Child Safety Program Evaluation Form
Please provide your feedback on the child safety program.
Your Name
First Name
Last Name
Your Relationship to the Child
Please Select
Parent
Guardian
Teacher
Caregiver
Other
Program Date Attended
-
Month
-
Day
Year
Date
How would you rate the overall effectiveness of the program?
1
2
3
4
5
What did you like most about the program?
What improvements would you suggest?
Would you recommend this program to others?
Yes
No
Submit
Should be Empty: