This form must be signed prior to being assigned an ministry appointment.
I, the undersigned, do hereby release The Rock Church and any of its staff, leaders and volunteers, from any harm or perceived harm resulting from my voluntary receiving of free prayer on this and subsequent visits. I understand that this pastoral care ministry is provided by a staff of volunteers representing the body of Jesus Christ. They are not trained or licensed medical professionals, or psychological counselors, or therapists, and they do not provide medical or psychological services. I acknowledge that I need to seek advice from my medical doctor, therapist, counselor or other professionals to confirm any results of prayer received before altering any prescribed course of action. I understand that this form and all data recorded on it is the sole property of The Rock Church. All content will be held in confidence for the sole purpose of the ministry unless I have given permission for such things to be shared.
Your Name (required)
Signature (required) Checking this box indicates electronic signature. Yes
Date: (mm/dd/yyyy)
(If you are under the age of 18, this form must be signed by a parent or guardian.)
Child's Age: (Child must be 13 years or older to receive a Sozo session)
Parent or Legal Guardian Name:
Signature of Parent or Legal Guardian: Checking this box indicates electronic signature: Yes
Witness: Checking this box indicates electronic signature: Yes
We ask you to pray about making a donation to The Rock to help us in the development and growth of this Sozo ministry. I understand that there is a suggested donation of $50 to help cover the cost of the room rental and other expenses. You can make checks to The Rock marked "Sozo Ministry" or you can donate cash or use a credit card using a Rock envelope. We will minister to you whether you give or not.
Δ
