Personal Ministry Request

Personal ministry at Guts Church is intended to support and equip church members with a biblical perspective for issues of concern in their lives. We believe that lasting victory comes about through a relationship with Jesus Christ, a lifestyle of renewing your mind to biblical promises, and accountable Christian relationships.

Full Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number*

Area CodePhone Number

E-mail

If requesting marriage ministry, please include the date of when you were married.*

Have you made Jesus the Lord of your life?*

If you answered yes to the above, how long have you been a believer?*

If this request involves a spouse, have they made Jesus Lord of their life?*

If so, how long have they been a believer?*

Have you completed our membership class?*

If so, when?*

Please state the nature of your need (be as specific as possible):*

Release of Liability for Pastoral Care Services

State of Oklahoma, County of Tulsa

For and in consideration of Guts Church's provision of personal ministry, the undersigned, being legally competent and fully authorized and empowered to do so, does hereby RELEASE, ACQUIT, AND FOREVER DISCHARGE GUTS CHURCH AND ALL PARTICIPATING MINISTERS CONNECTED WITH SAID MINISTRY, from any and all actions, courses of action, cleaims, demands, costs, loss of service, expenses and compensation, on account of any and all known and unknown personal injuries, mental anguish or agitation, and damage claims to person or property resulting from or arising out of or related to personal ministry services provided by Guts Church and/or its agents, representatives and/or employees in any way affectiong the undersigned parties.

By law, there are certain situations in which information about individuals undergoing personal ministry may be released with or without their permission. These situations are as follows:

1. Where children are physically abused, neglected, or sexually abused the proper auhtorities must be notified.

2. In emergency situations where there may be danger to the client or others, as with homicide or suicide, confidentiality may be broken.

3. If a court of law issues a legitimate subpoena relating to a child abuse case, we are required by law to provide the information specifically describe in the subpoena.

4. If an unreported life-threatening felony has been committed, we are required by law to report it to the police.

Before warning or notifying anyone, Guts Church will first take all possible steps to share that intention with the undersigned parties.

The undersigned parties have had the nature of the personal ministry to be provided fully explained to them prior to receiving sure services, and they freely enter into sure ministerial services with full knowledge of the nature of the ministerial services they are about to receive. The undersigned fuly understands the nature of a deliverance ministry such as that offered by Guts Church, and nevertheless, waive and release all claims for damages to their person or property arising out of or attributed to the spiritual, psychological, and/or mental problems which brought the undersigned to Guts church, or the undersigned at any point after the date of this release.

It is further understood and agreed that this waiver and release constitutes an admission and acknowledgment by this undersigned that they have received no warranty, guarantee, or promise of any particular result either expressed or implied from Guts Church, its pastors, representatives, employees or board of directors. The undersigned parties acknowledge and agree that the very nature of their problem(s) is/are necessarily such that no specific result(s) can be promised or warranted by any such ministry service.

This release contains the entire agreement between the parties hereto, and the terms of this waiver and release are contractual and not mere recital. The undersigned further states that they have carefully read the foregoing release, know the contents thereof, and sign the name of their own free act and deed.

I have read the agreement listed above and fully agree to any and all terms.*

Electronic Signature (Type full name)*

Date:*