RevInMo Intensive Training Courses - REGISTRATION FORM
Thank you for your interest in learning the Revolution in Motion system of movements and exercise sequences developed by Dr. Edythe Heus. Please complete the following prior to the scheduled training date.

A team member will contact you for the payment info to hold your spot -- spaces are limited. Any questions please email

Thank you and we look forward to seeing you!

(link to this registration form )
● LEVEL 1 Course +/- Certification (Unique exercises, sequences, trainer cues, use of balls and other equipment, analysis of movement & RevInMo Essentials)

● LEVEL 2 Course +/- Certification (Further analysis of movement and relation to RevInMo Essentials, planes of movement, role of emotions and mental state. Athletic performance exercises e.g. bosu ball, slideboard, jumpsoles, and custom equipment.)

● LEVEL 3 Course +/- Certification (Intense training in diagnostic skills, mastery in assessing clients, understand gaits movements, and reading people to get past barriers)

● PELVIC FLOOR Course +/- Certification (Exercises for core stability and strength, poise, athletic performance, sexual pleasure, and healing from prior pregnancies or surgeries)

● SENIORS Vitality Course +/- Certification (Designed to teach older adults of any level of fitness, including those with cognitive impairment, to stimulate the brain and improve strength and balance.)

● SPORTS-SPECIFIC Courses (golf, baseball, martial arts, skiing, etc. Please describe in Comments Box)
WHICH COURSE(S) ARE YOU REGISTERING FOR? (@ Agoura Hills, California unless specified otherwise) -- EARLY BIRD DISCOUNT $100 off if register now *
First and Last Name *
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Email *
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Phone (mobile or preferred#) *
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Mailing Address *
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Emergency Contact (Name, Mobile Phone #, Email) *
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Current Occupation *
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Education & Other Certifications *
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What distinguishes you as a trainer from other trainers in your area?
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What types of clients do you specialize in, enjoy working with, &/or want to work with more? (mark ALL that apply) *
How did you hear about Revolution in Motion & this course? *
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Purpose for taking Revolution in Motion course (select all that apply & add your own reasons for what you hope to get out of it) *
Have you done RevInMo exercises before? *
Are you interested in traveling to teach Revolution In Motion outside of your city? *
Do you want to be listed on the RevInMo website, newsletters, or mentioned on social media? If so, you give permission for RevInMo to use your Name, Photo, Video: *
Other comments, questions, info, or suggestions?
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