I (name) ______________________________ acknowledge that team members from Emerald Ministries have voluntarily agreed to pray for me. I understand that this session is not a professional counseling meeting and that none of the team members are licensed counselors. I understand that these team members are, to the best of their ability, doing what they can to help me achieve more freedom in my life.
I understand that Emerald Ministries makes no charge for its services and that donations are voluntary and tax deductible. I further state that I have voluntarily sought assistance of my own initiative and that I am under no obligation to accept or reject any of the advice or help that I might receive from the team members of this ministry.
Our team members offer biblical spiritual services to anyone who desires them regardless of ability to pay. Although there is no charge for our services, all efforts to build this ministry support and train our team members are paid directly form the donations of those receiving these services.
I understand that if I receive ministry from Emerald Ministries, the team is committed to respect the disclosed information, but not to complete confidentiality. The information, as needed, may be shared with other leaders of Emerald Ministries so as to further your total healing process. I understand that Emerald Ministries mandatorily reports child and elder abuse to the proper authorities.
I agree to hold Emerald Ministries and team members free from any and all liability, loss or damage of any kind that may arise as a result of assistance, which I have received, or from my involvement with Emerald Ministries.
I have read this disclaimer and release of liability and understand and agree with it and have executed it as my free and voluntary act.
Please type your name below to indicate your desire to be free in Jesus Christ.