Biblical Coaching and Counseling Consent Form Logo
  • Biblical Coaching and Counseling Consent Form

  • What You Need To Know

    • In 2011, Holly Wright founded For The Brokenhearted Ministry with the intention to help heal broken hearts through biblical guidance and counseling through the leading of the Holy Spirit.
    • With years of experience in a variety of ministry counsel; Holly offers biblical counseling, inner healing, spiritual warfare training, and discipleship for teenagers, adults, and married couples.
    • All of Holly's coaching and counseling sessions are conducted online through a Zoom partnership and there is a standard session fee of $100.00 per hour.
    • All sessions are non-refundable and payment is due upfront in order to book an appointment. 
    • All sessions will be cancelled after ten minutes of not showing up for any reason. You will have to purchase another session in order to reschedule.
    • If you cancel your session with 24 hour notice, you will have flexibility to reschedule without fees. 
    • There is a standard guideline for each participant in committing to be respectful, transparent, honest, determined, and fully participate while applying the tools given with the goal to move forward.  Otherwise, Holly holds the right to dissolve the sessions at her discretion.
    • Holly Wright is not a licensed therapist and cannot diagnose individuals or prescribe medication.
    • For The Brokenhearted Ministry is a biblically based prayer ministry and is considered a form of pastoral counseling. We work with you as you choose to work with us. If you are dealing with serious conditions like physical and mental illness, or addiction; Please do not disregard seeking professional help in conjunction with the help you seek through divine biblical healing.
    • For The Brokenhearted Ministry commits to keeping your personal information concealed and disclosed only between the ministry team members. However, the ministry is required by Texas law to report any physical and sexual abuse currently taking place with a minor. 
    • We are not licensed medical professionals: This ministry is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions you may have regarding a medical condition. We advise that you never disregard professional medical advice or delay in seeking treatment because of something you have read on this website or encountered through this ministry.
    • If you are under the age of 18, a parent or legal guardian needs to give permission for the minor to participate in receiving ministry, counsel, discipleship, deliverance, or coaching. The parent or legal guardian will need to sign this consent form on behalf of the minor.
  • Agreement

  • Standard Texas 'Hold Harmless' Liability Agreement

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    I hereby release, indemnify and forever hold harmless For The Brokenhearted Ministry and its agents, staff, employees, and volunteers of any damages, real or perceptual, arising from personal ministry in connection with the information submitted herein.

    1.) I release, waive, discharge and covenant not to sue For The Brokenhearted Ministry, their officers, servants, agents, volunteers, staff or employees from any and all liability, claims, demands, actions and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by me, or to any property belonging to me, whether caused by the negligence of the Ministry or otherwise, while participating in such activity, or while online or in, on or upon the premises where the activity is being conducted.

    2.) I am fully aware of risks and hazards connected with the activity, and I elect to voluntarily participate in the activity, and to engage in such activity knowing that the activity may be hazardous to me and my property. I voluntarily assume full responsibility for any risks of loss, property damage or personal injury, including death, that may be sustained by me, or any loss or damage to property owned by me, as a result of being engaged in such an activity, whether caused by the negligence of the Ministry or otherwise.

    3.) I further agree to indemnify and hold harmless the Ministry from any loss, liability, damage or costs, including court cost and attorney fees, that they may incur due to my participation in the activity, whether caused by negligence of the Ministry or otherwise.

    4.) It is my express intent that this Release and Hold Harmless Agreement shall bind the members of my family and spouse, if I am alive, and my heirs assigns and personal representative, if I am deceased, and shall be deemed as a release, waiver, discharge, and covenant not to sue the above named Ministry. I further agree that this Waiver of Liability and Hold Harmless Agreement shall be construed in accordance with the laws of the State of Texas.

    In signing this release, I acknowledge and represent that I have read the above Waiver and Liability and Hold Harmless Agreement, understand it and sign it voluntarily as my own free act and deed; no oral presentations, statements, or inducements, apart from the foregoing written agreement, have been made; I am at least eighteen (18) years of age and fully competent; and I execute this Release for full, adequate and complete consideration fully intending to be bound by same.

  • By signing this consent form you are agreeing to the terms in order to move forward. If you are under the age of 18, a parent or legal guardian must sign here.

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