2. Learn to Swim Program Survey
   City of Brownsville Parks and Rec requests your help. Please complete the following Customer Satisfaction Survey based on the program recently completed. Your opinion will be valued and will help to shape future operations. Thank you for your time.
6. First Name
7. Last Name
9. Address*
11. City
12. State
13. Zip Code*
15. What was your instructor's name?*
17. What class did you take (level/session)*
19. What is age of participant?*
21. What pool did you have you classes at?*

    1. Sams Pool
    2. Gonzalez Pool
23. The conditions of the pool/facility were:*

    1. Excellent
    2. Good
    3. Fair
    4. Poor
25. When you registered for this program, the process (forms, etc) was simple and comfortable.

    1. Very satisfied
    2. Somewhat satisfied
    3. Not satisified
27. Aquatics staff helpful and friendly?*

    1. Yes
    2. No
29. Were the classes well organized?*

    1. Yes, excellent
    2. Good, but needs improvement
    3. No
31. Did your classes start and end on time?

    1. Yes
    2. No
    3. Not sure
33. You or your child learned skills and progressed as you expected.*

    1. Very satisfied
    2. Somewhat satisfied
    3. Not satisfied
35. Program price and experience was a good value.*

    1. Very satisfied
    2. Somewhat satisfied
    3. Not satisfied
37. What did you or your child like best about the program?
39. What did you like least about the program?
41. Would you enroll yourself or child(ren) in this program again?*

    1. Yes
    2. Maybe
    3. No
43. Would you refer us to a friend?*

    1. Yes
    2. No
45. Do you or child have a special need?​ If Yes, would you like to have an accommodation provided by a Certified Therapeutic Recreation Specialist? *

    1. Yes
    2. No
47. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
49. Electronic Signature
Leave This Blank:


51. 1. Receive an email copy of this form.
52. Email address

    This field is not part of the form submission.

53. Submit

* indicates a required field