Uncle Toms Retirement Leisure Interest Survey

2012 by Tom King

INSTRUCTIONS:
Place a checkmark beside each of the recreational or leisure activities below that you think you might be interested
in, even the ones youve never tried. Remember in your late 50s, early 60s your right brain begins to grow again. It
hasnt done that since you were barely 20. It may explain why so many seniors get creative all of a sudden.
Grandma Moses, for instance, began her painting career late in life (which is why they called her Grandma).
Choose activities from the perspective of a participant, not a spectator. If you dont know what an activity is, look it
up on the Internet, call or go by your public library or just skip it. Score the responses from 1 to 5 as indicated:
1- No Interest

2- Little Interest

Team Sports
____ Soccer
____ Baseball/Softball
____ Football/Rugby
____ Basketball
____ Volleyball
____ Beach Volleyball
____ Handball

3-Average Interest

4-Above Average Interest

____ Cricket
____ Polo (Horseback)
____ Water Polo
____ Hockey
____ Lacrosse
____ Bowling
____ Dodgeball/Kickball

5- High Interest

____ Paintball
____ Hurling
____ Curling
____ Roller Derby
____ Crew Rowing
____ Other:______________
________________________

Individual or Partner Sports (Competitive)

____ Tennis
____ Competitive Fishing
____ Racketball
____ Golf
____ Squash
____ Miniature Golf
____ Handball
____ Disc/Frisbee golf
____ Badminton
____ Bocce
____ Bike Racing
____ Croquet
____ Competitive Swimming
____ Shuffleboard
____ Canoeing/Kayak
____ Bowling
Racing
____ Air Hockey
____ Canoe/Kayak
____ Boxing
Whitewater Slalom
____ Martial Arts
____ Power Boat Racing
____ Wrestling
____ Solo Rowing
____ Fencing
____ Sail Boat Racing
____ Laser Tag

____ Gymnastics
____ Track and Field
____ Winter Sports
____ Survival Games
____ Target Games/Darts
____ Ping pong
____ Archery
____ Trap Shooting
____ Horseshoes
____ Drag Racing
____ Dirt Track Racing
____ Motorcycle Racing
____ Other:______________
________________________

Individual Sports (Noncompetitive)

____ Hunting
____ Water Skiing
____ Fishing
____ Jet Skis
____ Kite flying
____ Scuba Diving

____ Swimming
____ Power Boating
____ Sailing

____Wind Surfing
____ Rafting/Kayaking
____ Canoeing
____ Snorkeling
____ Surfing
____ Hiking
____ Bicycling
____Mountain Biking
____ Speelunking/Cave
Exploration

____ Mountain Climbing

____ Rappelling
____ Parachuting
____ Base Jumping
____ Hang Gliding
____ Bungee Jumping
____ Camping
____ Ice Skating
____ Snow Skiing
____ Snowboarding

____ Motorcycling
____ 4-Wheeling
____ Roller-skating
____ Roller-blading
____ Skateboarding
____ Other:______________
________________________

Fitness
____ Aerobics
____ Weight-lifting
____ Jazzercize
____ Pilates
____ Tai-Chi
____ Kick Boxing

____Exercising/Gym/
Machines
____ Yoga
____ Jumping Rope
____ Jogging/Running
____ Walking

____ Freestyle running

____ Other:______________
________________________

Games
____Chess/Checkers
____ Billiards/Pool
____ Role Play/Charades
____ Board Games
____ Charades
____ Tactical/Strategy
Board Games

____ Dungeons & Dragon

Type RPGs
____ Video Games Arcade
____ Video Games
Strategy/Simulation
____ Video Games - RPGs
____ Video Games Puzzles

____ Video Games Word

Games
____ Card Games
____ Gambling
____ Puzzle Games
____ Other:______________
________________________

Collecting
____ Stamp Collecting
____ Coin Collecting
____ Rock Collecting
____ Art Collecting
____ Toy Soldier Collecting

____ Fossil Hunting

____ Antique Collecting
____ Butterfly Collecting
____ Seashell Collecting
____ Leaf Collecting

____ Flower Collecting

____ Rock Collecting
____ Doll Collecting
____ Other______________
____________________

Skilled Crafts Mechanical

____Wood-working
____ Gemology
____ Auto Mechanics
____ Home Repair
____ Carpentry
____ Leatherwork
____ Ceramics

____ Nature Crafts

____ Taxidermy
____Musical Instrument
Making
____ Puppet-Making
____ Vehicle Restoration
____ Lapidary

____ Model Making

____ Jewelry Making
____ Telescope-Making
____ Other:______________
________________________

Intellectual Pursuits
____ Philosophy/Religion
____ Mathematics
____ Crossword Puzzles
____ Brain Teasers
____ Natural Science/
Biology,etc
____ Astronomy
____ Physics

____ Space Science

____ Psychology/Social
Science
____ History/World Culture
____ Language Studies
____ Creative Writing/
Poetry
____ Blogging

____ Social Media,

Facebook, etc.
____ Reading
____ Geneology
____ Playing Stock Market
____ Other:______________
________________________

Domestic Arts
____ Interior Decorating
____ Landscaping/Yard Work
____ Cooking/Baking
____ Canning
____ Sewing/Stitching
____ Furniture Restoration/
Repair
____ Crochet/Knitting
____ Tie Dying

____ Scrap-booking
____ Flower Gardening
____ Vegetable/Herb
Gardening
____ Embroidery
____ Cross-Stitch
____ Quilting
____ Decoupage
____ Bonsai Culture

____ Weaving
____ Candle-making
____ Home Remodeling
____ Other:______________
________________________

Technical
____ Computer
Programming
____ Computer Building
____ Computer Graphic
Design
____ Electronics

____ Ham Radio

____ Flying
____ Slot car racing
____ Radio-Controlled Cars
____ Radio-Controlled Boats
____ Radio-Controlled Planes

____ Model Railroading

____ Shortwave Radio
____ Other:______________
________________________

Art
____ Photography
____ Sculpting
____ Painting
____ Sketching/Drawing
____ Pottery
____ Ceramics

____ Making Videos/ Home

Movies
____ Fashion Design
____ Tattooing
____ Sand Castles
____ Film-Making

____ Woodcarving
____ Whittling
____ Other:______________
________________________

Performing Arts
____ Acting/Play Production
____ Set Design
____ Costuming
____ Singing
____ Playing an Instrument

____ Dancing
____ Concerts/Ballet/Plays
____ Magic/Clowning
____ Juggling
____ Movie Theatres/Videos

____ Military Re-enacting

____ Storytelling
____ Standup Comedy
____ Other:_____________
________________________

Leisure/Family
____ Relaxation
____ Watching Sunset/
Sunrise
____ Day Dreaming/Thinking
____ Picnicking
____ Going to the Beach
____ Listening to Rain Drops
____ State/National Parks
____ Meditating
____ Shopping
____ Reminiscing/Diary
____ People Watching
____ Sunbathing
____ Television

____ Going to Playgrounds

____ Zoos/Aquariums
____ Cultural Events
____ Church Activities
____ Dating/Going Out With
Spouse
____ Hide & Seek/Tag
____ Traveling
____ Eating Out with Friends
____ Collecting Objects
____ Comic Books
____ Sporting Events
____ Volunteering
____ Roller Coasters/

Amusement Parks
____ Museums
____ Geo-caching
____ Kite Flying
____ Listening to Music
____ Shopping
____ Going to Movies
____ Metal Detecting
____ Other:______________
________________________

Nature Activities
____ Bird Watching
____ Whale Watching
____ Forestry
____ Zoology

____Microbiology
____Weather-Watching
____ Tornado Chasing
____ Wildflowers

____ Other:______________
________________________

Animal Care
____Horseback Riding
____ Animal Husbandry
____ Dogs
____ Cats
____ Aquarium Fish
____ Snakes
____ Aquaculture

