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Electronically FILED by Superior Court of California, County of Los Angeles on 01/06/2020 07:48 PM Sherri R.

Carter, Executive Officer/Clerk of Court, by K. Hung,Deputy Clerk

1 SCHEPER KIM & HARRIS LLP


WILLIAM H. FORMAN (State Bar No. 150477)
2 wforman@scheperkim.com
DAVID C. SCHEPER (State Bar No. 120174)
3 dscheper@scheperkim.com
MARGARET E. DAYTON (State Bar No. 274353)
4 pdayton@scheperkim.com
800 West Sixth Street, 18th Floor
5 Los Angeles, California 90017-2701
Telephone: (213) 613-4655
6 Facsimile: (213) 613-4656

7 Attorneys for Church of Scientology Celebrity


Centre International and Church of Scientology
8 International

9 SUPERIOR COURT OF THE STATE OF CALIFORNIA

10 COUNTY OF LOS ANGELES, CENTRAL DISTRICT

11

12 CHRISSIE CARNELL BIXLER; CEDRIC CASE NO. 19STCV29458


BIXLER-ZAVALA; JANE DOE #1; MARIE
13 BOBETTE RIALES; and JANE DOE #2, [Assigned to Hon. Steven J. Kleifield, Dept.
57]
14 Plaintiff,
DECLARATION OF MARGARET
15 v. MARMOLEJO IN SUPPORT OF
MOTION OF DEFENDANT CHURCH OF
16 CHURCH OF SCIENTOLOGY SCIENTOLOGY CELEBRITY CENTRE
INTERNATIONAL; RELIGIOUS INTERNATIONAL AND CHURCH OF
17 TECHNOLOGY CENTER; CHURCH OF SCIENTOLOGY INTERNATIONAL FOR
SCIENTOLOGY CELEBRITY CENTRE RELIGIOUS ARBITRATION
18 INTERNATIONAL; DAVID MISCAVIGE;
DANIEL MASTERSON; and DOES 1-25,
19 Filed Concurrently with:
Defendants. Notice of Motion and Motion for Religious
20 Arbitration; Memorandum of Points and
Authorities; Declaration of Lynn R. Farny,
21 Declaration of Sarah Heller; and [Proposed]
Order
22
Hearing Date: March 24, 2020
23 Time: 8:30 a.m.
Dept.: 57
24
Action filed: August 22, 2019
25 Trial date: Not yet set

26 RESERVATION NO: 847288614669

27

28

DECLARATION OF MARGARET MARMOLEJO IN SUPPORT OF MOTION FOR RELIGIOUS ARBITRATION


Exhibit 1
4. Scientology applied religious philosophy contains pastoral counseling procedures intended to
assist an individuai to gain greater knowiedge of seif. The Scientoiogy religion is all-denominationai
and weicomes members of aii faiths to participate in its services. The mission of the Church of
Scientoiogy is to help the individual achieve greater seif-confidence and personal integrity, thereby
enabiing him to trust and respect himseif and his feiiow man. The attainment of the benefits and
goals of Scientology religious phiiosophy requires each individual's dedicated participation, as only
through his own efforts can he achieve these. Accordingly, the Church makes no claims as to the
potentiai benefits which may be experienced by an individuai from participation in the Service.
5.1 have seen the film "Orientation" and I am now informed and aware that Scientology is a
reiigion, its teachings are reiigious and its daims are religious in nature. I further understand that if I
desire to participate in Scientoiogy services, 1 do so being fuiiy aware that these are religious
services and that I am participating in them under the ecciesiasticai principles of the Scientology
religion.
6. The many Scientology Churches, Missions and organizations aii 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 exciusive supervision and control of the above-named Church.
7.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 spirituai in nature. I
understand that by itseif the E-Meter does nothing, but serves oniy as a guide to ministers of the
Church to assist parishioners in locating areas of spirituai 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.
8. In connection with the Service, the Church may compiie a foider containing its notations of my
spirituai progress, known as a "Preciear Foider"(PC Foider), as well as other ecclesiastical files
containing notations regarding my spirituai progress. The contents of the folders are kept
confidential from persons who lack the ecclesiastical authority to gain access to such documents,
including the person whom the flies concern, and are subject to the priest-penitent privilege. I
understand that as a condition of being accepted for participation in the Service, I am giving up any
and ail rights of ownership, possession and control, copying and viewing of the PC Folder and other
files concerning myself, both with respect to the files themselves and the information contained
therein.

