Your Shopping Bag: 0 item(s) Total £0.00 View Bag

Questionnaire

Ruby's Funds mission is to open a fully inclusive sensory and soft play centre and social cafe for children and young people with disabilities and additional needs in Congleton, Cheshire.

Children and young people with disabilities and additional needs, along with their family, carers and friends, often have difficulty finding safe, accessible places to have fun and socialise. The centre will offer a safe, stimulating environment, giving individuals and groups the chance to explore and develop in an inclusive setting, which is also ideal for therapy, relaxation, education and most importantly friendship and fun.

In order for us to proceed with this project we need to find out how people would use the facilities available.

We would appreciate if you could take a few minutes to fill in the following form.

1: Do you think there is a need for a project of this nature in the local area?

	Yes:
	No:

2: Please tell us your postcode and tick the following to advise how far you would be prepared to travel to come to the play centre.

Your Postcode:
	Less than 5 miles:
	5 - 10 Miles:
	More than 10 miles:

3: Are you the parent⁄carer of a disabled child?

	Yes (go to question 4):
	No (go to question 7):

4: What type of disability does your child⁄young person have? Tick all that apply:

	Physical:
	Sensory:
	Communication:
	Learning:
	Medical:

5: In which age group is the child⁄young person? If you have more than one child⁄young person in the age brackets below, please state how many:

	Under 5:
	5 - 10:
	10 - 15:
	15 - 19:

6: Would you use the centre for your other children or just your disbaled child?

	Just my disabled child
	My other children

7: In which age group are your other children⁄young people? If you have more than one child⁄young person in the age brackets below, please state how many:

	Under 5:
	5 - 10:
	10 - 15:
	15 - 19:

8: How many times per month do you think you would use the centre?

	1 - 2 Times:
	3 - 4 Times:
	More often:

9: How long would you like a session to last?

	30 Minutes:
	60 Minutes:
	Other (please site):

10: Do you belong to a group that you think may wish to use the centre's facilities? If yes, please state (with contact details if appropriate)

11: Would you consider having a birthday party at the centre if this facility was avilable? (Please remeber this facility would be available and fully inclusive for disabled and none disabled children)

	Yes:
	No:

12: How much would you expect⁄be willing to pay to access the centre's sessions? (Cost per child, cost per session, parents and carers would not pay to access the centre)

	Under £5:
	Up to £8:
	Other (please state):

13: Would you use the cafe for for drinks and snacks?

	Yes:
	No:

14: Would you be prepared to pay an annual membership fee, which would entitle you to discounted rates for entry to the centre?

	No
	Up to £40 per year:
	Over £40 per year:

15: In the future the centre could provide more facilities. Please tick any of the following that would be of interest:

	Physiotherapy
	Relaxation therapies for parents⁄carers
	Speech & Language
	Birthday parties