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Release and Waiver of Claims

This Release and Waiver of Claims (“Agreement”) is made and entered into as of the date last signed below, between Rebuilt Ruins Ministries Inc. (RRM), including and on behalf of Rev. Matthew Grossman, ministry associates, and its employees, and volunteers, (collectively, “RRM”) and the individual listed in the signature block below (“Releasor”). By signing below, the parties agree to the terms of this Agreement.

Releasor desires to have RRM minister to Releasor with a spiritual evaluation, prayer, inner spiritual healing, and/or deliverance/exorcism (hereafter known as “the procedure”) whereby RRM shall attempt to free or deliver the Releasor from any evil spirits, demons, or any unwelcome and uninvited presence, and RRM agrees to perform the procedure.

Any such procedure is carries risks, including mental, physical, emotional and spiritual hazards. During the procedure, RRM may have to physically restrain Releasor to protect both Releasor and RRM. Releasor understands these risks and is signing this Agreement freely and voluntarily.

RRM makes no claims as to the results of the procedure due to the many and variable emotional, circumstantial, and spiritual factors involved.

Releasor irrevocably waives, releases, discharges, indemnifies and agrees to hold harmless RRM, its officers, directors, employees, and volunteers, as well as the owner or lessor of the facility used to perform the procedure from and against any and all actions, causes of action, suits, claims, damages, demands and liabilities of whatever nature, at law or in equity, now or hereafter existing, for any reason whatsoever, including, without limitation, personal injury, death and loss or damage to property arising out of or resulting from the procedure, including without limitation, attorneys’ fees and costs incurred by RRM in the defense of such actions.

Releasor acknowledges that by performing the procedure, RRM desires to free those in bondage to Satan. Any tithes, offerings, donations, or gifts provided by Releasor to RRM shall be used by RRM to spiritually assist other persons and to further RRM’s outreach.

The terms and provisions of this Agreement shall be binding upon the parties and their heirs, successors and assigns and shall be governed by California law without regard to its conflict of law principles. Any controversy arising from this Agreement will be conclusively determined by binding arbitration in San Diego, California, in accordance with the Rules of the American Arbitration Association. The Arbitrator's decision must be delivered in writing accompanied by written findings of fact and conclusions of law. The prevailing party shall be awarded its costs and reasonable attorneys’ fees.

Unless otherwise agreed in writing, RRM and Releasor agree that neither party shall divulge, disclose, publicize or, in any manner, make reference to this Agreement, the terms of this Agreement, the fact that any claims were made, or any of the specific allegations of the claims, except as may be necessary to effectuate the terms of this Agreement. Notwithstanding the above, a party to this Agreement may disclose the terms of this Agreement, or the circumstances or events leading up to this Agreement, if required to do so by law.

Releasor must be at least eighteen years old and mentally competent. If Releasor is under eighteen years of age, a parental or legal guardian signature and approval must be obtained prior to the procedure. In any situation where Releasor is not mentally competent or Releasor’s competence is in question, RRM may seek consent from a parent or legal guardian.

Except as otherwise agreed, no person or entity not a party to this Agreement will be a third party beneficiary. Neither party may assign this Agreement except upon written consent from the other party.

Releasor hereby grants permission to RRM, the rights of my image, in video or still, and of the likeness and sound of my voice as recorded on audio or video tape without payment or any other consideration. I understand that my image may be edited, copied, exhibited, published or distributed and waive the right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of my image or recording. I also understand that this material may be used in diverse educational settings within an unrestricted geographic area. 

By signing this release, I understand this permission signifies that photographic or video recordings of me may be electronically displayed via the Internet or in the public educational setting.


There is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed.


This release applies to photographic, audio or video recordings collected as part of the session listed on this document only.

This Agreement constitutes the entire understanding between the parties and supersedes any and all prior or contemporaneous discussions or agreements. This Agreement, including this paragraph, may be amended or modified only in writing signed by both parties or their authorized representatives. If any court rules that any provision of this Agreement is invalid or unenforceable, that ruling shall not affect the validity or enforcing of any other provision of this Agreement.

The parties agree to the terms of the Agreement, effective upon submission date of this form.

Thank you. Your form has been submitted.

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