Healthy Families Play Outside
Survey Form

* Denotes Required Field

If you participated in the 2008 or 2009 Lincoln Safari, you can re-register for 2010 by completing the form below.
Note: New participants need to register first.

Group Number:*Look Up

(Number's Only)

Which of the following years have you participated in the Lincoln Safari Program? (Check all that apply)*

2007-2008     2008-2009     2009-2010 (this year)

What is the one main reason for why you are participating in this program? (Briefly describe)*

How did you first hear about the Lincoln Safari Program? (Check all that apply)*

Television (commercials, local news)
Internet (local news or partner websites)
Radio
Billboard Adverstisement
Community Events (Family Health Fairs, Speaker Events, etc.)
Library
Newspaper
Community Newsletters (for example, "Lincoln Kids")
NEBRASKAland Magazine
Word of Mouth
Other (please specify below)



Based on your general opinion, please indicate your level of agreement with the following statements about children spending time outdoors.


Spending time oudoors is important to children's physical health.*

1 = Strongly Disagree, 4 = Neither, 7 = Strongly Agree
1      2      3      4      5      6      7

Spending time oudoors is important to children's performance in schoool.*

1 = Strongly Disagree, 4 = Neither, 7 = Strongly Agree
1      2      3      4      5      6      7

Spending time oudoors is important to children's mental health.*

1 = Strongly Disagree, 4 = Neither, 7 = Strongly Agree
1      2      3      4      5      6      7

Spending time oudoors is important to children's creativity.*

1 = Strongly Disagree, 4 = Neither or Nuetral, 7 = Strongly Agree
1      2      3      4      5      6      7

How well informed are you about opportunities for spending time outdoors near your home?*

1 = Not at All Informed, 4 = Neither, 7 = Extremely Informed
1      2      3      4      5      6      7

How frequently, in the past year, have you engaged in the following types of behaviors?


Spending time oudoors*

1 = Not at All, 4 = Neither, 7 = Very Frequently
1      2      3      4      5      6      7

Recycling behaviors (examples: recycling paper or plastic products)*

1 = Not at All, 4 = Neither, 7 = Very Frequently
1      2      3      4      5      6      7

"Green Consumer" behaviors (examples: buying products made from recycled materials, avoiding purchases that come in excess packaging, shopping for locally-grown foods)*

1 = Not at All, 4 = Neither, 7 = Very Frequently
1      2      3      4      5      6      7

"Reuse" behaviors (example: buying used appliances, repairing household items such as clothing or appliances)*

1 = Not at All, 4 = Neither, 7 = Very Frequently
1      2      3      4      5      6      7

"Energy Conservation" behaviors (examples: taking short showers, turning off lights when leaving a room, turning off water while brushing your teeth)*

1 = Not at All, 4 = Neither, 7 = Very Frequently
1      2      3      4      5      6      7

"Alternative Transportation" behaviors (examples: riding the bus, biking or walking to school/work, carpooling)*

1 = Not at All, 4 = Neither, 7 = Very Frequently
1      2      3      4      5      6      7

"Nature Stewardship" behaviors (examples: caring for neighborhood green spaces or wildlife in your area, planting trees, picking up litter along trails)*

1 = Not at All, 4 = Neither, 7 = Very Frequently
1      2      3      4      5      6      7

Below are statements representing different ways that people might think about wildlife. We’re interested in knowing your views about wildlife. This information will be used to better understand how participants in the Lincoln Safari Program feel about wildlife issues as well as to consider how future program offerings about wildlife may be developed or improved.

Humans should manage wildlife populations so that humans benefit.*

1 = Strongly Disagree, 4 = Neither, 7 = Strongly Agree
1      2      3      4      5      6      7

Animals should have rights similar to the rights of humans.*

1 = Strongly Disagree, 4 = Neither, 7 = Strongly Agree
1      2      3      4      5      6      7

We should strive for a world where there's an abundance of wildlife for hunting and fishing.*

1 = Strongly Disagree, 4 = Neither, 7 = Strongly Agree
1      2      3      4      5      6      7

I view all living things as part of one big family.*

1 = Strongly Disagree, 4 = Neither, 7 = Strongly Agree
1      2      3      4      5      6      7

Hunting does not respect thelives of animals.*

1 = Strongly Disagree, 4 = Neither, 7 = Strongly Agree
1      2      3      4      5      6      7

I feel a strong emotional bond with animals.*

1 = Strongly Disagree, 4 = Neither, 7 = Strongly Agree
1      2      3      4      5      6      7

The needs of humans should take priority over wildlife protection.*

1 = Strongly Disagree, 4 = Neither, 7 = Strongly Agree
1      2      3      4      5      6      7

I care about animals as much as I do other people.*

1 = Strongly Disagree, 4 = Neither, 7 = Strongly Agree
1      2      3      4      5      6      7

Wildlife are on earth primarily for people to use.*

1 = Strongly Disagree, 4 = Neither, 7 = Strongly Agree
1      2      3      4      5      6      7

Hunting is cruel and inhumane to the animals.*

1 = Strongly Disagree, 4 = Neither, 7 = Strongly Agree
1      2      3      4      5      6      7

We should strive for a world where humans and wildlife can live side by side without fear.*

1 = Strongly Disagree, 4 = Neither, 7 = Strongly Agree
1      2      3      4      5      6      7

I value the sense of companionship I receive from animals.*

1 = Strongly Disagree, 4 = Neither, 7 = Strongly Agree
1      2      3      4      5      6      7

Wildlife are like my family and I want to protect them.*

1 = Strongly Disagree, 4 = Neither, 7 = Strongly Agree
1      2      3      4      5      6      7

People who want to hunt should be provided the opportunity to do so.*

1 = Strongly Disagree, 4 = Neither, 7 = Strongly Agree
1      2      3      4      5      6      7

We may be interested in gathering further input from participants in the Lincoln Safari Program about their experiences. Toward this end, we would like to know if you would be interested in providing input in the future by way of email. Please check the box below if you are interested in this opportunity.
Yes, I would be interested in participating in a follow-up study about the Lincoln Safari Program.
(Participation would entitle my group to an invitation only Fall reception at the Lincoln Children’s Zoo.)


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