JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
YSPP Group Registration (ages 13-17)
The Youth Suicide Support Program is designed to support young people’s mental health as they struggle with loss due to suicide. This group provides a confidential space to discuss emotions, develop coping strategies, and connect with others facing similar challenges. It offers youth the opportunity to build meaningful connections and receive support from their peers, fostering a sense of community and shared understanding. Facilitated by experienced staff, the sessions focus on building resilience and promoting wellbeing for youth dealing with stress, anxiety, or thoughts of self-harm. Whether you’re seeking support for yourself or want to help others, this group offers understanding and guidance in a safe environment.
This group is designed for youth between the ages of 13-17 and is hosted at the YMCA in Lancaster on Tuesdays or Thursdays. A staff member will connect with you to provide all details.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Name of Parent/Guardian
*
Your answer
Phone number of Parent/Guardian
*
Your answer
Youth Name
*
Your answer
Youth Date of Birth
*
MM
/
DD
/
YYYY
Youth's Gender
*
Male
Female
Transgender
Non-bianary
Prefer not to say
Has the youth been impacted by suicide loss?
*
Yes
No
Prefer not to answer
By sharing your information, you’re agreeing to be contacted by our team with updates or support related to the group sessions.
*
Yes
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report