I need support YMCA enables people to develop their full potential in mind, body and spirit. Depending on the type of support you need, our wide variety of services might be able to help you.
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We believe in building resilience so people can experience fullness of life.
We believe every person has the right to a safe place to live.
Our youth clubs are fun, friendly and welcoming environments with lots of different activities available.
Our Perspectives Project exists to empower, educate and mentor young men caught up in the Criminal Justice System.
We believe that every person can enjoy community.
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<p><label> Your name (required)<br />
<span class="wpcf7-form-control-wrap your-name"><input type="text" name="your-name" value="" size="40" class="wpcf7-form-control wpcf7-text wpcf7-validates-as-required" aria-required="true" aria-invalid="false" /></span> </label></p>
<p><label> Date of birth (required)<br />
<span class="wpcf7-form-control-wrap your-dob"><input type="text" name="your-dob" value="" size="40" class="wpcf7-form-control wpcf7-text wpcf7-validates-as-required" aria-required="true" aria-invalid="false" /></span> </label></p>
<p><label> Address (required)<br />
<span class="wpcf7-form-control-wrap your-address"><input type="text" name="your-address" value="" size="40" class="wpcf7-form-control wpcf7-text wpcf7-validates-as-required" aria-required="true" aria-invalid="false" /></span> </label></p>
<p><label> Postcode (required)<br />
<span class="wpcf7-form-control-wrap your-postcode"><input type="text" name="your-postcode" value="" size="40" class="wpcf7-form-control wpcf7-text wpcf7-validates-as-required" aria-required="true" aria-invalid="false" /></span> </label></p>
<p><label> Mood scale: Please rate how you are currently feeling, 1 = least intense, 10 = most intense. The answers to these questions will help us complete your assessment.</p>
<p><label> Sad*<br />
<div class=ocrscf_rainbow-slider type="hidden" name="Sad" value="1" class="wpcf7-form-control wpcf7-rangeslider wpcf7-validates-as-rangeslider occf7rs-slider" readonly="readonly" step="1" min="1" max="10" prefixpos="left" slidershow="single" slider_style="rainbow" rangeshow="enable"><span class="wpcf7-form-control-wrap Sad"><input type="hidden" name="Sad" value="1" class="wpcf7-form-control wpcf7-rangeslider wpcf7-validates-as-rangeslider occf7rs-slider" readonly="readonly" step="1" min="1" max="10" prefixpos="left" slidershow="single" slider_style="rainbow" rangeshow="enable" data-formulas="" /></span></div></p>
<p><label> Worried*<br />
<div class=ocrscf_rainbow-slider type="hidden" name="Worried" value="1" class="wpcf7-form-control wpcf7-rangeslider wpcf7-validates-as-rangeslider occf7rs-slider" readonly="readonly" step="1" min="1" max="10" prefixpos="left" slidershow="single" slider_style="rainbow" rangeshow="enable"><span class="wpcf7-form-control-wrap Worried"><input type="hidden" name="Worried" value="1" class="wpcf7-form-control wpcf7-rangeslider wpcf7-validates-as-rangeslider occf7rs-slider" readonly="readonly" step="1" min="1" max="10" prefixpos="left" slidershow="single" slider_style="rainbow" rangeshow="enable" data-formulas="" /></span></div></p>
<p><label> Happy*<br />
<div class=ocrscf_rainbow-slider type="hidden" name="Happy" value="1" class="wpcf7-form-control wpcf7-rangeslider wpcf7-validates-as-rangeslider occf7rs-slider" readonly="readonly" step="1" min="1" max="10" prefixpos="left" slidershow="single" slider_style="rainbow" rangeshow="enable"><span class="wpcf7-form-control-wrap Happy"><input type="hidden" name="Happy" value="1" class="wpcf7-form-control wpcf7-rangeslider wpcf7-validates-as-rangeslider occf7rs-slider" readonly="readonly" step="1" min="1" max="10" prefixpos="left" slidershow="single" slider_style="rainbow" rangeshow="enable" data-formulas="" /></span></div></p>
<p><label> Panicked*<br />
<div class=ocrscf_rainbow-slider type="hidden" name="Panicked" value="1" class="wpcf7-form-control wpcf7-rangeslider wpcf7-validates-as-rangeslider occf7rs-slider" readonly="readonly" step="1" min="1" max="10" prefixpos="left" slidershow="single" slider_style="rainbow" rangeshow="enable"><span class="wpcf7-form-control-wrap Panicked"><input type="hidden" name="Panicked" value="1" class="wpcf7-form-control wpcf7-rangeslider wpcf7-validates-as-rangeslider occf7rs-slider" readonly="readonly" step="1" min="1" max="10" prefixpos="left" slidershow="single" slider_style="rainbow" rangeshow="enable" data-formulas="" /></span></div></p>
<p><label> Angry*<br />
<div class=ocrscf_rainbow-slider type="hidden" name="Angry" value="1" class="wpcf7-form-control wpcf7-rangeslider wpcf7-validates-as-rangeslider occf7rs-slider" readonly="readonly" step="1" min="1" max="10" prefixpos="left" slidershow="single" slider_style="rainbow" rangeshow="enable"><span class="wpcf7-form-control-wrap Angry"><input type="hidden" name="Angry" value="1" class="wpcf7-form-control wpcf7-rangeslider wpcf7-validates-as-rangeslider occf7rs-slider" readonly="readonly" step="1" min="1" max="10" prefixpos="left" slidershow="single" slider_style="rainbow" rangeshow="enable" data-formulas="" /></span></div></p>
