Playground Planning Form

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Project Name: *

Address: *

City: *

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Zip Code: *

Telephone (Main): *

Telephone (Cell):

Fax:

Email address:

Director/Administrator:

Telephone (Director):

Coordinator:

Telephone (Coordinator):

Select all that apply: Indoor
Backyard
Rooftop
Deck
In-Ground
Surface Mount
Cement
Asphalt
Dirt

Area Size:

Area Size Allocated:

Age Range: 2-5 yrs. 5-12 yrs. 2-12 yrs.

Maximum deck height for safety surfacing:

How many children are you looking to occupy at the same time?

ADA Wheelchair accommodations required? Yes No

Is the ground level? Yes No

Sub-Flooring preperation? Yes No

Water drainage issue? Yes No

Fencing/Gates required? Yes No

Consider the age groups.  Take into account the various child development requirements i.e. motor skills, upper body development, hand and eye coordination etc.

Slides:

Climbers:

Barriers:

Connectors/Links:

Ramps/Bridges:

Roofs:

No-Deck:

Spring Bouncers:

Free Standing:

Sand & Water:

Swings:

Motion Activity:

Fitness/Horizon:

Health-Trail:

List four of the most important components you would like us to include (i.e. spiral slide, clatter bridge):

Select all that apply: Gazebo/Shelters
Benches
Game Tables
Picnic Tables
Planters
Water Fountains
Trash Receptacles
Bike Rack
Bleachers

Select all that apply: Basketball System
Tetherball System
Volleyball System
Tennis System
Football System
Badminton System

Are there any other details you would like to share?