Your information will be securely kept in the strictest confidence and shared only with the instructors that are required to know this information to be able to help you.

Name *

First Name

Last Name

Email *

Phone *

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact Person *

First Name

Last Name

Phone number of emergency contact *

Do you have any health or medical problems? Eg; Heart Issues, asthma, high blood pressure *

yes

If yes, please explain and mention medication taken.

Do you have any pain or injuries/conditions that may affect your movements in any way?

yes

If yes, please explain.

Do you have osteoporosis or osteopenia? *

Yes

Are you currently pregnant or have you recently given birth in the last 12 months? *

yes

Have you had any recent surgeries that we should know about? *

yes

If yes, please explain.

Waiver of Liability and Prospective Release *

I declare that I am over 18 years of age (or have otherwise provided parental consent) and acknowledge and understand that I have voluntarily chosen to participate in the classes and activities offered by Your Balance Project. I acknowledge and agree that the workouts are a recreational sports activity and may involve strenuous physical activity including, but not limited to stretches, lifts, use of props, use of reformer machines, gymnastic movements, strenuous bodyweight exercises and other strenuous activities that I am not obliged to perform, nor am I obliged to participate in any activity that I do not wish to do, and that it is my right to refuse such participation at any time during classes. I understand that there are inherent risks in all aspects of physical exercise, and I acknowledge that I have been informed of the possible strenuous nature of training. I agree that prior to my participation I will inform Your Balance Project of any known medical conditions or factors that may place me at risk. Your Balance Project may request a medical release from my medical practitioner prior to participation. I will inform Your Balance Project of any symptoms before, during and after participation in a class. I also understand that if I am a prenatal or postnatal client, that I must consult with my physician and receive clearance to perform physical exercise. I release Your Balance Project and its staff, employers and agents from any and all liability for any loss, damage, injury or expense that I may suffer, or that my next of kin may suffer as a result of my participation in the classes, activities and services provided by Your Balance Project. I agree to hold harmless and indemnify Your Balance Project and its employees and agents from any and all liability for any damage to the property of, or personal injury to, any third party, resulting from my participation in any program, activity or service provided by Your Balance Project. If any portion of this agreement is held invalid, I agree that the remainder of the agreement shall remain in full force and effect. In checking the box below I declare that I have advised Your Balance Project of any injury, back, neck or joint pain, restricted movement, heart issues, asthma, or high or low blood pressure, arthritis, slipped or bulging vertebral disk, pelvic floor conditions, dizziness, diabetes, epilepsy, hernia, bone degeneration, high cholesterol, allergies or chronic illness. I also declare that I have notified Your Balance Project if I am pregnant and/or have given birth in the last 12 months, or if I have undergone surgery in the past 12 months. If any of the above health conditions apply to you, please include full details in this form. I have read the above release and waiver of liability and fully understand its contents. I voluntarily agree to the terms and conditions stated above.

I agree to the above waiver *

yes

Thank you! We can’t wait to see you in class!

Receive our free monthly guided stretches.

Name *

First Name

Last Name

Email *

Thank you!

Your Balance Project

390 Burke Rd,
Camberwell, 3124, VIC

Phone: 0481 766 990

SMS: 0481 766 990

Email: yourbalanceproject@gmail.com

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About us

Location

Terms & Conditions

Liability Waiver & Release

FAQs

We are dedicated to creating an inclusive and welcoming environment for all, embracing the diversity of the many communities we serve. We believe that Pilates is for everyone, regardless of race, gender, age, ability, or background. Our studio is a space free from discrimination, where every individual can exercise safely while feeling supported, valued, and empowered. We celebrate the unique experiences and perspectives that each person brings, and we are committed to fostering a community where respect, kindness, and inclusivity are at the heart of everything we do.