PERSONAL MINISTRY AGREEMENT
I request personal counseling and ministry from Dr. Timothy Davis (Dr. Davis) or the Cleansing Discipleship (CD) team of Cleansing The Church Ministries (CCM). As a condition of that ministry, I acknowledge the following items and agree to them. I understand:
1. Dr. Davis has his higher education degrees in Theology and Biblical Counseling. He is not a state licensed therapist. The Holy Bible is used as the foundation of his counsel and personal advice.
2. The biblical ministry I receive from a CCM CD team is not counseling as licensed by the State of California nor any other agency. I understand that ministry is provided by licensed ministers and church lay persons.
3. All information disclosed within ministry sessions is strictly confidential and will not be revealed to anyone outside of the ministry team without my written permission. The only exceptions are when disclosure is required or permitted by law. Those situations typically involve substantial risk of physical harm to oneself or to others, or suspected abuse of children or the elderly.
4. To experience personal freedom requires my cooperation and active commitment to exercise my will; however, I understand that no specific outcome can be guaranteed.
5. Though CCM and Dr. Davis do not charge an hourly fee for any form of ministry, all recipients are asked to make a financial contribution. I commit to a minimum donation of $20 for a 30 minute phone call, $75 for a 60 minute Zoom call, or $100 for a 90 minute in person ministry session. All forms of payment will go directly to Cleansing the Church Ministries.
RELEASE OF LIABILITY
PARTICIPANT, ON PARTICIPANT’S BEHALF, AND ON BEHALF OF PARTICIPANT’S HEIRS, SUCCESSORS OR ASSIGNS, ADMINISTRATORS AND PERSONAL REPRESENTATIVES FULLY RELEASES AND FOREVER DISCHARGES (i) Cleansing The Church Ministries (CCM), (ii) Victory Village Church, and each of their respective direct and indirect subsidiaries, affiliates, partners and related entities, (iii) each of their respective directors, officers, ministers, employees, agents, insurers, attorneys, shareholders and representatives, and (iv) each predecessor, successor, and assign thereof, from and against any and all actions, charges, claims, losses, costs, damages, expenses (including attorneys’ fees and expenses) and liabilities of any kind or character, whether known or unknown, in connection with, arising out of or in any way related to Participant’s participation in Personal Ministry and any other Ministry-related activities, including but not limited to claims of negligence or wrongdoing, personal injury or harm (including serious bodily injury and/or death), and property damage or loss of any kind or nature.
Furthermore, Participant expressly waives and relinquishes all rights and benefits afforded by Section 1542 of the Civil Code of the State of California, and does so understanding and acknowledging the significance and consequence of such specific waiver of Section 1542. Section 1542 of the Civil Code of the State of California states: “A general release does not extend to claims which the creditor does not know or suspect to exist in his favor at the time of executing the release, which if known by him must have materially affected his settlement with the debtor.”
I have read, understand, and accept this Ministry Agreement and Release of Liability. This agreement and consent cover the length of time I participate in ministry with Dr. Davis and/or CCM.
Please fill in the form below and press Send.
PO Box 534
Hampton, IL 61256
Phone call: $20 > 30 minutes
Zoom call: $75 > 60 minutes
In person: $100 > 90 minutes
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