Walk To School Day Post-Event Response Form
1st time participant Previous participant
What was the actual number student walkers in your event? (enter number here)
What were the actual numbers of non-student participants? Principal Building teachers Other building staff (food service, para-professionals, custodian) *School board members *Superintendent or other district administrators Parents or other family member of students *Legislators High school students-athletes, marching band, volunteers Media *Representatives of community partners-fire, police, health dept. *Local celebrities Other *Mayor or other city council representative
For each category above with an asterisk (*), please list the names of persons and agencies that were in attendance:
Please provide a brief description of your event (including any interesting, unusual or special components that would generate interest).
Please describe any activities or exciting new developments that may result from your participation in Walk to School Day.
What efforts are in place at your school to assure that daily physical activity is addressed in the school setting?
Does your school have a sustainable walking program for students that will continue throughout the school year? Please describe:
What percentage of school children that live within 1 mile of schools could safely walk to school? 10% or less 11-50% 51-75% 76-100%
Are children allowed to ride bikes to school? Yes No
What percentage of school children that live within 2 miles of schools could safely bike to school? 10% or less 11-50% 51-75% 76-100%
If your students are not able to safely walk/bike to school, what will you do about the problem in order to encourage decision-makers to improve the walking environment?
Where it is safe, are you actively promoting walking or biking to school? Yes No
To whom could we send information regarding increasing the walkability of your community? (Please provide their name and address below).
Would you like to receive information on the CDC School Health Index for assessing and planning for physical activity, nutrition, and tobacco use prevention strategies for your school? Yes No
Was the web-based program easy to use? Yes No
Which parts of the downloads were most helpful to you? Sample parent letter Ideas for incentives sponsors could provide Permission form Information on walking school bus and bike train Letters to sponsors, legislators, key leaders and volunteers Press release or other promotional materials Walkability survey Thank you letters Ideas to use all year Walkability survey results letter to parents Tally form by school on participants and impediments Sample certificate for participation in event "Improving Your Community's Foot Travel" form
Was the walkability Survey easy for participants to use? Yes No
Were the stickers enjoyed and worn by the participants? Yes No
Are there any other materials you would like us to include in the Walk to School Day promotion?
Additional comments about how the program could be improved?
Are you planning to repeat this event again next year? Yes No
THANK YOU FOR YOUR TIME!
