If you are interested in scheduling a Deliverance or Discovery Inner Healing Session with us, please fill out all sections of the Ministry Application below. By voluntarily filling this out, you are acknowledging that should a session be scheduled, you will also need to sign our general release agreement prior to any ministry taking place.

Upon completion of this application you will be automatically redireted to a confirmation page. Please read the entire page as you will receive some very specific infromation regarding our approval process. Also make sure to check your email for the auto email confirmation that is sent as well.

Disclaimer: Filling out this application does not guarantee a ministry session. Please answer all questions truthfully, be concise, and include things that you may feel have already been addressed.

Rebuilt Ruins Ministry Application

First Name

Last Name

Birthday

Month

Day

Year

Phone

I agree to receive Text/SMS messages from Rebuilt Ruins Ministries at the phone number provided

City of Residence

State of Residence

Gender

Is Jesus Your Lord & Savior?

Do you need

How did you hear about Rebuilt Ruins Ministries?

Marital Status

Parental Status

Are you in the Military

Do you currently attend church?

If so, where?

Ethnic/Cultural Background

(Please be specific, as this info can help us with curse breaking)

Dad's Ethnicity

Mom's Ethnicity

Physical, Mental, Emoitonal, Spiritual Background

I'm currently under care of a

Licensed Therapist

Psychologist

Psychiatrist

Not Applicable

Physical Health Issues

Mental Health Issues

Trauma

Have you previously had Deliverance ministry?

In my previous deliverance session(s)

Demons manifested when confronted

Demons were confronted by name

Demons were cast out by name

Demons were not confronted

Are you aware of any unbroken Soul Ties or Spirit Spouses?

Have you previously had Inner Healing ministry?

Please check all that currently or previously apply

This information is very important even if you feel like you have already dealt with it.

Have you ever made any pacts/oaths/contracts/deals with the devil/demons?

Are you aware of any satanic/demonic dedications, legal rights the enemy might claim against you, or specific curses placed on you or your bloodline?

Is there anything else you would like to share that you feel is important to achieving your freedom?

What would you like to achieve from a session with us if we have one?

I recognize that true and lasting healing and deliverance is a journey, and I am committed to pursuing a closer relationship with God to protect and cultivate the freedom and healing I receive in my session.

I understand that sessions generally last between 90 minutes and two hours. To support the mission of Rebuilt Ruins Ministries, a $100 donation is suggested at the end of my session. If I’m able, I may give more, and if not, I’ll contribute what I can.

I have truthfully and voluntarily completed this application to the best of my knowledge and ability. I consent to participate in a session if my application is approved.

I understand that some sessions may be recorded for educational or ministry purposes and that my attendance implies consent to be filmed. If my session is selected to be recorded, I will be notified prior to scheduling. If I have concerns about being recorded, I will notify Pastor Matt or the ministry team in advance to discuss accommodations.

I approve both Email and Phone correspondence from Rebuilt Ruins.

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Upon completion of this application you will be automatically redireted to a confirmation page. Please read the entire page as you will receive some very specific infromation regarding our approval process. Also make sure to check your email for the auto email confirmation that is sent as well.

​

Rebuilt Ruins Ministry Application

Ethnic/Cultural Background

Physical, Mental, Emoitonal, Spiritual Background

Please check all that currently or previously apply