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Elijah House 201 Application

Facilitated Video School 201 Student Application

Elijah House Training for Prayer Ministry CONFIDENTIAL: This form us confidential and for facilitators only

Select all that apply:
Multi-line address
Which of the following Elijah House books have you read?
Which of the following Elijah House Classes have you completed?
Are you in a relationship with a spiritual leader in a pastoral role who knows you, is aware of your spiritual condition, and can hold you accountable?
Yes
No
Are you presently ministering to others?
Are you receiving prayer counseling or secular counseling at this time?
Yes
No
Have you been diagnosed with Dissociative Identity Disorder, Borderline Personality Disorder, or have you been a victim of Ritualized Abuse?
Yes
No

Notice Regarding Emotional Intensity and Legal Obligations

Elijah House School of Heart Healing courses can sometimes be emotionally intense due to the personal nature of the content. Participants may experience various emotional responses, such as anger, prejudice, resentment, anxiety, insomnia, depression, or dissociation. These responses are a natural part of the healing process. While the School offers valuable tools for heart healing, it is not possible to address all of your personal life issues within the scope of this course. Healing is an ongoing, lifelong process.

We encourage you to continue pursuing personal ministry and counseling after the School, if needed. If you have significant personal issues that require immediate attention, we recommend seeking counseling or ministry prior to enrolling in the course. If you are already seeing a counselor or therapist, we ask that you discuss the course with them and obtain their approval before enrolling.

Please provide your signature below to indicate your support of your participation. Please note that if a participant confesses to a crime during a small group session, the small group leader is required to report this to the lead Facilitator of the School. The Facilitator will follow state laws and, if necessary, report the crime to the appropriate authorities.

Application and Indemnity Agreement

Having reviewed and accepted the school enrollment information, the requirements outlined in this application, and the Elijah House Student Manual, I prayerfully submit my application. I agree to respectfully abide by the decision of the Elijah House Video School Facilitator regarding the suitability of my attendance at this time.

I agree to indemnify and hold harmless Elijah House, Inc., the Video School Facilitator and their team, and any Host (facility or spiritual mentor) from any claims, liabilities, or damages arising from my personal emotional, mental, or physical responses to the teachings and small group sessions during the school. I also agree to indemnify and hold harmless Elijah House, Inc., the Video School Facilitator, their team, and any related host or spiritual advisor from any costs, including time, travel, accommodations, or other incidental expenses, should the school be canceled, my acceptance delayed, or I am asked to discontinue the course to seek ministry before continuing at a later time.

I understand and agree to maintain the confidentiality of any information shared by leaders and students during class or in small groups, whether communicated verbally, in writing, or through any other means, including digital or online platforms. I understand that my signature testifies that all information provided is true, that I accept all terms of enrollment, and will provide sufficient funds in a timely manner for my participation in the school.

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