I do hereby release Camarillo Healing Rooms and their volunteers and staff from any liability and for any harm or perceived harm resulting from my voluntarily receiving prayer ministry on this and all subsequent visits. I understand that Camarillo Healing Rooms is staffed by volunteers representing the broad body of Christ who reflect many denominations and local churches. They are not trained or licensed professionals of counseling, therapy or medical services. I understand that if I am currently taking medication or operating under the advice of a professional service provider that I will allow them (medical doctor, therapist, counselor, etc.) to confirm any healing outcome(s) from prayer ministry I received before altering any prescribed course of action. I acknowledge and agree that if I report any instance of, or plan to, harm myself or others, Camarillo Healing Rooms will contact the proper professional(s). I understand that this form and all data recorded on it is the sole property of Camarillo Healing Rooms, and all content will be held confidentially and will be shared with our prayer ministers for the sole purpose of providing Christian healing prayer to me. I understand that by providing my email address and phone number that I am granting Camarillo Healing Rooms to contact me regarding the appointment I have scheduled.