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Have you or a family member used our Inclusion Services previously?

Yes
No
Closed to responses

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Have you or a family member participated in our Therapeutic Recreation Programs previously?

Yes
No
Closed to responses

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Would you be interested in learning more about our Inclusion Services and/or Therapeutic Recreation programs and activities?

Yes
No
Closed to responses

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If you would like to learn about our Therapeutic Recreation and Inclusion Services programs, how would you prefer to receive the information? (Check all that interest you.)

Virginia Beach Beacon
E-mail newsletter
Flyer or handout
City of Virginia Beach website (vbgov.com)
Public school system
Virginia Beach Parks & Recreation mailer
Social media platforms (Facebook, Twitter)
Other
Closed to responses

PLEASE TELL US ABOUT THE PARTICIPANT(S) 

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How many individuals in your household could be served by Inclusion Services or Therapeutic Recreation programs?

1
2
3
4
Other (please specify below)
Closed to responses

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How old is (are) the participant(s)? Select all that apply.

1 - 2
3 - 5
6 - 12
13 - 15
16 - 21
22 - 35
36 - 55
Over 55
Closed to responses

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What disability group(s) does the participant most identify with? (Check all that apply)

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What type of support system does the participant have? (Check all that apply)

Family
Caregiver / Guardian (Non-Relative)
Group Home
Independent
Other (please specify below)
Closed to responses

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Does the participant require mobility assistance?

Yes
No
Closed to responses

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If the participant does require mobility assistance, please indicate what type. (Check all that apply.)

Cane
Walker
Wheelchair
Other (please specify below)
Closed to responses

INCLUSION SERVICES / ACCESSIBILITY

Question title

Which of the following current program areas would the participant be interested in accessing? (Check all that apply)

Before and after school programs
Summer camps
Early Childhood (pre-K)
Learn to swim lessons
Dance classes
Martial arts classes
Fitness classes (land or water)
Weight training / Personal fitness
Forever Young (program for older adults)
Athletic Teams
Other (please specify below)
Closed to responses

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Would you be interested in the following meetings or training sessions? (Check all that apply)

Parent information meetings (Special Education Plans, Preparing your child for camp, etc.)
Disability trainings
Other (please indicate below)
Closed to responses

THERAPEUTIC RECREATION PROGRAMS 

Question title

Which of the following current services and programs interest the participant? (Check all that apply)

Learn To Swim – youth and adult
Around Town for ages 14 & up (social program that incorporates community outings)
Champions (middle/high school after school program)
Your Way to 5K for ages 12 and up (walking, running or rolling)
Camp Explore for ages 6 – 22 (summer day camp)
New and Junior Ventures for ages 13 – 22 (summer camp for higher functioning participants)
Outdoor Challenges Series for ages 12 and up (hiking, kayaking, climbing wall, paddle board, etc.)
Ability Builders for ages 22 – 30 (social skill based program meets two mornings per week)
Other (please indicate below)
Closed to responses

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What type of therapeutic recreation special events (one-time programs) would interest the participant? (Check all that apply)

Arts and Crafts (ex. making Holiday cards/decorations, woodworking, paint nights, sewing, etc.)
Dances
Holiday themed events
Outdoor events (kayaking, paddle boarding, camping, etc.)
Swimming activities (movies in the pool, family swim, family water safety, etc.)
Fitness and wellness events
Outings / Day Trips
Other (please specify below)
Closed to responses

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In addition to our current program offerings, which of the following programs interest the participant? (Check all that apply)

Monthly family programs (activities, community outings, swim day, etc.)
Children's fitness and wellness (ages 6 – 13)
Sensory play hour (ages 3 – 6)
Adaptive golf (for individuals with physical disabilities)
Adaptive golf (for individuals on the autism spectrum or who have intellectual disabilities)
Summer day camp for preschoolers (ages 4 – 5)
Adaptive Pickle Ball (for adults with joint/muscle ailments)
Adaptive fitness classes
Water exercise / aerobics
Never Too Late (Recreation therapy for older adults)
Cooking and Nutrition
Gardening
Dance
Art classes
Other (please specify below)
Closed to responses

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At what times would you be interested in programs being offered ? (Check all that apply)

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ADDITIONAL INFORMATION

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If you would like to receive future emails from the Parks & Recreation department about our services, events and information, please provide your email address:

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If you are interested in serving in an advisory role for Inclusion Services and Therapeutic Recreation, please provide your contact information: