This is a transcript from the documents in jpg format to be found here: http://homepages.skylink.net/~teddy/contract/contract.htm

The bold, capital, italics letters etc have been respected, like in the original


With observations of legal nature: document just below --Blue text between square brackets : observations from the webmaster --

or, naked document without observations: after the first

Le même en français

Ce court document est cité en grande partie ou en totalité, et critiqué tout du long. A l'origine, il s'agit d'un document écrit dans une autre langue, et traduit par les soins du webmaster.

Le résumer serait revenu à le paraphraser purement et simplement, paragraphe par paragraphe.


Church of Scientology

Celebrity Centre

(name)

(hereinafter referred to as "the Church")

Religious Services Enrollment
Application / Agreement
and
General Release


I__________________, HEREBY ACKNOWLEDGE that I am voluntarily applying to participate in the RELIGIOUS SERVICE(S)

known as

_______________________

_______________________

_______________________

(hereinafter referred to as "the "Service")

In exchange for being permitted to participate in the service, I acknowledge and agree as follows:

1. Scientology has been represented to me as an applied religious philosophy and as a religion recognized as such all over the world, devoted to the study and handling of the human spirit in relationship to itself, universes and other life. The word scientology comes from the Latin "scio", meaning knowing in the fullest sense of the word, and the Greek "logos", meaning "study of". "Dianetics" spiritual healing technology is part of the Scientology® religion and is the study of what the soul is doing to the body. The word Dianetics is from the greek "dia", trhough", and "nous", "soul", thus "through soul".

2. The American author and philosopher L. Ron Hubbard ("LRH" hereinafter) is the founder of the Scientology religion. His writings and recorded spoken words on the subjects of Scientology and Dianetics are a record of his observations and research into the nature of the human spirit and condition. These writings contain a guide intended to assist persons to become more aware of themselves as persons, restoring respect for self and others, and not for treating or diagnosing ailments of the body, nor for engaging in teaching or practicing medical arts or sciences. If you have come here to be cured of a physical illness, see the registrar and so inform her so that she can arrange for a competent medical examination and treatment. When you are physically well, you can begin Scientology training and processing on your road to total freedom. [in the absolute, this is illegal: none other than the person (unless unconscious) can estimate what is a competent medical treatment.]

3. The writings of LRH are presented as a part of the record of his research and should be construed only as a written report of such research and not as a statement of claims by the Church or by LRH. None of the organizations which espouse, present, propagate or practice the Scientology religion makes any claim that the nature or purpose of


page 2


Scientology, or of Dianetics, or the writings of LRH, is contrary to this description or that the application of this or any other Scientology practices will have any particular effect on any particular person. Thus the Church makes no claims as to the results which may be forthcoming from the Service. [otherwise said, scientology is nil and of nil effect].

4. Scientology applied religious philosophy contains pastoral counselling procedures intended to assist an individual to gain greater knowledge of self. The Scientology religion is all-denominational and welcomes members of all faiths to participate in its services. The mission of the Church of Scientology is to help the individual achieve greater self-confidence and personal integrity, thereby enabling him to trust and respect himself and his fellow man. The attainment of the benefits and goals of Scientology religious philosophy requires each individual's dedicated participation, as only through his own efforts can achieve these [this is the KEY sentence: scientology does NOTHING, but you're able to do ANYTHING all by yourself]. Accordingly, the Church makes no claims as to the potential benefits which may be experiences by an individual from participation in the Service.

5. The many scientology Churches, Missions and organizations all over the world are each totally and legally independent from one another, connected only by ecclesiastical bonds. Accordingly, the Service is being offered under the exclusive supervision and control of the above-named Church. [this clause has been put here because the fraud wants to avoid that people claiming for fraud could be paid by the managing bodies of the scam. It's illegal and a false declaration as sentenced before the Senior Courts in California, and by a court in Paris, - 13th penal room in 1978 - which has sentenced L. Ron Hubbard himself, recognizing therefore the links between himself and the scientology organizations and their activities]

6. The Service may include the use of a religious artifact known as the "E-Meter", for the primary purpose of locating and resolving problems and difficulties which are spiritual in nature. I understand that by itself the E-Meter does nothing, but serves only as a guide to ministers of the Church to assist parishioners in locating areas of spiritual distress or travail, and that it is not intended or effective for the diagnosis, treatment or prevention of any disease, or for the improvement of health or any bodily function.

