Step One: Fill out and submit the form.

Step Two: Select and purchase the number of sessions you would like. You may prefer to go one session at a time, or you may want to purchase one of the packages. You get to choose!

We’re praying for you!

STEP 1: Please complete this form

* indicates required field

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Cell Phone, within the USA

(###)

###

####

Cell phone, if outside of the USA

Country

(###)

###

####

Landline, if no cell phone

(###)

###

####

Email Address

Birthdate

MM

DD

YYYY

Occupation

Briefly describe your faith journey with the Lord.

Describe your current church, house church, or family of faith.

What drew you to PACEM?

What are some of your goals, needs, issues, etc., where you would like help?

Consent Statement

I do hereby release Arise! Women and their volunteers and/or staff from any liability for any harm, or perceived harm, resulting from my voluntary receipt of help through PACEM coaching. I understand that Arise! Women is a prayer and spiritual ministry center and not a licensed counseling, medical, or therapeutic center. Therefore, Arise! Women does not routinely keep detailed records and will not provide information for lawyers, or disability claims, or similar matters. I understand that if I am currently taking medication or operating under the advice of a professional service, I will allow them (my medical doctor, therapist, counselor, etc.) to confirm any results of prayer or advice received before I alter any prescribed course of action. I also release Arise! Women and their volunteers and/or staff from any liabilities of first-time knowledge of physical and/or sexual abuse to a minor that is told to them during prayer time. I understand that under the laws of Minnesota, they are obligated to contact the proper authorities regarding this knowledge. For Online Appointments: I understand that I will be using a third-party video conferencing program to communicate during my online prayer appointment. Arise! Women will not record these coaching appointments and will work to keep my time of ministry as secure as possible. With any online platform, there are certain security risks. In the rare case of security breach, I will not hold Arise! Women liable for any security issues pertaining to my online coaching appointment.

Consent Statement

I acknowledge the consent statement as described above, and I confirm that I am 18 years of age or older.

Step Two: Purchase your sessions below!

PACEM SESSIONS

from $60.00

One-hour or Package Session. One Hour: $60. 4 sessions: $215. 8 sessions: $425

All purchases are non-refundable.

You may reschedule an appointment if you contact Arise! Women 24 hours before the start of the session. Your sessions are valid after the purchase date for:

*30 days for single sessions

*90 days for the four-session package

*180 days for the eight-session package.

Session:

Quantity: