Body Project Australia Registration Form

The Body Project is a 4-week program for young people who want to improve their body image and self-esteem. You will learn strategies to feel more comfortable and accepting of your body. It is a requirement that you are able to attend all 4 sessions for this program.

Who: Young people aged 16-25 who identify as female
When: Thursdays 4:30-6:00pm, starting 6th April - 27th April
Where: Boroondara Youth Hub - Level 1, 360 Burwood Road, Hawthorn
Cost: Free!

Once you register, we will contact you to provide more information and to answer any questions you might have.
If you have any queries about the program, please email headspace.enquiries@accesshc.org.au or call (03) 9006 6500.

Personal Details

Given name (first name) *

Surname (last name) *

Preferred Name

Date of Birth *

Gender *

Pronouns *

Contact Information

Address *

Postcode *

Contact number *

Email Address *

Emergency Contact

Name *

Relationship *

Contact number *

More information

Do you need an interpreter?

Do you have any dietary requirements?

Do you have any allergies?

Do you consent to receive a survey? A link to the survey will be texted to you 24 hours prior to group sessions.

Yes No

I declare that the information I have provided to the best of my knowledge is true and correct *

Enter your full name *

Signature *

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Date *