Testimony Release Form

PURPOSE: Our desire is to give glory to God for His love and power and encourage people to trust Him for healing and miracles. Your story can be used to tell the continuing story of God’s goodness.

We will share your testimony anonymously unless you would like your name to be used. If you would like your name to be used please indicate this at the end of the form.

First Name*
Last Name*
Email*
1. What did you receive prayer for?*
2. Did you have a doctor's diagnosis? If so, what was it?*
3. How severe was the injury, sickness or disability?*
4. How long had you had this condition?*
5. What happened as a result of prayer?*
TESTIMONY RELEASE FORM
I understand that my testimony may be used to describe what happened to me and I authorise Eastgate to release the testimony with the inclusion of any biographical information that I have provided. I do not expect any monetary reimbursement for the use of this testimony and waive my right to inspect or approve of any finished product.
Consent*
Please confirm that you have read the statement above and consent to the uses stipulated.
I consent to the uses stipulated
Please indicate your age*
- 18 or over
- Under 18
Please use my name on this testimony*
- Yes
- No
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Testimony Release Form

TESTIMONY RELEASE FORM