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S. Has your child asked you for permission to walk or bike to /from school in the last year? [:] Yes rl No <br />9. At what grade would you allow your child to walk or bike to /from school without an adult? <br />(Select a grade between PK,K,1,2,3...) m grade (or) 1:1 I would not feel comfortable at any grade <br />Place a clear `W inside box. If you make a mistake, fill the entire box, and then mark the correct box <br />10. What of the following issues affected your decision to 11. Would you probably let your child walk or bike to /from <br />allow, or not allow, your child to walk or bike to /from school if this problem were changed or improved? (Select one <br />school? (Select ALL that apply) choice per line, mark box with X) <br />❑ My child already walks or bikes to /from school <br />Distance.............................................................................. ............................... ❑ Yes 1:1 No I❑ Not Sure <br />Convenience of driving ...................................................... ............................... ❑ Yes 1:1 No Not Sure <br />Time................................................................................... ............................... 1:1 Yes ❑ No Not Sure <br />❑ Child's before or after - school activities .............................. ............................... ❑ Yes 1:1 No El Not Sure <br />nSpeed of traffic along route ............................................... ............................... Yes No ❑ Not Sure <br />❑ Amount of traffic along route ............................................ ............................... Yes No n Not Sure <br />❑ Adults to walk or bike with ................................................ ............................... Yes No 1:1 Not Sure <br />nSidewalks or pathways ....................................................... ............................... ❑ Yes No n Not Sure <br />❑ Safety of intersections and crossings ................................ ............................... 1:1 Yes ❑ No n Not Sure <br />Crossing guards .................................................................. ............................... ❑ Yes 11 No 1:1 Not Sure <br />Violence or crime ............................................................... ............................... 1:1 Yes El No ❑ Not Sure <br />Weather or climate ............................................................. ............................... ❑ Yes 0 No 0 Not Sure <br />+ I Place a clear `X' inside box. If you make a mistake, fill the entire box, and then mark the correct box <br />12. In your opinion, how much does your child's school encourage or discourage walking and biking to /from school? <br />Strongly Encourages Encourages Neither Discourages Strongly Discourages <br />13. How much fun Iswalking or biking to /from school for your child? <br />Very Fun Fun Neutral Boring Very Boring <br />14. How healthy is walking or biking to /from school for your child? <br />E] Very Healthy 1:1 Healthy 1:1 Neutral Unhealthy n Very Unhealthy <br />+ I Place a clear `X' inside box. If you make a mistake, fill the entire box, and then mark the correct box <br />+ <br />15. What is the highest grade or year of school you completed? <br />❑ Grades 1 through 8 (Elementary) College 1 to 3 years (Some college or technical school) <br />nGrades 9 through 11 (Some high school) College 4 years or more (College graduate) <br />nGrade 12 or GED (High school graduate) n Prefer not to answer <br />16. Please provide any additional comments below. <br />