I, the parent or guardian of a minor child (under the age of 18) listed below, do hereby certify that I voluntarily consent to have my child ministered to by Set Free Ministries.  

I am aware that the SFM staff member (full, part-time, or volunteer) meeting with my child may need to intervene or contact appropriate authorities if he/she feels that my child is a potential risk to his/herself or others. 

I understand that some or all of the procedures used by the SFM encourager may or may not be clinically demonstrated as guaranteeing either short or long term results.  I fully understand that the ministry my child is receiving is NOT counseling in any form but rather encouragement and prayer ministry.  I accept this ministry fully and completely and do not hold anyone responsible for ANY outcome that may arise as a result of this ministry.  I do not hold SFM or its encourager responsible for any further or additional care that my child may need in the future.  I take full responsibility for my child’s life, health and well being now and in the days to come. 

I am voluntarily accepting this offer of ministry and acknowledge that I understand that I am free to terminate my child’s participation at any time for any reason.  I understand that I must take full responsibility for any and all consequences for prematurely terminating the spiritual intervention done for or on my child’s behalf.  I also understand that once my child leaves this place of ministry, I accept full responsibility for any choices I make that may be detrimental or harmful to my child.  I also accept full responsibility for all aftercare and follow-up ministry since this ministry opportunity is limited to particular time frames and does not provide for any promise of future other kinds of ministry. 

I also fully understand that this ministry opportunity is being offered on a donation basis.  I understand that this is not a professional counseling office nor are those providing ministry holding themselves out to be professional counselors but rather as encouragement and prayer ministers.  I accept this ministry opportunity on behalf of my child as a gift and can freely give as I choose to support this cause but am under no obligation to pay for this service should I choose not to do so.  If I choose to contribute any money to this ministry it is to be viewed as a token of my appreciation and not as payment for services rendered.