This can be filled out by the participant or together with a caregiver. Please fill out to the best of your ability!
How long have you been part of the Hanai program?1 year2 years3 years4+ years
On a scale of 1-10, how would you rate the Hanai program?
Are there any mentors who have had a positive, long-lasting influence on you?YesNo
If so, who?
On a scale of 1 to 10, how would you rate the leadership of your mentors?
What is your favorite part about the Hanai Program?
What was your favorite 2023 Hanai memory?
What were your 3 favorite outing activities this year?
What activities would you like to do if you joined next year?
What kind of lunches / snacks would you like if you joined next year?
Did you like the group you were in? Why or why not?
How could Urban Surf 4 Kids make this a better experience for you?
Would you recommend this program to other kids that are part of Urban Surf 4 Kids?YesNoMaybe
How many adult mentors have you developed a close bond to?12345+
Who were they?
How many participants have you developed a close bond to? 12345+
What did you benefit from this program? (Select all that apply)New mentorsNew friendsNew hobbiesTrying out new activitiesConfidenceSocial Skills
More:_____
How important is this program to your overall quality of life?Not importantSomewhat importantImportantVery important
Before Hanai outings, what was typically your mood? (Select all that apply)CalmHappyExcitedContentIndifferentScaredSadNervousUpsetAngry
After Hanai outings, what was typically your mood? (Select all that apply)CalmHappyExcitedContentIndifferentScaredSadNervousUpsetAngry
Do you want to be part of next year’s Hanai program?YesNoMaybe
Are there any last words you'd like to say to your 2023 Hanai mentors? Please include the group you / your child were in so we can share your testimony / feedback with them!
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