Name of parent or legal guardian *

First Name

Last Name

Phone

(###)

###

####

What forms of childcare do you currently use, or plan to use in the coming year? *

Check all that apply

Stay at home parent (part time or full time)

Family care (grandparents, aunties, etc)

Nanny

Hort

Waldkita

Waldspielgruppe

Kita (indoor)

Spielgruppe (indoor)

Other

How often does your child play outside in Nature? *

Estimate the days when your child is outdoors in a natural environment for an hour or more

Almost everyday

Several times a week

On weekends

Occasionally

What outdoor skills does your child already have? *

My child can often....

Play happily outside when it's raining

Ride along on an adult's bike

Recognise plants that are spikey!

Ask before putting wild berries or leaves in their mouth

Understand one and two-step directions and try to follow them (e.g. "Let's go gather leaves and put them in a big pile!")