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Questions marked with a * are required Exit Survey
 
Tell us about yourself!
* First Name : 
* Last Name : 
Phone : 
Email Address : 
 
 
 
* Park name?
 
 
(On a scale of 0-10), how much trash is in the park today?
* Trash on the ground
-
* Trash in the stream
-
* Overflowing trash cans
-
 
 
 
* How safe do you feel in the park?
Very unsafe
A little unsafe
Neutral
Safe
Very safe
 
 
 
What is making you feel unsafe?
   
 
 
 
* Is anything broken, hazardous or needing attention?
 
No, nothing
 
Bench
 
Picnic table
 
Lighting
 
Tree
 
Branches on path
 
Pothole
 
Open fire or unlicensed BBQ
 
Car driving in park
 
Sign
 
Sidewalk
 
Graffiti
 
Tire ruts in grass
 
Grass is uncut
 
Drinking fountain
 
Restroom
 
Other

 
 
 
Give the location of anything selected in Q4 as needing attention.
   
 
 
How activated is the park?
* Number of people using the park today
* Programming for youth
* Programming for adults
 
 
 
Are there any environmental health hazards?
 
Stream is polluted
 
Standing rainwater
 
Mosquitos or other insects
 
Invasive plants
 
No, nothing
 
Other

 
 
 
* I spoke to park users, and they said the park needs more: