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Hold Harmless Agreement

 

To whom it may concern:

This is to certify that I voluntarily consent to participate in prayer ministry session(s) withthe following facilitator(s) _____________________________________________________

_____________________________________________________

Please put your initials on the lines provided to indicate your agreement in each of the following areas and your signature at the end of this Agreement Form.

THE PERSON(S) AND/OR ORGANIZATION(S): I understand that the person(s) and/or organization(s) named in this Agreement are prayer partners or facilitators who are praying with me as I seek help from God. I fully understand that the person(s) and/or organization(s) named in this Agreement are MERELY facilitating prayer ministry session(s) and DO NOT hold themselves out to be professional or licensed facilitators, counselors, therapists, medical or psychological practitioners, or ministers.  ________

THE PROCEDURE: I fully understand thatthe encouragement I receive from this person(s) and/or organization(s) is NOT held to be counseling in any form, but rather prayer ministry. I understand that some or all of the procedures used to give spiritual or emotional encouragement to me or anyone present may or may not be clinically demonstrated as guaranteeing either short term or long term results.  ________

PARTICIPATION IN PRAYER MINISTRY SESSION(S): I am freely choosing to participate in prayer ministry sessions in order to receive encouragement through prayer ministry, and acknowledge that I have been told that I am free to cease my participation at any time for any reason. I also understand that I have the option of terminating any prayer sessions, or this Agreement, at any time. I understand that I must take full responsibility for any and all consequences of prematurely terminating my participation

in prayer ministry session(s)________ 

DURING PRAYER MINISTRY SESSION(S): I acknowledge that I may personally receive ministry through interaction with the facilitator(s) or other participants. I DO NOT hold the person(s) and/or organization(s) named in this Agreement responsible for whatever may emotionally, spiritually, mentally, or physically manifest during any prayer ministry session(s) in which I may participate, now or in the future. ________  

FOLLOWING PRAYER MINISTRY SESSION(S): I DO NOT hold the person(s) and/or organization(s) named herein responsible for my well being at any time during or following prayer ministry session(s). I DO NOT hold the persons and/or organizations named in this Agreement responsible for any further care I may need in the future, in that I take full responsibility for my life, health, and well being, now and in the days to come. I am fully aware that the person(s) and/or organization(s) named in this Agreement ARE NOT obligated or expected at any level or degree to provide ongoing prayer ministry, additional prayer ministry, ministry between sessions, or any other ministry, pastoring, counseling, psychotherapy, or medical psychiatric services on my behalf following the prayer ministry session(s). ________

A GIFT OF GRATITUDE FOR PRAYER MINISTRY SESSION(S): I understand that any monies I provide to person(s) and/or organization(s) that might be named in this Agreement for the encouragement I may receive is seen as a gift of gratitude and NOT compensation for services rendered. I am under no obligation to pay for this service if I choose not to do so. ________

CONFIDENTIALITY: I understand that the person(s) and/or organization(s) named in this Agreement willkeep confidential any personal information that may be shared by anyone duringthe prayerministry session(s). I also accept responsibility for keeping confidential any personal information that may be shared by anyone during the
prayer ministry session(s). ________

Signed by ____________________________________________

Witness ______________________________________________

Date _________________________________________________
 
 
 
 
 
 
 
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