Testimony Form
 

 
Thanks for spending 7mins to record your testimony and shape the future of the planet!
 
 
BSSM Class *
Please Check Any That Apply: *
On the scale below, please choose your pain level before you were ministered to. 1 being slight pain and10 being severe pain. *
On the scale below, please choose your pain level after you were ministered to. 1 being slight pain and10 being severe pain. *
Are you in the care of a professional service? *
 
Which area of society would your testimony 'influence' or 'relate to'?

eg. Prayed for my boss at work who then as a result got family restoration = family mountain & business mountain

 *
 
Tags

Please choose all that apply
Miracles:
Physical Healing:
Spiritual:
Inner Healing
Prosperity:
Permission to Share: *
May Bethel Healing Rooms Staff contact you to follow up regarding this visit? *
Media Participation
Waiver and Release Form
 
I hereby give my permission to Bethel Church and any associated organizations or contractors to photograph, videotape, record testimonies and/or otherwise make recordings of me (including name, face, likeness, appearance and/or voice) for any legitimate use without limitation or reservation. I understand that these recordings may be used for production, publishing, website material, media sources and in connection with publicity, all forms of advertising, and promotional materials. I agree to relinquish to Bethel Church all right, title, financial remuneration, and interest in the recordings. I further agree that I, on behalf of myself as well as my heirs, legal representatives, successors or assignees, will hold Bethel Church harmless from any and all liability and will never assert any claim against Bethel Church and/or the aforementioned arising from or out of the media productions, reproduction and/or use of the aforementioned media recordings. 
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Are you a legal adult? *
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