Parent Survey About Walking and Biking to School
Dear Parent or Caregiver:

Your child's school wants to learn your thoughts 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 you receive a survey link for more than one child from a 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 nor your child's name will be associated with any results.

Thank you for participating!

1. School Name
Your answer
2. Grade
3. Gender
4. How many children do you have in this school?
5. What is the street intersection nearest your home? (provide the names of two intersecting streets)
Your answer
6. How far does your child live from school?
7. On most days, how does your child arrive and leave for school? (select one choice per column)
Arrive at school
Leave from school
Walk
Bike
School Bus
Family vehicle or Lyft/Uber (only children in your family)
Carpool (children from other families)
Transit (city bus, subway, etc)
Other (skateboard, scooter, inline skates, etc)
8. How long does it normally take your child to get to/from school? (select one choice per column)
Travel time to school
Travel time from school
Less than 5 minutes
5 - 10 minutes
11 - 20 minutes
More than 20 minutes
Don't know / Not sure
9. Has your child asked you for permission to walk or bike to/from school in the last year?
10. At what grade would (or did) you allow your child to walk or bike to/from school without an adult?
11. What of the following issues affected your decision to allow, or not allow, your child to walk or bike to/from school? (please respond for each item)
Yes
No
Not sure
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 intersections and crossings
Crossing guards
Violence or crime
Weather or climate
12. In your opinion, how much does your child's school encourage or discourage walking and biking to/from school?
Strongly Encourages
Strongly Discourages
13. How much fun is walking or biking to/from school for your child?
Very Fun
Very Boring
14. How healthy is walking or biking to/from school for your child?
Very Healthy
Very Unhealthy
15. Please provide any additional comments below
Your answer
16. Does this school have a Safe Routes to School program?
17. Are you willing to help with any of the following activities? (please check all that apply)
18. If you are interested in any of the above activities, please provide your name and phone and/or email. (note: other survey answers will remain anonymous)
Your answer
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