Tai Chi on the Lawn Equalities Monitoring Form 2022 The Hidden Gardens The Hidden Gardens embraces and promotes equality and diversity in our community activities. The information below helps us to ensure we promote equality and diversity in our activities, and may also be used anonymously in funding applications or project evaluations. It is helpful for us to have, but providing it isn’t mandatory- just leave anything blank if you prefer not to answer. OK Question Title * 1. Which age group do you fit into? 16-24 25-44 45-54 55-64 65-74 65-74 65-74 95+ Prefer not to say OK Question Title * 2. How would you describe your Gender Identity? Male / Man including Trans Man Female / Woman including Trans Woman Different Gender Identity Prefer not to say If you would like to provide further information on your gender identity, please do so here: OK Question Title * 3. Sexual Orientation:Which of the following best describes your sexual orientation? Heterosexual/straight Bi/bisexual Gay/lesbian Prefer not to say If you prefer to use another term, please provide this here OK Question Title * 4. How would you describe your ethnicity? OK Question Title * 5. Religion / Belief OK Question Title * 6. Employment Status (please tick all that apply) Full-time Employed Part-time Employed Self-Employed Unemployed Retired Carer Student Refugee or Asylum seeker Prefer not to say Other (please specify) OK Question Title * 7. Disability: Do you consider yourself to be disabled under the Equality Act 2010? A disabled person is defined under the Equality Act 2010 as someone with a “ physical or mental impairment which has a substantial and long term adverse effect on that person’s ability to carry out normal day to day activities. “ Yes No Prefer not to say If yes, please give us a brief description of your disability OK Question Title * 8. Do you have caring responsibilities? If yes please tick all that apply None Primary carer of a child/children (under 18) Primary carer of disabled child/children Primary carer of disabled adult (18 and over) Primary carer of older person/people (65 and over) Secondary carer Prefer not to say OK Question Title * 9. Pregnancy and maternity - are you pregnant, on maternity leave or returning from maternity leave? Yes No Prefer not to say OK Please note if you have any concerns about your ability to practice Tai Chi safely, please consult your doctor. OK THANK YOU!