7. In connection with the Service, the Church may compile a folder containing its notations of my spirituel progress, known as "the Preclear folder" (PC folder), as well as other ecclesiastical files containing notations regarding my spiritual progress. The contents of the folders are kept confidential from persons who lack ecclesiastical atuthority to gain access to such documents, including the person whom the files concern., and are subject to priest- penitent privilege. I understand that as a condition of being accepted for participation in the Service, I am giving up any and all rights of ownership possession and control, copying or viewing of the PC folder and other files concerning myself, both with respect to the files themselmves and the information contained therein. [here it is an nil attempt from the scam to avoid being forced to obey to privacy laws as well to computer's files, and FOIA act in USA]

8. I understand and acknowledge that because of constitutionnal prohibitions which forbid governmental interference with religious services or dispute resolutions procedures [nil and untrue], that in the event I have any dispute with the Church which cannot be resolved informally by direct communication, resolution of that dispute may be pursued solely through the internal procedures of the Church's Ethics, Justice and Binding Religious Arbitration system. Moreover, I hereby expressly agree that any controversy arising under this Application/Agreement or in connection with my participation in the Service shall be resolved by such Binding Religious Arbitration. I understand and acknolwledge that the Church's religious dispute resolution procedure includes application to senior ecclesiastical bodies, including, as necessary, final submission of the dispute to the International Justice Chief of the Mother Church - Church of Scientology International ["IJC"] or his designate. [without the client being aware, he could therefore be forced to go to Los Angeles to "resolve" the situation: that's where IJC lies]

Any dispute, claim or controversy which remains still unresolved after submession to the IJC shall be submitted to Binding Religious Arbitration in accordance with the published arbitration procedures of Church of Scientology International, which provides taht:

a. I shall submit a request for arbitration to the IJC with a copy to the Church, and shall designate one arbitrator with my request.


b. Within fifteen (15) days after receiving the request for arbitration, the Church shall designate an arbitrator. If the Church has not designated an arbitrator within fifteen (15) days, then the IJC shall designate the second arbitrator;

c. The two arbitrators so designated shall select a third arbitrator within fifteen(15) days after the designation of the second arbitrator. If the arbitrators are unable to designate a


(page 3)

third arbitrator within the fifteen (15) days period, then the IJC shall choose such arbitrator. Consistent with the intent taht the arbitration be conducted in accordance with Scientology principles of justice and fairness, all arbitrators shall be Scientologists in good standing with the Mother Church.

IN ACCORDANCE WITH THE RELIGIOUS NATURE OF THE SERVICES TO BE PROVIDED, I ACKNOWLEDGE, UNDERSTAND AND AGREE THAT IN NO EVENT SHALL ANY DISPUTE, CLAIM OR CONTROVERSY ARISING OUT OF MY PARTICIPATION IN THE SERVICE BE SUBMITTED TO A COURT FOR JUDICIAL DETERMINATION. MOREOVER, I UNDERSTAND AND AGREE THAT BY SIGNING AND SUBMITTING THIS APPLICATION/AGREEMENT, I AM WAIVING ANY RIGHT WHICH I MAY HAVE TO HAVE DISPUTES HEREUNDER DECIDED IN A COURT OF LAW, BEFORE A JUDGE OR A JUDGE AND JURY.

9. I further understand, acknowledge and agree that the Church is under no duty whatsoever to return any portion of any religious donation received from me. However, I further understand and acknowledge that under certain circumstances provided for in the published policies and procedures of the Claims and Verification Board, refunds may be obtained through my strict compliance with those published policies and procedures. [no such policies or rules are detailed to be read here, so, the clause is nil] I further acknowledge and agree that the refubnd procedures require my direct participation to the exclusion of any third parties, including butt not limited to, attorneys. [evident purpose: the scam wants to avoid a professional view on the... scam]


10. I understand and acknowledge that I am applying for the Service with the intention of self-improvement and spiritual advancement. Accordingly, before I go on to a further service, it is essential that I am completely satisfied with the results obtained from my prior service. I further understand and acknowledge (1) that while the Church holds out the possibility of a better life through adherence to its beliefs and practices, individual spiritual advancement is not always an easy and confortable task, and (1) that my success in scientology ultimately depends on my own ability and determination to overcome the shortcomings and harmful patterns of my past.
[besides being nil, this bizarre clause can be summarized as: making the client guilty of his own state, and affirming as well that scientology does nothing in itself, but is no more than a "Coué - a self-convincing-" method]

11. I understand and acknowledge that the Service is designed to give spiritual aid, is not medical treatment, nor is it designed to provide any physical gains. I am also aware that I should not participate in the Service if I have a physical or emotional condition which would be aggravated by participation in the Service or make the Service activities particularly uncomfortable or distressful to me. Knowing this, I am voluntarily participating in the Service with knowledge of the general activities involved and I HEREBY AGREE TO ACCEPT ANY AND ALL KNOWN OR UNKNOWN RISKS OF INJURY, LOSS OR DAMAGE. [this "clause", nil as the others, demonstrates very clearly that scientology knows well that is is really dangerous for most people. Moreover, if it was applicable, it would allow anyone in the scam to abuse of any rights you could have without allowing you to sue any abuse].