____ Cattle Ranching

____ Sheep Herding
____ Emus/Ostriches
____ Ferrets/Chinchillas
____ Animal Refuges
____ Bird Rescue
____ Animal Rescue

____ Bee-Keeping
____ Other:______________
________________________

Volunteering/Civic Activities
____ Being in Clubs/Groups
____ Civic/Political Work
____ Youth Work
____ Scouting
____ Animal Refuges
____ Animal Shelter

____ Animal Rescue

____ Nursing Homes
____ Homeless Shelters
____ Misc. Nonprofit
____ Nonprofit Board Work
____ Charity Fund-raisers

____ Charity Golf

____ Mentoring
____Business Consulting
____ Other:______________
________________________

LEISURE INTEREST EVALUATION

A. List the activities above that scored a 4 or 5 in each category.
a. Team Sports

b. Individual/Partner Sports (Nompetitive)

c. Individual Sports (Noncompetitive)

d. Fitness

e. Games

f.

Skilled Crafts/Mechanical

g. Intellectual Pursuits

h. Domestic Arts

i.

Technical

j.

Arts

k. Theater/Performing Arts

l.

Leisure/Family

m. Nature Activities

n. Animal Care

o. Volunteering/Civic Activities

B. What recreational interests above have you taken classes or lessons in or have self taught skills?
Recreational Interest
Sample: Canoeing

____________________
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Skill Level (Beginner, Average, Intermediate, Advanced + type of skill

Advanced - Red Cross Certified Instructor, instructor at camp 3 summer, exp. Guide
________________________________________________________
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C. Which activities do you most enjoy and why?

Activity
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____________________
____________________
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Reason
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D. Which Activities Do You Do With Family?

____________________
____________________
____________________
____________________

_______________________
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___________________________
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___________________________

E. What Activities Do You Like to Do With Friends or Colleagues

____________________
____________________
____________________
____________________

_______________________
_______________________
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_______________________

___________________________
___________________________
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___________________________

F. Name activities you like to do by yourself.

____________________
____________________
____________________
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G. What are your three favorite activities? (those you do most regularly)
____________________

_______________________

___________________________

H. List clubs, organizations, sport teams, volunteer clubs you belong to.

I.

What new activities would you like to try or learn more about?
____________________
____________________
____________________

J.

_______________________
_______________________
_______________________

___________________________
___________________________
___________________________

Is there anything which prevents you from doing the activities you want to do?
____ A disability

____ Financial issues

_____ Transportation

_____ Health

____ Other:_____________________________________________________________________
K. What types of activities do you NOT participate in because of unpleasant features associated with
the activity?
Those that involve:
SPEED Y or N

HEIGHT Y or N

ANIMALS Y or N

TOUCHING Y or N

DARKNESS Y or N

TIGHT PLACES Y or N

INSECTS Y or N

BIRDS

DIRT Y or N

RURAL PLACES Y or N

CROWDS Y or N

CLIMBING Y or N

SOLITUDE Y or N

LOUD NOISES Y or N

ALLERGENS Y or N

PHYSICAL EXERTION Y or N

Y or N

WATER Y or N

PEOPLE I DONT KNOW Y or N

0THER:______________________________________________________________________

L. What activities did you used to do often would like to take up again?
____________________
_______________________
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____________________
_______________________
___________________________
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M. Does alcohol help you enjoy your leisure?
Never

Once a month

Twice a month

Three times a month

N. Do you use drugs for leisure enjoyment?

Never

Once a month

Twice a month

Three times a month

O. Do you gamble for your enjoyment?

Never

Once a month

Twice a month

Three times a month

P. Are you happy how you spend your leisure time?

No

Sometimes

About half and half

Most of the time

Almost all the time

Most of the time

Always

Q. Do you enjoy an active social life?

No

Sometimes

About half and half

R. Do you ever feel bored?

Never

Sometimes

About average I guess Most of the time

Every day pretty much

S. Do you exercise?
Never

Once a week

Twice a week

Three or more times a week

T. How hard do you exercise? (select the level equivalent to your workout)
I avoid it

An easy stroll

A brisk walk

A moderate gym workout

A strenuous workout