Balanced BodyWorks Registration Form

First Name
Last Name
Home Phone
Work Phone
Cell Phone
Email Address

Please indicate if you have any of the following conditions that may keep you from physical activity (Check all that apply):

Have you had any surgeries, health conditions we should be aware of?

FEES: Pilates, Functional Training, Personal Training, Ballet and PBT

Single Session: $75
10 Session Package: $690
20 Session Package: $1,360

Introduction package: $160
(3 Private sessions - NEW CLIENTS ONLY)

Duos (2 people):
Single Session: $98 ($49 per person)
10 Session Package: $880 ($440 per person)

Single Session: $27
10 Session Package: $220
20 Session Package: $420


Therapeutic Massage, blade, Active Release Techniques (A.R.T.), Active Isolated Stretch (A.I.S.)
90 mins: $124 - 60 mins: $83 - 25 mins: $46
* Rock Tape $15 per site

Sign up on a first-come basis
Payment is due when services are rendered
Cancellation: 24-hour notice (no charge)
Same day or no-show (full charge)

Packages expire six (6) months from date of purchase
Cash or Check only - Payable to Balanced BodyWorks
Major credit cards accepted

Balanced BodyWorks is not responsible for any injuries a client may receive while on the premises. Each client assumes the risk involved in participating in any exercise-related sessions. Please consult with your physician before starting any exercise program.

Reservations are not complete until payment has been made. Payments may be mailed or presented directly to Balanced BodyWorks or may be made by credit card on the next page after completing and submitting this form.

By submitting this form you are stipulatimg that you have read and understood the terms, fees and conditions stated above.