12. I acknowledge that I am making this application to be permitted to participate in the Service on my own determinism, recognizing that I am personally responsible for my present and future condition of life, and attest that I have no record of being committed in an institution for mental or emotional disorders, nor do I have a criminal record for a felony offense. I am not connected with any person (such as martital or familial ties) of known antagonism for spiritual treatment or Scientology, nor have I or any member of my immediate family ever threatened to sue, embarrass or attack Scientology, nor have I or any of my immediate family ever threatened to sue, embarrass or attack Scientology, nor have I or any of my immediate family ever been part of such an attack. I further attest that I am not attempting to investigate Scientology as a representative of the news media, a government body or other organization, entity or person. Rather, I am applying to participate the Service to achieve spiritual betterment, and I truly perceive that persons can be helped to gain greater understanding and happiness in life, and I am applying honestly and in good faith to derive all personal gain from the Service.

13. This application for permission to participate the Service will become a legally binding agreement between myself and the Church upon its acceptance by the Church. In determining whether to accept this application, the Church will rely on the representations and promises which I have made herein.

AS FURTHER CONSIDERATION for being permitted by the Church to participate in the Service and use its facilities and other facilities provided for such purpose:

1. I, ON BEHALF OF MYSELF AND ON BEHALF OF MY HEIRS, DISTRIBUTEES, LEGAL REPRESENTATIVES AND ASSIGNS, AGREE NOT TO MAKE CLAIMS AGAINST, SUE, ATTACH THE PROPERTY OF, OR PROSECUTE the Chruch, the successors and assigns of L. Ron Hubbard, the Church of Scientology International, and any affiliated Churches, Missions, corporations,associations, partnerships or organizations, and/or their officers, directors, trustees, agents, servants, sucessors, heirs, executors or representatives, and/or the owners, managers, employees, agents or representatives of, or associated with, any facilities conducting to the Service (hereinfater collectively referred to as"the Releasees") for physical, mental or emotional injury or property damage resulting from the neigligence or other acts, howsoever caused, of any Releasee or of any employee, agent or contractor of the Church, its affiliates, or other Releasee, in any way relating to my participation in the Service.

2. IN ADDITION, I HEREBY RELEASE AND DISCHARGE THE RELEASEES from all actions, claims or demands I, my heirs, distributees, guardians, legal representatives or assigns now have or may hereafter have for physical , mental or emotional injury or property damage resulting in any way from my participation in the Service.

3. I FURTHER AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS THE RELEASEES and each of them from any loss, liability, damage or cost they may incur due to my participation in the Service and/or due to my presence or action in or about the Church premises or the facilities provided for the Service. [this one clause is the most abusive of all: indeed, if applicable, it would allow the scam to get money from Courts because someone would have sued it for fraud, by instance]

4. I further agree and understand that should any provisions of this Agreement be, for any reason, unenforceable, the balance shall nonetheless be of full force and effect. [not surprisingly, this clause says clearly that scientology attorneys having established this contract know that all other clauses are nil; but they try once again to make believe the whole would be valid, whatever many clauses would be nil]

I HAVE CAREFULLY READ THIS APPLICATION/AGREEMENT AND GENERAL RELEASE AND FULLY UNDERSTAND ITS CONTENTS AND CONSEQUENCES. I AM AWARE THAT BY SIGNING BELOW, I AM FOREVER GIVING UP MY RIGHT TO SUE THE CHURCH, ITS STAFF AND:OR OTHER SCIENTOLOGY RELATED ORGANIZATIONS FOR ANY INJURY OR DAMAGE SUFFERED IN ANY WAY CONNECTED WITH THE SERVICES ACTIVITIES.

I sign this APPLICATION/AGREEMENT AND GENERAL RELEASE of my own free will on this _____ day of ________, 199___, intending to be legally bound hereby and request that I be permitted in the Religious Service(s) named above.


