Consent & Self Declaration Form

To,

Pastor / Secretary

Prayer Centre:

Address:

Subject: Regarding voluntary prayer & attendance in Prayer Centre

I, the undersigned, with full consciousness, free will, and voluntary intention, hereby declare that I am participating in the prayers, worship, and religious activities of ___________________ Prayer Centre of my own choice, since 2026-10-04.

There is no pressure, inducement, temptation, lure, or threat of any kind upon me. My decision to attend the Prayer Centre is completely personal, voluntary, and independent.

My Personal details are as follows:

Full Name:

Age (Years):

Gender: Male Female Other

Identity Proof Number:

I hereby confirm that attending the Prayer Centre, participating in prayers, religious meetings, and other gatherings is part of my religious freedom and right, guaranteed under Articles 25 to 28 of the Constitution of India.

If anyone makes false allegations against me or the Prayer Centre in this regard, this self-declaration should be treated as evidence and used accordingly.

Witness Details:

Witness Name:

Witness Relation:

Witness Signature:

Date:

Place:

Applicant's Signature / Thumb Impression:

Consent & Self Declaration Form

My Personal details are as follows:

Witness Details:

Applicant's Photograph (Selfie):