Bikeability Plus: Family Self-Assessment (Summer 2022) Question Title 1. About you Name: Email address: Postcode: OK Question Title 2. Number of adults who will receive training OK Question Title 3. Number of children who will receive training OK Question Title 4. Ages of children, e.g. 4, 5 & 7 OK Question Title 5. What would be your preferred choice of venue for training? Please tick all that apply. Shaw House, Newbury RG14 2DR Linear Park, Calcot RG31 7AW Kennet Leisure Centre, Thatcham RG19 4LJ Cotswold Leisure Centre, Tilehurst RG31 6SL OK Question Title 6. What would be your preferred day of the week for training? Please tick all that apply. Monday Tuesday Wednesday Thursday Friday OK Question Title 7. What would be your preferred choice of time for training? Please tick all that apply. 9am - 12noon 1pm - 4pm OK Question Title 8. How often do you cycle together as a family group? Every day A few times a week About once a week A few times a month Once a month Less than once a month OK Question Title 9. Have any children in the household had Bikeability training? Yes No OK Question Title 10. How confident are you cycling on roads? Extremely confident Very confident Somewhat confident Not so confident Not at all confident OK Question Title 11. How confident are you cycling on roads with your family? Extremely confident Very confident Somewhat confident Not so confident Not at all confident OK Question Title 12. Have any adults in the household had cycle training in the last ten years? Yes No OK DONE