=Not Important/ 5=Very Important 1 2 3 4 5 Type of surfacing used (rubber, grass, wood chips/mulch, etc.) Type of surfacing used (rubber, grass, wood chips/mulch, etc.) 1 Type of surfacing used (rubber, grass, wood chips/mulch, etc.) 2 Type of surfacing used (rubber, grass, wood chips/mulch, etc.) 3 Type of surfacing used (rubber, grass, wood chips/mulch, etc.) 4 Type of surfacing used (rubber, grass, wood chips/mulch, etc.) 5 Ramps on playground Ramps on playground 1 Ramps on playground 2 Ramps on playground 3 Ramps on playground 4 Ramps on playground 5 Shaded areas Shaded areas 1 Shaded areas 2 Shaded areas 3 Shaded areas 4 Shaded areas 5 Benches and rest areas Benches and rest areas 1 Benches and rest areas 2 Benches and rest areas 3 Benches and rest areas 4 Benches and rest areas 5 Picnic shelters and tables Picnic shelters and tables 1 Picnic shelters and tables 2 Picnic shelters and tables 3 Picnic shelters and tables 4 Picnic shelters and tables 5 Fences Fences 1 Fences 2 Fences 3 Fences 4 Fences 5 Natural Spaces (trees, flowers, etc.) Natural Spaces (trees, flowers, etc.) 1 Natural Spaces (trees, flowers, etc.) 2 Natural Spaces (trees, flowers, etc.) 3 Natural Spaces (trees, flowers, etc.) 4 Natural Spaces (trees, flowers, etc.) 5 Question Title * 7. What is one thing you would choose to include in a playground? Question Title * 8. Do you have any additional feedback regarding a playground you would like us to know? Question Title * 9. Please indicate your gender Male Female I prefer not to answer Question Title * 10. What is your age? 18-24 25-34 35-44 45-54 55-64 65-74 75 or older I prefer not to answer Question Title * 11. What race do you consider yourself to be? White Asian, Asian Indian or Pacific Islander Native American Black or African American Hispanic, Latino or Spanish I prefer not to answer Other (please specify) Question Title * 12. Does anyone in your household have a disability? (For the purposes of this survey, a disability is defined as a physical or mental impairment that substantially limits one or more major life activities.) Yes No I prefer not to answer Done