Inner Healing Prayer Ministry Application

Thank you for your interest in having Inner Healing Prayer with our team! Please fill out the form below.

After receiving your completed form, someone from our team will contact you via email with any follow up questions and to schedule your session. Sessions take place on 2nd and 4th Thursday evenings at 6:30 pm. If you are unable to have a prayer session at this time, we will do our best to accommodate you.

For the value of the time spent ministering to you, there is a suggested donation of $50.00 for those that are not members of Shiloh Central Church. Inner Healing Prayer sessions are free for Shiloh Central Church members, but they may also donate if desired. You may donate at the link below or with cash or check at the time of your appointment.

Donate to Inner Healing Prayer Ministry

Name

First Name

Last Name

Email

Phone

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Age:

Gender:

Church You Are Attending:

Have you ever received ministry from Shiloh's Inner Healing Prayer Ministry?

Yes

No

Why do you want to receive Inner Healing Prayer ministry?

Who referred you to Inner Healing Prayer?

Do you attend a Lighthouse Group (small/home groups, etc.)?

If not, we strongly recommend that you find one. We recommend that you share your Inner Healing Prayer experience with someone that you trust, but that you do not consider your “best friend.” This person will be able to pray with you and help hold you accountable.

Yes

No

LIABILITY RELEASE FORM

I acknowledge that the team members of the Inner Healing Prayer Ministry of Shiloh Central Church have voluntarily agreed to pray for me. I understand that this session is not a professional counseling meeting, and that the team is not practicing under a counseling license. 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 Shiloh Central Church is a non-profit Texas corporation, and makes no charge for its services. I further state that I 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. I understand that if I receive ministry from the Inner Healing Prayer Ministry of Shiloh Central Church, 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 the Inner Healing Prayer Ministry, so as to further my total healing process. This may include future sessions with spiritual mentors in the church to set appropriate boundaries for my personal and spiritual growth. Shiloh Central Church mandatorily reports child or elder abuse to the proper authorities. I agree to hold Shiloh Central Church and its Inner Healing Prayer Ministry team members free from any and all liability, loss, or damage of any kind that may arise as a result of the assistance I have received, or from my involvement with Shiloh Central Church.

I have read this disclaimer and release of liability, understand and agree with it, and have executed it as my free and voluntary act.

Signature: PRINT NAME BELOW to sign release.