_____________________ _______________________
SIGNATURE (Participant) (Parent/guardian if Minor)

_____________________ _______________________
(printed full name)

_____________________ ______________________________/________
(Home street adress) (Witness signature) (date)

_____________________
(City and State/Country)


Having reviewed the above application, the Church, in reliance and conditioned on the truthful representations and agreements made therein, on this ______day of _________, 199__, accepts the applicant for participation in the above-named Religious Service(s).

CHURCH OF SCIENTOLOGY CELEBRITY CENTRE®

_______________________________
(Name)

By its:___________________________
(Title)

_______________________________
(Signature)



©1992 CSI. All Rights Reserved. SCIENTOLOGY Symbol, DIANETICS, CELEBRITY CENTRE, and E-METER are trademarks owned by tReligious Technology Center and are used with its pemission. SCIENTOLOGIST is a collective membership mark and designates membership in the affiliated churches and missions of SCIENTOLOGY. Scientology is an applied religious philosophy. item #1369

|[even in the copyrights clauses, there is something inapplicable: "the collective membership" of "scientologist" presupposing that if you are no longer paying the membership cards, you're no longer allowed to say you are scientologist.]


Church of Scientology

Celebrity Centre

(name)

(hereinafter referred to as "the Church")

Religious Services Enrollment
Application / Agreement
and
General Release


I__________________, HEREBY ACKNOWLEDGE that I am voluntarily applying to participate in the RELIGIOUS SERVICE(S)

known as

_______________________

_______________________

_______________________

(hereinafter referred to as "the "Service")

In exchange for being permitted to participate in the service, I acknowledge and agree as follows:

1. Scientology has been represented to me as an applied religious philosophy and as a religion recognized as such all over the world, devoted to the study and handling of the human spirit in relationship to itself, universes and other life. The word scientology comes from the Latin "scio", meaning knowing in the fullest sense of the word, and the Greek "logos", meaning "study of". "Dianetics" spiritual healing technology is part of the Scientology® religion and is the study of what the soul is doing to the body. The word Dianetics is from the greek "dia", trhough", and "nous", "soul", thus "through soul".

2. The American author and philosopher L. Ron Hubbard ("LRH" hereinafter) is the founder of the Scientology religion. His writings and recorded spoken words on the subjects of Scientology and Dianetics are a record of his observations and research into the nature of the human spirit and condition. These writings contain a guide intended to assist persons to become more aware of themselves as persons, restoring respect for self and others, and not for treating or diagnosing ailments of the body, nor for engaging in teaching or practicing medical arts or sciences. If you have come here to be cured of a physical illness, see the registrar and so inform her so that she can arrange for a competent medical examination and treatment. When you are physically well, you can begin Scientology training and processing on your road to total freedom.

3. The writings of LRH are presented as a part of the record of his research and should be construed only as a written report of such research and not as a statement of claims by the Church or by LRH. None of the organizations which espouse, present, propagate or practice the Scientology religion makes any claim that the nature or purpose of


page 2


Scientology, or of Dianetics, or the writings of LRH, is contrary to this description or that the application of this or any other Scientology practices will have any particular effect on any particular person. Thus the Church makes no claims as to the results which may be forthcoming from the Service.

4. Scientology applied religious philosophy contains pastoral counselling procedures intended to assist an individual to gain greater knowledge of self. The Scientology religion is all-denominational and welcomes members of all faiths to participate in its services. The mission of the Church of Scientology is to help the individual achieve greater self-confidence and personal integrity, thereby enabling him to trust and respect himself and his fellow man. The attainment of the benefits and goals of Scientology religious philosophy requires each individual's dedicated participation, as only through his own efforts can achieve these . Accordingly, the Church makes no claims as to the potential benefits which may be experiences by an individual from participation in the Service.

5. The many scientology Churches, Missions and organizations all over the world are each totally and legally independent from one another, connected only by ecclesiastical bonds. Accordingly, the Service is being offered under the exclusive supervision and control of the above-named Church.

6. The Service may include the use of a religious artifact known as the "E-Meter", for the primary purpose of locating and resolving problems and difficulties which are spiritual in nature. I understand that by itself the E-Meter does nothing, but serves only as a guide to ministers of the Church to assist parishioners in locating areas of spiritual distress or travail, and that it is not intended or effective for the diagnosis, treatment or prevention of any disease, or for the improvement of health or any bodily function.

