We Want to Hear from YOU!

Thank you for taking the time to share your YMCA experience. With your feedback, we will be able to share the impact the Y has on our children, families and individuals to build a stronger community.

By filling out this form, you are giving us permission to share your story with volunteers, staff and our community. Please share as much detail as possible.

First

Last

Email

Please provide your mailing address if you would like to be eligible to receive a prize for your submission.

Address

Address 2

City/Town

State/Province

Zip/Postal Code

Phone

Preferred Contact Method

Phone

Branch

Y Staff Who Have Been a Part of My Y Journey:

How long have you been a member of the Y?

Which YMCA program has impacted you the most?

What was your purpose for participating in the programs you selected?

Tell us about your journey.

How has the Y made an impact on you/your family in any significant way?

What do you feel is interesting or unique about your experience at the Y?

What does the Y mean to you?

Finish this statement: "If not for the YMCA..."

Would you be willing to participate in a brief interview detailing your experience with the YMCA?

yes, written word only

yes, written words and photos only

yes, written words, photo and video

Upload images

Maximum 5 files.
4 MB limit.
Allowed types: gif, jpg, png.

I wish to remain anonymous, but give the Y permission to share it with volunteers, staff, and community (Names will be changed)

Acknowledgement

By submitting my Y Story, I acknowledge that I hereby give the YMCA of Greater Dayton and its affiliates permission, at no charge, to use my Story, including any and all text, photographs, and other content, in any medium for any purpose consistent with the YMCA of Greater Dayton's charitable mission. Further, I represent and warrant that my Story is true and correct, that I have obtained sufficient releases from all persons whose name, portrait, or picture is featured in any text or images in my Story, and that my Story does not infringe or otherwise violate the intellectual property rights, privacy rights, or publicity rights of any other person. I represent that I am over the age of eighteen (18) or that I am the parent or legal guardian of the minor child(ren) submitting this Story and that I have read the foregoing and fully understand its contents. The YMCA of Greater Dayton is committed to protecting your privacy and will not disclose your information to any third party without consent.