Winter Cycle School Program Survey
Please help Shift become the premier Cycling Resource Center for Lane County by sharing your feedback on bicycle-based programming.
Name
First Name
Last Name
Please share your email if you would like to receive updates from Shift:
example@example.com
Today's Date
-
Month
-
Day
Year
Date
How many children under age 18 are in your household?
0
1
2
3
4
More than 4
What is the age range of the children?
under 5
6 - 11
12 - 15
16+
Does your child(ren)/family speak a language other than English at home?
No
Yes
If Yes, what language?
Does your child(ren)/family receive assistance for food, housing, or healthcare (for example: OHP, SNAP, FRPL)?
No
Yes
Unsure
What type of programming would your child/family participate in at Shift Community Cycles?
YES - Would Participate
MAYBE - Might Participate
NO - Would Not Participate
Learn To Ride a Bike
Road Safety While On A Bike
Trail Navigation
Feeling Independent, Having Fun While On A Bike
Basic Bike Maintenance
Bike Mechanics
Creative/Artistic Ways to Reduce Waste and Reuse Things
Build Connections with Peers
Build Connections with Trusted Adults
Build A Sense of Community
Group Rides
Find Their Niche in the Cycling Community
In your opinion, what is the most important topic for your child to learn about cycling?
Safety
Rules of the Road
Route Planning - getting to/from school and other destinations
Reduce the Fear of Cycling, build confidence and independence
Other
Do you prefer:
Please Select
Activities that you can do with your child(ren)
Activities that you can drop your child(ren) off at
Would your child(ren) benefit from programs and activities specifically with children with a shared identity? If so, what identity? (Ex: racial, sexual, or language-based?)
What length of activity time works best for your family?
1 hour
1 - 2 hours
2 - 3 hours
3 - 4 hours
half or full day
What time of day best suits your child's schedule to attend Cycle School or other Shift Community Cycles programs?
During the day, weekday
During the day, weekend
After school
Afternoon, weekend
Evening, weekday
Evening, weekend
Other
Would you like to see Shift programming offered: (choose all that apply)
At schools
At local parks
At our Bike Shop
Another Community Location
Other
Would you be interested in adult programming at Shift Community Cycles? If so, what sort of programming would you be likely to attend?
Do you have other ideas for how Shift can accomplish our mission of providing bicycle access and education to our underserved communities?
Submit
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