New Activities at Chester RUFC

We'd like you to complete this short survey so that we can gauge the level of interest for various activities for adults and children at the Rugby Club.

Question Title

* 1. Please can you tell us about yourself and your partner

	Male	Female	Age 20-29	Age 30-39	Age 40-49	Age 50+
Self	Self Male	Self Female	Self Age 20-29	Self Age 30-39	Self Age 40-49	Self Age 50+
Partner	Partner Male	Partner Female	Partner Age 20-29	Partner Age 30-39	Partner Age 40-49	Partner Age 50+

Other (please specify)

Question Title

* 2. Which of the following activities would you and your family be interested in at the Rugby Club?

Please check all that apply

	Self	Partner	Child 1	Child 2	Child 3
Squash (Current player)	Squash (Current player) Self	Squash (Current player) Partner	Squash (Current player) Child 1	Squash (Current player) Child 2	Squash (Current player) Child 3
Squash (Coaching provided)	Squash (Coaching provided) Self	Squash (Coaching provided) Partner	Squash (Coaching provided) Child 1	Squash (Coaching provided) Child 2	Squash (Coaching provided) Child 3
Racketball (Coaching provided)	Racketball (Coaching provided) Self	Racketball (Coaching provided) Partner	Racketball (Coaching provided) Child 1	Racketball (Coaching provided) Child 2	Racketball (Coaching provided) Child 3
Fitness (e.g. Zumba, boxercise)	Fitness (e.g. Zumba, boxercise) Self	Fitness (e.g. Zumba, boxercise) Partner	Fitness (e.g. Zumba, boxercise) Child 1	Fitness (e.g. Zumba, boxercise) Child 2	Fitness (e.g. Zumba, boxercise) Child 3
Pilates	Pilates Self	Pilates Partner	Pilates Child 1	Pilates Child 2	Pilates Child 3
Yoga	Yoga Self	Yoga Partner	Yoga Child 1	Yoga Child 2	Yoga Child 3
Aerobics	Aerobics Self	Aerobics Partner	Aerobics Child 1	Aerobics Child 2	Aerobics Child 3
Dance (e.g. salsa)	Dance (e.g. salsa) Self	Dance (e.g. salsa) Partner	Dance (e.g. salsa) Child 1	Dance (e.g. salsa) Child 2	Dance (e.g. salsa) Child 3

Which other activities would you be interested in?

Question Title

* 3. If you are a parent or guardian, please tell us about your children (if you're not a parent or guardian, just skip this question)

	Child 1	Child 2	Child 3
Male	Male Child 1	Male Child 2	Male Child 3
Female	Female Child 1	Female Child 2	Female Child 3
U6	U6 Child 1	U6 Child 2	U6 Child 3
U7	U7 Child 1	U7 Child 2	U7 Child 3
U8	U8 Child 1	U8 Child 2	U8 Child 3
U9	U9 Child 1	U9 Child 2	U9 Child 3
U10	U10 Child 1	U10 Child 2	U10 Child 3
U11	U11 Child 1	U11 Child 2	U11 Child 3
U12	U12 Child 1	U12 Child 2	U12 Child 3
U13	U13 Child 1	U13 Child 2	U13 Child 3
U14	U14 Child 1	U14 Child 2	U14 Child 3
U15	U15 Child 1	U15 Child 2	U15 Child 3
U16	U16 Child 1	U16 Child 2	U16 Child 3
Junior Colts	Junior Colts Child 1	Junior Colts Child 2	Junior Colts Child 3
Senior Colts	Senior Colts Child 1	Senior Colts Child 2	Senior Colts Child 3

Other (please specify)