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 redirected to a confirmation page. Please read the entire page, as you will receive some very specific information regarding our approval process.

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, Emotional, Spiritual Background

I’m currently under the care of a

Licensed Therapist

Psychologist

Psychiatrist

Not Applicable

Physical Health Issues

Mental Health Issues

Trauma

Have you previously had Inner Healing ministry?

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?

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?

Are you comfortable with a mixed-gender ministry team in your session?

We’ll do our best to accommodate, but preferences may impact scheduling and wait time.

Would you like to request Pastor Matt as the lead for your session?

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 ministry sessions may be recorded for educational, training, and other ministry-related purposes. By attending and participating in a ministry session, I consent to being filmed and/or recorded. If I have any concerns about my session being recorded, I agree to notify Pastor Matt directly in advance so accommodations can be discussed.

Please Enter Today's Date

Month

Day

Year

I approve both Email and Phone correspondence from Rebuilt Ruins.