Prayer Mountain Consent Form

Are you allergic to any foods? Required

Yes

No

Are you allergic to any medications? Required

Yes

No

Do you take any medications regularly? Required

Yes

No

Do you have any medical restrictions? Required

Yes

No

I give Kingdom Advancers permission to use any photographs and/or videos taken of me at Prayer Mountain for any online releases, publications and any other communications related to the mission of Kingdom Advancers. Yes OR No Required

Yes

No

I give Kingdom Advancers permission to partake in any deliverance on me during Prayer Mountain. Yes OR No Required

Yes

No

I agree that I am coming to Prayer Mountain at my own risk and that I do not hold Kingdom Advancers liable for anything. Yes OR No Required

Yes

No

I agree that I am responsible for all of my personal belongings. Yes OR No Required

Yes

No

I agree that I have answered the following questions to the best of my knowledge. Yes OR No Required

Yes

No

Kingdom Advancers

Personal Information

Emergency contact Info

Medical Restrictions/Allergies

Consent

Electronically sign first and last name