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2. Park Visited
4. Date
6. How often do you visit this park?
8. Amenities used while at this park:

   1. Shelters
   2. Swings
   3. Benches

   1. Sports Fields
   2. Playgrounds
10. Are there any other amenities you use at this park?
12. Please rate the following:
14. Overall cleanliness

    1. Poor
    2. Fair
    3. Good
    4. Very Good
    5. Excellent
15. Feeling of safety at this park

    1. Poor
    2. Fair
    3. Good
    4. Very Good
    5. Excellent
16. Cleanliness of restrooms if applicable

    1. Poor
    2. Fair
    3. Good
    4. Very Good
    5. Excellent
18. Condition of facilities and equipment

    1. Poor
    2. Fair
    3. Good
    4. Very Good
    5. Excellent
19. Maintenance and upkeep of the park

    1. Poor
    2. Fair
    3. Good
    4. Very Good
    5. Excellent
21. Any other comments or suggestions?
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24. Email address

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