Welcome to BOUNCE (Oct/Nov 2020)

We are so glad that you're joining us!

Please answer the following questions to help us tailor the course to your needs. All answers will be treated with respect and kept confidential.

This course is offered in partnership between Get Berkshire Active and Moonshot Series. The special nature of our service imposes certain monitoring responsibilities. This information, such as name, postal address, e-mail address and other additional information, is collected and stored in accordance with the EU Data Protection Regulation principles. Personal information is also processed to undertake research. For this reason the information processed may include name, contact details, family details, lifestyle and social circumstances. The sensitive types of information may include physical or mental health details, racial or ethnic origin and religious or other beliefs. This information is about survey respondents. Where necessary or required non-identifiable information may be shared with partners, service providers, Sport England or survey and research organisations. To view our full privacy policy visit. http://www.getberkshireactive.org/1451/privacy-and-terms/

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* 1. What are you hoping to get from this course?

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* 2. Please answer the following questions on a 1-5 scale

	Totally disagree	Somewhat disagree	Neutral	Somewhat agree	Totally agree
I can always manage to solve difficult problems if I try hard enough	I can always manage to solve difficult problems if I try hard enough Totally disagree	I can always manage to solve difficult problems if I try hard enough Somewhat disagree	I can always manage to solve difficult problems if I try hard enough Neutral	I can always manage to solve difficult problems if I try hard enough Somewhat agree	I can always manage to solve difficult problems if I try hard enough Totally agree
It is easy for me to stick to my aims and accomplish my goals	It is easy for me to stick to my aims and accomplish my goals Totally disagree	It is easy for me to stick to my aims and accomplish my goals Somewhat disagree	It is easy for me to stick to my aims and accomplish my goals Neutral	It is easy for me to stick to my aims and accomplish my goals Somewhat agree	It is easy for me to stick to my aims and accomplish my goals Totally agree
I am confident that I could deal with unexpected events well	I am confident that I could deal with unexpected events well Totally disagree	I am confident that I could deal with unexpected events well Somewhat disagree	I am confident that I could deal with unexpected events well Neutral	I am confident that I could deal with unexpected events well Somewhat agree	I am confident that I could deal with unexpected events well Totally agree
I know how to bounce back from setbacks	I know how to bounce back from setbacks Totally disagree	I know how to bounce back from setbacks Somewhat disagree	I know how to bounce back from setbacks Neutral	I know how to bounce back from setbacks Somewhat agree	I know how to bounce back from setbacks Totally agree
I can solve most problems if I invest the necessary effort	I can solve most problems if I invest the necessary effort Totally disagree	I can solve most problems if I invest the necessary effort Somewhat disagree	I can solve most problems if I invest the necessary effort Neutral	I can solve most problems if I invest the necessary effort Somewhat agree	I can solve most problems if I invest the necessary effort Totally agree
I can remain calm when facing difficulties because I have coping abilities	I can remain calm when facing difficulties because I have coping abilities Totally disagree	I can remain calm when facing difficulties because I have coping abilities Somewhat disagree	I can remain calm when facing difficulties because I have coping abilities Neutral	I can remain calm when facing difficulties because I have coping abilities Somewhat agree	I can remain calm when facing difficulties because I have coping abilities Totally agree
I know what my strengths are	I know what my strengths are Totally disagree	I know what my strengths are Somewhat disagree	I know what my strengths are Neutral	I know what my strengths are Somewhat agree	I know what my strengths are Totally agree
I know how to overcome negative thinking	I know how to overcome negative thinking Totally disagree	I know how to overcome negative thinking Somewhat disagree	I know how to overcome negative thinking Neutral	I know how to overcome negative thinking Somewhat agree	I know how to overcome negative thinking Totally agree
I know how to get the best out of myself	I know how to get the best out of myself Totally disagree	I know how to get the best out of myself Somewhat disagree	I know how to get the best out of myself Neutral	I know how to get the best out of myself Somewhat agree	I know how to get the best out of myself Totally agree
I believe in myself	I believe in myself Totally disagree	I believe in myself Somewhat disagree	I believe in myself Neutral	I believe in myself Somewhat agree	I believe in myself Totally agree
I can usually handle whatever comes my way	I can usually handle whatever comes my way Totally disagree	I can usually handle whatever comes my way Somewhat disagree	I can usually handle whatever comes my way Neutral	I can usually handle whatever comes my way Somewhat agree	I can usually handle whatever comes my way Totally agree
I exercise regularly	I exercise regularly Totally disagree	I exercise regularly Somewhat disagree	I exercise regularly Neutral	I exercise regularly Somewhat agree	I exercise regularly Totally agree
I eat a healthy diet	I eat a healthy diet Totally disagree	I eat a healthy diet Somewhat disagree	I eat a healthy diet Neutral	I eat a healthy diet Somewhat agree	I eat a healthy diet Totally agree
I generally sleep well	I generally sleep well Totally disagree	I generally sleep well Somewhat disagree	I generally sleep well Neutral	I generally sleep well Somewhat agree	I generally sleep well Totally agree
I have a plan for the future and have steps towards getting there	I have a plan for the future and have steps towards getting there Totally disagree	I have a plan for the future and have steps towards getting there Somewhat disagree	I have a plan for the future and have steps towards getting there Neutral	I have a plan for the future and have steps towards getting there Somewhat agree	I have a plan for the future and have steps towards getting there Totally agree
I feel confident about the future	I feel confident about the future Totally disagree	I feel confident about the future Somewhat disagree	I feel confident about the future Neutral	I feel confident about the future Somewhat agree	I feel confident about the future Totally agree

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* 3. Do you have any learning needs you would like us to be aware of?

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* 4. Would you like to take part in some virtual physical activity sessions?

Yes

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* 5. Have you ever been arrested or have a criminal conviction?

Yes

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* 6. Bounce is available in 2 formats:

Option 1 = 6 x 45 minute weekly small group sessions held online with a coach to guide you through. Sessions will start on Monday 16th November at 10am and run for 6 weeks. You will be joined by other people in a similar position to you, and these sessions will be interactive with an opportunity for you to share your thoughts and questions. You're welcome to have your video on or off for these sessions. Whichever you are more comfortable with.

Option 2 = 6 online learning sessions progressing at your own pace. You will be sent a link to the course and will have 10 weeks to complete 6 sessions. You will complete this by yourself, but you will have the opportunity to send in questions you have.

Which option works best for you?

Weekly online group sessions starting on Monday 2nd November at 10am

Self-led online course

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* 7. Would you like to join a private facebook group to chat with other people completing this course?

Yes

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* 8. Please leave your contact details so we can enrol you on the course. We will not share your details with anyone else.

Name *

Postal Code

Mobile

Email Address *

Date of Birth (e.g. 19.05.1985)