Participant Feedback Questionnaire In order to provide optimal services to our clients and participants, we need information from you. Please take time to complete this questionnaire honestly. Your answers are very important to us and will remain anonymous! One questionnaire per person, please. 1. Which classes have you attended? (Check all that apply) Aerobics CardioKickboxing Pilates 2. At which location have you attended classes? (Check all that apply) Lake Arbor Bowie Deerfield Run Bladensburg 3. How far did you travel to attend class? (Check all that apply) 0-5 miles 6-10 miles 11-15 miles 16+ miles 4. How many classes have you attended? (Check one) 1-4 5-8 9-12 13-20 Over 20 5. What is your age? (Check one) 13-18 19-24 25-34 35-44 45-54 55-65 Over 65 6. What other activity do you participate in outside of these classes? (Check all that apply) Running Swimming Organized Sports Yoga Personal Trainer Other Group Fitness Class 7. When is the most convenient time for you to workout? (Check all that apply) Weekdays: 4:30-6:00pm 6:00-7:30pm 7:30-10:00pm Saturdays: 7:00-8:30am 8:30-10:00am 10:00-11:30am 8. On a scale of 1 to 5, rate the level of difficulty of the classes you have attended. (1 - easy, 2 - somewhat moderate, 3 - moderate, 4 - difficult, 5 - extremely difficult) Aerobics 1 2 3 4 5 N/A CardioKickboxing 1 2 3 4 5 N/A Pilates 1 2 3 4 5 N/A 9. Rate your current activity level. (1 - New to Exercise, 2 - Beginner, 3 - Intermediate, 4 - Advanced, 5 - Athletic) Aerobics 1 2 3 4 5 N/A CardioKickboxing 1 2 3 4 5 N/A Pilates 1 2 3 4 5 N/A 10. How would you rate your eating habits? (Check one) Unhealthy Somewhat Healthy Healthy Extremely Healthy 11. What other classes/programs would you like to see offered by KJ Total Fitness? (Check all that apply) Weight Training Boot Camp Kickbox-a-thon Nutrition Club Youth Aerobics 5K run Yoga Senior Aerobics 12. On a scale of 1 to 5, please rate your class instructor(s). (1 - poor, 2 - fair, 3 - neutral, 4 - good 5 - excellent) Ayanna: 1 2 3 4 5 N/A - Timeliness 1 2 3 4 5 N/A - Appearance 1 2 3 4 5 N/A - Skilled 1 2 3 4 5 N/A - Approachable 1 2 3 4 5 N/A - Challenging 1 2 3 4 5 N/A - Motivating Danita: 1 2 3 4 5 N/A - Timeliness 1 2 3 4 5 N/A - Appearance 1 2 3 4 5 N/A - Skilled 1 2 3 4 5 N/A - Approachable 1 2 3 4 5 N/A - Challenging 1 2 3 4 5 N/A - Motivating Debbie: 1 2 3 4 5 N/A - Timeliness 1 2 3 4 5 N/A - Appearance 1 2 3 4 5 N/A - Skilled 1 2 3 4 5 N/A - Approachable 1 2 3 4 5 N/A - Challenging 1 2 3 4 5 N/A - Motivating Erica: 1 2 3 4 5 N/A - Timeliness 1 2 3 4 5 N/A - Appearance 1 2 3 4 5 N/A - Skilled 1 2 3 4 5 N/A - Approachable 1 2 3 4 5 N/A - Challenging 1 2 3 4 5 N/A - Motivating Leslie: 1 2 3 4 5 N/A - Timeliness 1 2 3 4 5 N/A - Appearance 1 2 3 4 5 N/A - Skilled 1 2 3 4 5 N/A - Approachable 1 2 3 4 5 N/A - Challenging 1 2 3 4 5 N/A - Motivating Kim: 1 2 3 4 5 N/A - Timeliness 1 2 3 4 5 N/A - Appearance 1 2 3 4 5 N/A - Skilled 1 2 3 4 5 N/A - Approachable 1 2 3 4 5 N/A - Challenging 1 2 3 4 5 N/A - Motivating Stan: 1 2 3 4 5 N/A - Timeliness 1 2 3 4 5 N/A - Appearance 1 2 3 4 5 N/A - Skilled 1 2 3 4 5 N/A - Approachable 1 2 3 4 5 N/A - Challenging 1 2 3 4 5 N/A - Motivating 13. How would you rate the location and conditions of the room the class was held? (Check one) Excellent Adequate Passable Insufficient Uncomfortable Please share any comments or concerns in the space provided below. Thank you for your time and assistance in providing feedback on the KJ Total Fitness classes/programs.