The Bounce Back

Application Form & Coaching Agreement

You will receive an email with payment details on completion of this form.

Health + Emotional Wellbeing

Please share, in full confidence, any important physical, emotional, hormonal, nervous system, or mental health information you feel relevant for me to know before we begin working together.

Please include:

• current diagnoses

• medications or supplements

• significant stress, burnout, trauma, anxiety, grief, or major life changes

• pregnancy or breastfeeding

• anything else important regarding your wellbeing or support needs

Your Intentions

Why are you joining this container at this point in your life?

What are you currently struggling with most?

What are you hoping to experience, create, heal, shift, or move toward through this work together?

What would a successful transformation look and feel like for you?

Coaching Agreement + Disclaimer

This container is intended for educational, emotional wellbeing, mindset, nervous system, lifestyle, and personal development purposes only.

Hannah Barnes does not diagnose, treat, prescribe for, or cure medical or psychological conditions. This work is not a substitute for medical advice, psychotherapy, psychiatric care, or licensed healthcare treatment.

By participating in this container, you acknowledge that:

• you are fully responsible for your own decisions, wellbeing, actions, and results

• all recommendations are voluntarily implemented at your own discretion

• results are not guaranteed and vary between individuals

• payment plans remain your responsibility until completed

• all payments are non-refundable unless otherwise agreed in writing

• respectful communication and personal responsibility are expected throughout the container

• all coaching materials, recordings, teachings, and content remain the intellectual property of Hannah Barnes and may not be shared, copied, or redistributed

  
  

If at any point additional medical or psychological support is required, you understand you are responsible for seeking appropriate professional care.

By participating, you acknowledge that you are voluntarily engaging in this coaching container and accept full responsibility for your physical, emotional, mental, and spiritual wellbeing

Program Structure

This container runs for 10 weeks and includes:

• 5 live group coaching calls

• Telegram group support throughout the container

• mindset, emotional wellbeing, nervous system, lifestyle, and personal growth support

Start Date:

Tuesday 26 May 2026

First Live Zoom Call:

Tuesday 26 May at 10:30am NZT

Container Duration:

10 weeks

Telegram support is available during business hours Monday–Friday. While Hannah will be present regularly throughout the container, responses are not guaranteed instantly and boundaries around personal time, weekends, and after-hours are respected.

Clients are encouraged to use the Telegram space respectfully, responsibly, and with consideration for the group environment.

Public Acknowledgement

The Client grants the Coach permission to acknowledge their participation and share results for promotional or testimonial purposes, while ensuring full anonymity unless explicit permission is provided.

Consent

By adding their full name and date to this Agreement and making payment, the Client affirms that they have read, understood, and agreed to the terms and conditions outlined herein. The Client acknowledges that their participation is voluntary and that they accept full responsibility for their decisions and actions.