Feel Good Families sign up form

Gender

Male

Female

How did you find out about Feel Good Families?

Community Event

Website

Poster / Banner in Community

Social media

Other

Thinking about YOUR activity levels over the last 7 days, would you say you were:

Inactive - doing fewer than 30 minutes of activity per week

Fairly active - doing 30 to 149 minutes activity per week

Active - doing at least 150 minutes activity per week

Thinking about your CHILD's or children's activity levels over the last 7 days, would you say they were:

Active every day (60 minutes or more every day)

Active across the week (an average of 60 minutes or more a day but not every day)

Fairly active (an average of 30 to 59 minutes a day)

Less active (less than an average of 30 minutes per day)

Does your family access Healthy Start vouchers or free school meals?

Please tick all that apply to your family.

Healthy start vouchers

Free school meals

None

Would you be interested in being part of a parent forum around activities and family services for Ashfield?

Yes

No