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LITTLE CANADA PARKS & RECREATION DEPARTMENT <br />PROGRAM EVALUATION <br />This information is confidential. It will be useful in selecting instructors /coaches as well as modifying <br />activities and facilities for future programs. <br />Year & month program was held: <br />Name of program: <br />Division or age of participant: <br />Coach or instructor names: <br />Head <br />1st Asst. <br />2nd Asst. <br />Please circle the appropriate response with "1" being poor and "5" being excellent. <br />(Y = yes, N = no, U = undecided) <br />Teaches good sportsmanship <br />Teaches basic & essential fundamentals <br />Maintains appropriate discipline <br />Communicates well with participants <br />Communicates well with parents <br />Uses time efficiently <br />Was on time <br />Was in control of himself /herself at all times <br />Provided fair participation time to all <br />Treats participants, parents, officials with respect <br />Would you or your child participate again with the <br />same coach or instructor? <br />Overall condition of facility or fields <br />Overall condition of equipment <br />Overall satisfaction with program <br />Comments: <br />Head <br />Assistants <br />1st 2nd <br />12345 12345 12345 <br />12345 12345 12345 <br />12345 12345 12345 <br />12345 12345 12345 <br />12345 12345 12345 <br />12345 12345 12345 <br />12345 12345 12345 <br />12345 12345 12345 <br />12345 12345 12345 <br />12345 12345 12345 <br />Y N U Y N U Y N U <br />12345 12345 12345 <br />12345 12345 12345 <br />12345 12345 12345 <br />Name & Phone #: (optional) <br />Page 99 <br />