Adaptive Recreation Programs
The Woburn Recreation will be adding more adaptive recreation programs for the residents of Woburn. We are asking you to take a few minutes to let us know what type of programming you would like to see us offer. If you have a child or adult with special needs please take a moment to fill out this brief survey.
If you have any questions at all please feel free to contact the Woburn Recreation Department at (781) 897-5805.
E-mail address
Your answer
Gender of participant
Female
Male
Prefer not to say
Other:
Clear selection
What is the age of your child/family member that participates in Adaptive Recreation programs?
If more than one member in household requires accommodations please write both ages.
Your answer
Has your child participated in any Woburn Recreation Department Program in the past?
Yes
No
Clear selection
Has your child participated in other programs offered by surrounding Cities/Towns Recreation Departments?
Yes
No
Clear selection
If yes, which programs?
Your answer
On a scale of 1 - 5 with 5 being the most limiting, how would you rate the disability limits participation?
1. Little or no limitation
2 Mild limitation
3 Moderate limitation
4 Moderately severe limitation
5 Severe limitation
Clear selection
In your opinion, which of the following creates the greatest barrier to participating in recreation or sports activities in Woburn?
Please select all that apply
Lack of early experience opportunities
Lack of understanding and awareness of how to include people with a disability
Limited opportunities and programs for participation
Lack of accessible facilities
Limited access to information and resources
Check all recreation program areas of interest:
Please select all that apply
Great Interest
Some Interest
No Interest
Social Groups
Sports & Athletics
Arts & Crafts
Music
Hobby/Skills/Leisure programs
Self-development Programs
Aquatics
Community Outings
Fitness/Exercise/Wellness programs
Great Interest
Some Interest
No Interest
Social Groups
Sports & Athletics
Arts & Crafts
Music
Hobby/Skills/Leisure programs
Self-development Programs
Aquatics
Community Outings
Fitness/Exercise/Wellness programs
Clear selection
Any specific program you are interested in the Woburn Recreation Department offering?
Your answer
Are you interested in inclusion programs or do you prefer programs exclusive to special needs peers?
Inclusive activities
Exclusive activities
Both
Clear selection
What time(s) of day are best for programs?
Morning
Afternoon
Evening
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Morning
Afternoon
Evening
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Any additional feedback or comments?
Your answer
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