JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Zen Gorillas - General Application
YOUR HOLISTIC MOVEMENT JOURNEY STARTS HERE.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Full Name
*
Your answer
Birth Place, Date & Time
*
Your answer
Spoken Languages
*
Your answer
Phone / Social Media Contact
*
Your answer
In short, describe your background in Movement / Practice / Training / Sport if any.
*
Your answer
What is your Occupation / Vocation / Study status and how many hours go into this weekly?
*
Your answer
Do you have any dependants, like children or other, for whom you need to care for?
*
Your answer
What is your regular Sleeping Pattern? If irregular, describe in short why you feel that is.
*
Your answer
In short, describe your relationship with food. What is your typical daily diet pattern? Include fresh water in Litres.
*
Your answer
Name any known ailments, injuries or personal circumstances of physical, mental or any other nature (including any medication or substances of any kind) which you feel may hinder your progress?
*
Your answer
Describe your relationship to any stimulants and/or numbing agents such as nicotine, alcohol, caffeine, processed sugars and/or other chemicals or substances, if any? How frequently and with what intention?
*
Your answer
How would you rate your recent / current level of physical activity from Low, Medium and High? Chose one.
*
Low
Medium
High
Required
Name a book, documentary, philosopher, artist, or person(s) which has considerably influenced you. In short, describe why.
*
Your answer
In six words, describe the type of student you perceive yourself to be.
*
Your answer
What truly makes you happy? Ponder / Share your Life Vision and Dream - to be discussed.
*
Your answer
Outline one to three goals you aim to achieve through your Movement Journey.
*
Your answer
Please share your reasons for wanting to work with Wayne
.
*
Your answer
Confirm your Movement Journey Type.
Visit
www.zengorillas.com
for more details on courses
NOTE - fees exclude gym-entry costs
*
Choose
Session - 15.000 ISK [ 12.500 ISK for active members of The Movement Lab ]
Three Sessions - 40.000 ISK [ 32.000 ISK for active members of The Movement Lab ]
6 Sessions - 75.000 ISK [ 60.000 ISK for active members of The Movement Lab ]
Zen Gorillas' GROUND Course - 4 WEEK X8 Sessions (2/wk)
Zen Gorillas' Mixed Movement Course - 4 WEEK X8 Sessions (2/wk)
Online Session - 75 US Dollars each
Confirm your Payment Method
*
Revolut > @waynescah
Bank Transfer > KT 231179-2759 / AC 0101-26-231179
Cash
Part Transfer Part Cash
Other:
Zen Gorillas’ Social Media may include images of our practices, OK?
*
Yes
No
Do you understand and agree that you take full responsibility for your attendance, health, safety and well-being during ALL practices with ZEN GORILLAS and your teachers?
*
Yes
No
Confirm your Movement Journey start date with Zen Gorillas?
*
MM
/
DD
/
YYYY
Additional Notes by Student
Your answer
Send me a copy of my responses.
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
