The Hidden Gardens- Tai Chi Equal Opportunities Monitoring The Hidden Gardens is committed to ensuring its opportunities are open to all in the community. And working with partners to reduce barriers to participation. The information gathered on this form is therefore helpful. It is confidential and will only be used to report on the range of people participating in our activities. You do not have to answer any or all of the questions on the form but it is a great help to us if you do. OK Question Title * 1. Which one of the following best describes your gender? Female Male Prefer not to say If you describe your gender with another term, please provide this here OK Question Title * 2. Disability: Do you have any of the following conditions which have lasted or expected to last for at least 12 months? No disability or impairment Hearing impairment Visual impairment Learning disability Mental ill health Physical impairment Long term illness Prefer not to say Other (please specify) OK Question Title * 3. What is your ethnicity? (Please select all that apply.) Asian - Bangladeshi Asian - British Asian - Indian Asian - Pakistani Asian - Scottish Black - African Black - British Black - Caribbean Black- Scottish Black British Chinese Latin American Middle Eastern White - British White - Irish White - Scottish Mixed ethnicity Prefer not to say Other ethnic background (please specify) OK Question Title * 4. Which age group do you fit into? 16-24 25-44 45-54 55-64 65-74 75-84 85-94 95+ Prefer not to say OK DONE - THANK YOU!