Consent / Registration Form - I (print your name) __________________________________________________ hereby give consent to the organization/church, to which I am handing in this form, to use the following personal information for my pastoral care, participation in church related activities and emergency care. I understand that my personal information will only be given to pastoral and/or church staff, program leaders, event coordinators and emergency personnel on a need to know basis. My personal information will be securely stored in an appropriate place, and will not be passed on to any third parties without my/our prior consent. By signing and dating this Consent form I indicate that I have read, understand and approve the above and that this information will be stored for a minimum of one (1) year. Signature _____________________________________________ Date ___________________________________ (please type name in box below) *
(A printed version of this form will be available for you to sign in person at the first Freedom Session Meeting you attend)