7. In connection with the Service, the Church may compile a folder containing its notations of my spirituel progress, known as "the Preclear folder" (PC folder), as well as other ecclesiastical files containing notations regarding my spiritual progress. The contents of the folders are kept confidential from persons who lack ecclesiastical atuthority to gain access to such documents, including the person whom the files concern., and are subject to priest- penitent privilege. I understand that as a condition of being accepted for participation in the Service, I am giving up any and all rights of ownership possession and control, copying or viewing of the PC folder and other files concerning myself, both with respect to the files themselmves and the information contained therein.

8. I understand and acknowledge that because of constitutionnal prohibitions which forbid governmental interference with religious services or dispute resolutions procedures, that in the event I have any dispute with the Church which cannot be resolved informally by direct communication, resolution of that dispute may be pursued solely through the internal procedures of the Church's Ethics, Justice and Binding Religious Arbitration system. Moreover, I hereby expressly agree that any controversy arising under this Application/Agreement or in connection with my participation in the Service shall be resolved by such Binding Religious Arbitration. I understand and acknolwledge that the Church's religious dispute resolution procedure includes application to senior ecclesiastical bodies, including, as necessary, final submission of the dispute to the International Justice Chief of the Mother Church - Church of Scientology International ["IJC"] or his designate.

Any dispute, claim or controversy which remains still unresolved after submession to the IJC shall be submitted to Binding Religious Arbitration in accordance with the published arbitration procedures of Church of Scientology International, which provides taht:

a. I shall submit a request for arbitration to the IJC with a copy to the Church, and shall designate one arbitrator with my request.


b. Within fifteen (15) days after receiving the request for arbitration, the Church shall designate an arbitrator. If the Church has not designated an arbitrator within fifteen (15) days, then the IJC shall designate the second arbitrator;

c. The two arbitrators so designated shall select a third arbitrator within fifteen(15) days after the designation of the second arbitrator. If the arbitrators are unable to designate a


(page 3)

third arbitrator within the fifteen (15) days period, then the IJC shall choose such arbitrator. Consistent with the intent taht the arbitration be conducted in accordance with Scientology principles of justice and fairness, all arbitrators shall be Scientologists in good standing with the Mother Church.

IN ACCORDANCE WITH THE RELIGIOUS NATURE OF THE SERVICES TO BE PROVIDED, I ACKNOWLEDGE, UNDERSTAND AND AGREE THAT IN NO EVENT SHALL ANY DISPUTE, CLAIM OR CONTROVERSY ARISING OUT OF MY PARTICIPATION IN THE SERVICE BE SUBMITTED TO A COURT FOR JUDICIAL DETERMINATION. MOREOVER, I UNDERSTAND AND AGREE THAT BY SIGNING AND SUBMITTING THIS APPLICATION/AGREEMENT, I AM WAIVING ANY RIGHT WHICH I MAY HAVE TO HAVE DISPUTES HEREUNDER DECIDED IN A COURT OF LAW, BEFORE A JUDGE OR A JUDGE AND JURY.

9. I further understand, acknowledge and agree that the Church is under no duty whatsoever to return any portion of any religious donation received from me. However, I further understand and acknowledge that under certain circumstances provided for in the published policies and procedures of the Claims and Verification Board, refunds may be obtained through my strict compliance with those published policies and procedures. I further acknowledge and agree that the refubnd procedures require my direct participation to the exclusion of any third parties, including butt not limited to, attorneys.


10. I understand and acknowledge that I am applying for the Service with the intention of self-improvement and spiritual advancement. Accordingly, before I go on to a further service, it is essential that I am completely satisfied with the results obtained from my prior service. I further understand and acknowledge (1) that while the Church holds out the possibility of a better life through adherence to its beliefs and practices, individual spiritual advancement is not always an easy and confortable task, and (1) that my success in scientology ultimately depends on my own ability and determination to overcome the shortcomings and harmful patterns of my past.

11. I understand and acknowledge that the Service is designed to give spiritual aid, is not medical treatment, nor is it designed to provide any physical gains. I am also aware that I should not participate in the Service if I have a physical or emotional condition which would be aggravated by participation in the Service or make the Service activities particularly uncomfortable or distressful to me. Knowing this, I am voluntarily participating in the Service with knowledge of the general activities involved and I HEREBY AGREE TO ACCEPT ANY AND ALL KNOWN OR UNKNOWN RISKS OF INJURY, LOSS OR DAMAGE.