<p><label> Low*<br />
<div class=ocrscf_rainbow-slider type="hidden" name="Low" value="1" class="wpcf7-form-control wpcf7-rangeslider wpcf7-validates-as-rangeslider occf7rs-slider" readonly="readonly" step="1" min="1" max="10" prefixpos="left" slidershow="single" slider_style="rainbow" rangeshow="enable"><span class="wpcf7-form-control-wrap Low"><input type="hidden" name="Low" value="1" class="wpcf7-form-control wpcf7-rangeslider wpcf7-validates-as-rangeslider occf7rs-slider" readonly="readonly" step="1" min="1" max="10" prefixpos="left" slidershow="single" slider_style="rainbow" rangeshow="enable" data-formulas="" /></span></div></p>
<p><label> Calm*<br />
<div class=ocrscf_rainbow-slider type="hidden" name="Low" value="1" class="wpcf7-form-control wpcf7-rangeslider wpcf7-validates-as-rangeslider occf7rs-slider" readonly="readonly" step="1" min="1" max="10" prefixpos="left" slidershow="single" slider_style="rainbow" rangeshow="enable"><span class="wpcf7-form-control-wrap Low"><input type="hidden" name="Low" value="1" class="wpcf7-form-control wpcf7-rangeslider wpcf7-validates-as-rangeslider occf7rs-slider" readonly="readonly" step="1" min="1" max="10" prefixpos="left" slidershow="single" slider_style="rainbow" rangeshow="enable" data-formulas="" /></span></div></p>
<p><label> What would you like to change about the way you are feeling? For example, if you had a magic wand that could get rid of this feeling, how would your life be different?*<br />
<span class="wpcf7-form-control-wrap Whatwouldyouchange"><textarea name="Whatwouldyouchange" cols="40" rows="10" class="wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required" aria-required="true" aria-invalid="false"></textarea></span></p>
<p><label> How safe do you feel?<br />
1(not safe) 10(very safe)</p>
<p><label> From yourself?*<br />
<div class=ocrscf_rainbow-slider type="hidden" name="Fromyourself" value="1" class="wpcf7-form-control wpcf7-rangeslider wpcf7-validates-as-rangeslider occf7rs-slider" readonly="readonly" step="1" min="1" max="10" prefixpos="left" slidershow="single" slider_style="rainbow" rangeshow="enable"><span class="wpcf7-form-control-wrap Fromyourself"><input type="hidden" name="Fromyourself" value="1" class="wpcf7-form-control wpcf7-rangeslider wpcf7-validates-as-rangeslider occf7rs-slider" readonly="readonly" step="1" min="1" max="10" prefixpos="left" slidershow="single" slider_style="rainbow" rangeshow="enable" data-formulas="" /></span></div></p>
<p><label> From others?*<br />
<div class=ocrscf_rainbow-slider type="hidden" name="Fromothers" value="1" class="wpcf7-form-control wpcf7-rangeslider wpcf7-validates-as-rangeslider occf7rs-slider" readonly="readonly" step="1" min="1" max="10" prefixpos="left" slidershow="single" slider_style="rainbow" rangeshow="enable"><span class="wpcf7-form-control-wrap Fromothers"><input type="hidden" name="Fromothers" value="1" class="wpcf7-form-control wpcf7-rangeslider wpcf7-validates-as-rangeslider occf7rs-slider" readonly="readonly" step="1" min="1" max="10" prefixpos="left" slidershow="single" slider_style="rainbow" rangeshow="enable" data-formulas="" /></span></div></p>
<p><label> Overall?*<br />
<div class=ocrscf_rainbow-slider type="hidden" name="Overall" value="1" class="wpcf7-form-control wpcf7-rangeslider wpcf7-validates-as-rangeslider occf7rs-slider" readonly="readonly" step="1" min="1" max="10" prefixpos="left" slidershow="single" slider_style="rainbow" rangeshow="enable"><span class="wpcf7-form-control-wrap Overall"><input type="hidden" name="Overall" value="1" class="wpcf7-form-control wpcf7-rangeslider wpcf7-validates-as-rangeslider occf7rs-slider" readonly="readonly" step="1" min="1" max="10" prefixpos="left" slidershow="single" slider_style="rainbow" rangeshow="enable" data-formulas="" /></span></div></p>
<p><label> Your phone number*<br />
<span class="wpcf7-form-control-wrap Phonenumber"><input type="tel" name="Phonenumber" value="" size="40" class="wpcf7-form-control wpcf7-text wpcf7-tel wpcf7-validates-as-required wpcf7-validates-as-tel" aria-required="true" aria-invalid="false" /></span></p>
<p><label> Your email address<br />
<span class="wpcf7-form-control-wrap Emailaddress"><input type="email" name="Emailaddress" value="" size="40" class="wpcf7-form-control wpcf7-text wpcf7-email wpcf7-validates-as-email" aria-invalid="false" /></span></p>
<p><label> What is your preferred way for us to contact you? e.g. phone call, email<br />
<span class="wpcf7-form-control-wrap Whatisyourpreferredwayforustocontactyouegphonecallemail"><input type="text" name="Whatisyourpreferredwayforustocontactyoue.g.phonecallemail" value="" size="40" class="wpcf7-form-control wpcf7-text" aria-invalid="false" /></span></p>
<p><label> Thank you for taking the time to complete this form. Please press submit so that we can begin your assessment.</p>
<p><input type="submit" value="Submit your form" class="wpcf7-form-control wpcf7-submit" /></p>
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