YearsresidinginCumberlandCounty
Age&GenderoftheHousehold
Age Gender
Doanymembersofyour householdhaveadisabilityas definedbytheAmericanwith DisabilitiesAct(ADA)?
Whattypeof accommodationsareneeded toservethoseinyourfamily?
HandicapParking
HearingAssistance
AdditionalStaff
AlternativeSeatingOptions AdaptiveEquipment
Whattypeofprogramswouldbestservethe individualswithdisabilitiesinyourfamily?
Prioritizewhichdemographic needrecreationopportunities
D i s a b l e d V e t e r a n s F a m i l i e s T e e n s A d u l t s S p e c i a l P o p u l a t i o n s Y o u t h
1 2 3 4 5 6 7 8
Whatparkandrecreationfacilities inHopeMillsdoyouvisit?
Whydoyouvisitthe facilitiesyouselected?
Pleaseindicatehow oftenyouoramember ofyourhousehold participatesinthe variousactivities listed.
Pleaseindicatehow oftenyouoramember ofyourhousehold participatesinthe variousactivities listed.
GroupFitness
Pleaseindicatehow oftenyouoramember ofyourhousehold participatesinthe variousactivities listed.
Outofbelowlistedactivities/programs,whichone(s)didyouoramemberofyour householdNOTparticipateinduetoalackofnearbyfacilitiesORlackofinterest?
Pleasemarkthetopthreeindoor recreationspacesmostneededin thecommunity
IndoorAllInclusive&Accessible
