Online Prayer Request
Name
Your Personal Email
Mobile Phone Number *
My preferred device is: *
Preferred time for prayer session
LEGAL LIABILITY RELEASE I, the undersigned, do hereby release Brisbane Healing Rooms Australia Inc. and their volunteers or staff from any liability, for any harm or perceived harm resulting from any voluntary receiving of free prayer on this and subsequent visits. I understand that these Healing Rooms are staffed by volunteers representing the broad body of Christ and reflect many denominations and churches. They are not trained or licensed professionals of counselling, therapy or medical services. I understand that it is my responsibility to let the team leader know if I/my child experiences physical discomfort during the prayer session. I understand that if I am currently taking medication, or operating under the advice of a professional service, I will allow them [my medical doctor, therapist, counsellor etc.] to confirm any results of prayer received before altering any prescribed course of action.If I report a serious indictable offence at any time, The Director may disclose this to the relevant authorities. *
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