|
Do you organise physical activity or sport in Brighton & Hove?
Would you like more members, coaches or volunteers?
Do you need training, funding or any other kind of help?
Then let us know about it by taking part in the most comprehensive survey of physical activity and sport ever carried out in the City.
Active For Life is funded by Brighton & Hove City Council and Brighton & Hove City Teaching Primary Care Trust to support local activity groups. As well as telling us how we can support you, the survey will result in the creation of an online community directory which is just one way that we aim to get more people, more active, more often.
Inclusion in the database is completely free. You can choose whether details of your activity are kept confidentially by Active For Life or are available to the general public.
More information.
|
|
Yes, I would like our group to be in the directory. I will use the check
boxes to indicate which information may be made available publicly and
which is to be kept confidential. I understand that Brighton & Hove
City Council and Primary Care Trust will handle all my information, both
public and confidential, in accordance with the Data Protection Act. |
|
No, I do not wish our group to be included in the on-line directory.
The information I provide is confidential. It may be used only by Active
For Life to plan and provide me with support in the form of training,
information or advice. I understand that Brighton & Hove City Council
and Primary Care Trust will handle all my information in accordance with
the Data Protection Act. |
| |
| |
| |
Section One – Contact Details
|
| Advice about completing this form online. |
| |
| |
| What is the name that your group or sessions are known by? |
|
|
| |
| |
| Details of main contact: |
| |
Please choose a general category (first 8 in list) or a specific category:
|
|
other
(please specify)
|
|
| |
Please provide a single sentence to introduce
your sessions or group.
This will appear under your group’s name if you have chosen to be in the
directory. |
|
|
|
| |
Do you have a quote or recommendation
from a previous participant?
This will appear under your group’s name if you have chosen to be in the
directory.
For privacy, please change the name of the contributor.
If a child has
provided the quote, please indicate their age.
(30 words maximum)
|
|
|
|
| |
| |
Section Three – About your participants
|
| |
| |
What is the age range of your participants (tick all that apply)
0-4
5-9
10-14
15-17
18-49
50-59
Over 60's
|
Public
Confidential |
| |
| |
Are your sessions:
For everyone in the age group(s) you have specified.
Specifically for people from particular backgrounds.
If you run both types of session, please tick both boxes.
|
Public
Confidential |
| |
|
If any or all of your sessions are for people from particular backgrounds please select these from the list below.
|
|
|
(tick all that apply)
Girls/women
Boys/men
Older people
People from black and minority ethnic groups
People with disabilities
Unemployed adults
Specific neighbourhood(s) or residential area(s) (please specify)
Refugees or asylum seekers
People who are lesbian, gay, bisexual or transgender
Low income families
People with a history of drug or alcohol dependency
Young people at risk of exclusion
Ex-offenders
People who are overweight or obese
People with cardio-vascular disorders
People recovering from stroke
People with mental health problems
People who have sedentary lifestyles
other (please specify)
|
| |
| |
Section Four – About your sessions |
| |
| |
Do you use a single or multiple venues?
|
|
|
Single Venue If you select 'Single Venue' then please enter the address, including post code, below.
Multiple Venues If you select 'Multiple Venues' then please leave the address section blank.
|
| |
| Address
|
Public
Confidential |
| Town/City
|
| County
|
| Post Code
eg BN1 1NB
|
| |
| |
When do your sessions take place?
Are you an afterschool club? Yes No
Are you a holiday scheme? Yes No
Are your sessions:
By arrangement i.e. people should contact you for details?
A combination of regular and arranged sessions?
At regular times?
|
|
| |
|
If your sessions are regular, please
enter times/days/months below.
(If your sessions are by arrangement,
please leave this section blank).
Morning
Afternoon
Evening
If you can give specific times, please do so:
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
All year round
Seasonal
(please give details below)
|
Public
Confidential |
| |
| |
| |
Which of the following are available at your activity venue?
Bike stands
Bus stop - please give route number(s) if known -
Free on-road parking
Free off-road parking
Voucher / Pay display parking
Creche
Cafe/Refreshments
|
| |
| |
Please select one of the following statements to tell people how to get involved:
Prior booking required. Contact for details.
Drop in at any session.
|
Public
Confidential |
| |
Do people pay to take part?
Yes
No
If yes, please provide details of membership and/or charges,
including any discounts or concessions you offer:
|
| |
| |
Please provide details of access to your sessions for people with disabilities:
e.g. transport arrangements, toilets, access ramps, hearing loop, large print leaflets, audiotapes, volunteer assistance etc.
Would you be happy for someone to contact you to discuss his or her
particular needs?
Yes
No |
Public
Confidential |
| |
| |
The information in the following sections
will not appear in the directory.
The answers you give us will help us find out what providers of sport
and activity in Brighton & Hove need, so we can respond accordingly. |
|
| Do you have a quality mark or have you been inspected according to any
recognised standards in your particular sport or activity?
No
Yes
If yes, please provide details
|
|
If you work with young people or vulnerable adults, please tell us for which staff you carry out CRB checks?
all staff, including those not directly involved in activities
all activity staff
only activity staff who work without direct supervision
other (please specify)
|
