Have you had an Isaiah 61 Prayer Session before? *

Yes

No

Name *

First Name

Last Name

Gender *

Male

Female

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Marital Status *

Single

Married

Are you a member of Living Rock Church? *

Yes

No

Do you have any special requests?

Yes

No

Are you comfortable with a mixed gender prayer team? *

Yes

No

What days work best for your appointment?

Check all that apply.

Monday

Tuesday

Wednesday

Thursday

What time of day do you prefer?

Check all that apply.

Morning (8am - 12pm)

Afternoon (12pm - 4pm)

Evening (4pm - 8pm)

Do you prefer in-person or online?

In-Person

Online

Either