KIDS CAN ACHIEVE HOLIDAY SCHEME

EVALUATION FORM

Name of child (optional):	Name of parent/ carer (optional):

Which holiday scheme has your child attended? (Please circle) Half-term/ Easter/ Summer/ Christmas

Did your child access Play Scheme or Youth Holiday Scheme? (Please circle) Play Scheme / Youth Holiday Scheme / Not sure

Please tick an appropriate answer	Agree	Neither agree nor disagree	Disagree
My child enjoyed the holiday scheme
My child enjoyed the planned activities
I was happy with the feedback I received
The scheme met my child's needs
The staff were informed and helpful
I received a Carers Pack
I have signed and returned the forms in it
I would send my child to future schemes

Why did you choose this holiday scheme?

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What difference has attending the scheme made to you and your children?

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Were there any activities that were particularly beneficial to your child?

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Do you have any suggestions or comments that you feel would benefit future playschemes?

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Which of the following services/ activities currently provided by KCA do you use/ would like to use?

Service/ activity	I use this service	I would like to use this service
Sessional Day Care (referral only)
After School Club (under 12s)
Youth Group (12-19s)
Coffee Morning (Parents)
Art Club (under 12s)
Complementary Therapies
Football Club (under 12s)
Autistic Family Centred Counselling
1:1 support re: ADHD (parenting matters, help with education, benefit forms etc)
Support with education issues in schools- pre-exclusions, IEPs and appeals (re: ADHD and/ or behavioural problems)

Are there any other services/ activities that you would like KCA to provide?

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Would you like us to contact you regarding any of your comments? If so, please provide a contact telephone number or email address.

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