12. I acknowledge that I am making this application to be permitted to participate in the Service on my own determinism, recognizing that I am personally responsible for my present and future condition of life, and attest that I have no record of being committed in an institution for mental or emotional disorders, nor do I have a criminal record for a felony offense. I am not connected with any person (such as martital or familial ties) of known antagonism for spiritual treatment or Scientology, nor have I or any member of my immediate family ever threatened to sue, embarrass or attack Scientology, nor have I or any of my immediate family ever threatened to sue, embarrass or attack Scientology, nor have I or any of my immediate family ever been part of such an attack. I further attest that I am not attempting to investigate Scientology as a representative of the news media, a government body or other organization, entity or person. Rather, I am applying to participate the Service to achieve spiritual betterment, and I truly perceive that persons can be helped to gain greater understanding and happiness in life, and I am applying honestly and in good faith to derive all personal gain from the Service.

13. This application for permission to participate the Service will become a legally binding agreement between myself and the Church upon its acceptance by the Church. In determining whether to accept this application, the Church will rely on the representations and promises which I have made herein.

AS FURTHER CONSIDERATION for being permitted by the Church to participate in the Service and use its facilities and other facilities provided for such purpose:

1. I, ON BEHALF OF MYSELF AND ON BEHALF OF MY HEIRS, DISTRIBUTEES, LEGAL REPRESENTATIVES AND ASSIGNS, AGREE NOT TO MAKE CLAIMS AGAINST, SUE, ATTACH THE PROPERTY OF, OR PROSECUTE the Chruch, the successors and assigns of L. Ron Hubbard, the Church of Scientology International, and any affiliated Churches, Missions, corporations,associations, partnerships or organizations, and/or their officers, directors, trustees, agents, servants, sucessors, heirs, executors or representatives, and/or the owners, managers, employees, agents or representatives of, or associated with, any facilities conducting to the Service (hereinfater collectively referred to as"the Releasees") for physical, mental or emotional injury or property damage resulting from the neigligence or other acts, howsoever caused, of any Releasee or of any employee, agent or contractor of the Church, its affiliates, or other Releasee, in any way relating to my participation in the Service.

2. IN ADDITION, I HEREBY RELEASE AND DISCHARGE THE RELEASEES from all actions, claims or demands I, my heirs, distributees, guardians, legal representatives or assigns now have or may hereafter have for physical , mental or emotional injury or property damage resulting in any way from my participation in the Service.

3. I FURTHER AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS THE RELEASEES and each of them from any loss, liability, damage or cost they may incur due to my participation in the Service and/or due to my presence or action in or about the Church premises or the facilities provided for the Service.

4. I further agree and understand that should any provisions of this Agreement be, for any reason, unenforceable, the balance shall nonetheless be of full force and effect.

I HAVE CAREFULLY READ THIS APPLICATION/AGREEMENT AND GENERAL RELEASE AND FULLY UNDERSTAND ITS CONTENTS AND CONSEQUENCES. I AM AWARE THAT BY SIGNING BELOW, I AM FOREVER GIVING UP MY RIGHT TO SUE THE CHURCH, ITS STAFF AND:OR OTHER SCIENTOLOGY RELATED ORGANIZATIONS FOR ANY INJURY OR DAMAGE SUFFERED IN ANY WAY CONNECTED WITH THE SERVICES ACTIVITIES.

I sign this APPLICATION/AGREEMENT AND GENERAL RELEASE of my own free will on this _____ day of ________, 199___, intending to be legally bound hereby and request that I be permitted in the Religious Service(s) named above.


_____________________ _______________________
SIGNATURE (Participant) (Parent/guardian if Minor)

_____________________ _______________________
(printed full name)

_____________________ ______________________________/________
(Home street adress) (Witness signature) (date)

_____________________
(City and State/Country)


Having reviewed the above application, the Church, in reliance and conditioned on the truthful representations and agreements made therein, on this ______day of _________, 199__, accepts the applicant for participation in the above-named Religious Service(s).

CHURCH OF SCIENTOLOGY CELEBRITY CENTRE®

_______________________________
(Name)

By its:___________________________
(Title)

_______________________________
(Signature)



©1992 CSI. All Rights Reserved. SCIENTOLOGY Symbol, DIANETICS, CELEBRITY CENTRE, and E-METER are trademarks owned by tReligious Technology Center and are used with its pemission. SCIENTOLOGIST is a collective membership mark and designates membership in the affiliated churches and missions of SCIENTOLOGY. Scientology is an applied religious philosophy. item #1369


PS from the webmaster: don't fear to expose this fraudulous so-called "agreement". It can't be copyrighted valuably, like a lot of those incredibly fraudulous similar contracts or papers from the profitable ruthless global scam.