SOZO Application

Name*

First Last

Email*

Phone*

Gender*

Male
Female

Birthdate*

Age*

Name of Parent or Guardian*

First Last

Marital Status*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Who referred you to the SOZO ministry?

Have you a received SOZO before?*

Yes, at RockPoint
Yes, at Another Location
No, I Have Not

Why would you like to receive a SOZO?*

Have you received counseling from your church or a licensed counselor?*

Yes
No

With Whom?*

Do you have a home church?*

Yes
No

Name of Home Church*

Do you have a leadership role in your home church?*

Yes
No

What is your leadership role?*

Check All That Apply*

Liability Release for RockPoint Church SOZO Ministry. I acknowledge that team members from the SOZO Ministry of RockPoint Church have voluntarily agreed to pray for me. I understand this session is not a professional counseling meeting and none of the team members are licensed counselors. I understand these team members are, to the best of their ability, doing what they can to help me achieve more freedom in my life. I understand RockPoint Church, Newberg is a nonprofit Oregon Corporation that makes no charge for its services (*although a donation of $60 is suggested). I further state that I have voluntarily sought assistance of my own initiative and that I am under no obligation to accept or reject any of the advice or help that I might receive from the team members of this ministry. I understand that if I receive ministry from the RockPoint SOZO Ministry, the team is committed to respect the disclosed information, but not to complete confidentiality. The information, as needed, may be shared with other leaders of the SOZO Ministry so as to further my total healing process. This may include future meetings with spiritual mentors in the church to set appropriate guidelines for my spiritual growth. I agree to hold RockPoint Church and its SOZO team members and pastors free from any and all liability, loss, or damage of any kind that may arise as a result of assistance which I have received or from my involvement with RockPoint Church.*

I have read, understand, and agree to this release form

4301 N College St
Newberg, OR 97132

503-538-2283
Church Office

admin@rockpt.org
prayer@rockpt.org

SOZO Application