9. 1 understand and acknowledge that because of constitutional prohibitions which forbid


governmental interference with reiigious services or dispute resolution procedures, that in the
event 1 have ciny dispute, claim or controversy with the Church including, but not limited to any
dispute, claim or controversy arising under this Application/Agreement or in connection with my
participation in the Service, which cannot be resolved informally by direct communication,
resolution of that dispute, claim or controversy 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. 1 understand and acknowledge 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 still remains unresolved after submission to the IJC shall
be submitted to Binding Religious Arbitration in accordance with the published arbitration
procedures of Church of Scientology International, which provide that:
a. 1 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 third arbitrator within
the fifteen (15) day period, then the IJC shall choose such arbitrator. Consistent with the Intent that
the arbitration be conducted in accordance with Scientology principles of justice and fairness, and
consistent with the ecclesiastical nature of the procedures and the dispute, claim or controversy to
which such procedures relate, ail 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 SUCH DISPUTES, CLAIMS OR CONTROVERSIES DECIDED IN A COURT OF LAW, BEFORE A
JUDGE OR A JUDGE AND JURY.
10.1 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 ecclesiastical policies
specifically Including Scientology Policy Directive 13 March 1996, Return of Donations,(which Is
available upon request) and procedures of the Claims Verification Board, a return of donations may
be obtained through my strict compliance with those published policies and procedures. I further
acknowledge and agree that such procedures require my direct participation to the exclusion of any
third parties. Including, but not limited to, attorneys, and that such returns of donations are
exclusively within the ecclesiastical authority of the Claims Verification Board and at the sole
discretion of the Church. I further understand, acknowledge and agree that any violation of or
deviation from such published policies or this paragraph by me voids any possibility of my receiving
a return of donation.

11, 1 understand, acknowledge and agree 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 I obtained from my prior service. I further
understand and acknowledge (I) that while the Church holds out the posslbllify of a better life
through adherence to Its beliefs and practices. Individual spiritual advancement Is not always an
easy or comfortable task, and (II) that my success In Scientology ultimately depends on my own
ability, strength and determination to overcome the shortcomings and harmful patterns of my past.
12. I understand, acknowledge and agree 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.
13.1 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 In 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 marital or familial ties) of known antagonism to spiritual treatment or
Scientology, nor have I or any member of my Immediate family ever threatened to sue, embarrass
or attacl< Scientology, nor have 1 or any of my Immediate family ever been a party to 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 in the Service to achieve spiritual betterment, and I truly believe 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 possible personal gain from the Service.
14. This application for permission to participate In the Service will become a legally binding
agreement between myself and the Church only 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:
1.1, 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 Church, the successors and assigns of L. Ron Hubbetrd, Religious
Technology Center and Its principals, the Church of Scientology International, and any affiliated
Exhibit 2
4.Scientology applied religious philosophy contains pastoral counseling procedures intended to
cisslst an Individual to gain greater knowledge of self. The Scientology religion Is all-denominatlond
and welcomes members of all faiths to participate In Its services. The mission ofthe Church of
Scientology Is to help the Individual achieve greater self-confidence and peiwnal Integrity, thereby
enabling him to trust and respect himself and his fellow man.T^e attainpient.ofthe benefits and
goals of Scientology religious philosophy requires each lndivl<d.uaTs dedicated participation, as only
through his own efforts can he achieve these. Accordingly, the Church makes no claims as to the
potential benefits which may be experienced by an Individual from participation In the Service.
5.1 have seen the film "Orientation" and 1 am now Informed and aware that Scientology Is a
religion. Its teachings are religious and Its claims are religious In nature. 1 further understand that If I
desire to participate In Scientology services, 1 do so being fully aware that these are religious
services and that I am participating In them under the ecclesiastical principles of the Scientology
religion.
6.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.
7.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 splritucd 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.
8. In connection with the Service, the Church may compile a folder containing Its notations of my
spiritual progress, known as a "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 the ecclesiastical authority to gain access to such documents.
Including the person whom the files concern, and are subject to the priest-penitent privilege. 1
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 and viewing of the PC Folder and other
files concerning myself, both with respect to the files themselves and the Information contained
therein.

9.1 understand and acknowledge that because of constitutional prohibitions which forbid
gpvernmental Interference with'religious services or dispute resolution procedures, that In the
event 1 have any dispute, claim of controvert with the Church Including, but not limited to any
dispute, claim or controversy arising under this Application/Agreement or In connection with my
participation In the Service, which cannot be;resolved Informally by direct communication,
resolution of that dispute, claim or controversy may b^ pursued solely through the Internal
plrocedtiresbf-the Cffiirch's Ethics, Justice and Binding Religious Arbltratioh tystem. Moreover, I
hereby expressly agree that any controversy arising under this Application/Agreement or In
conrrectlon with my particlpatloni In the Service shall be resolved by such Binding Religious
Arbitration. I understand and acknowledge that the Church's religious dispute resolution procedure
Includes application to senior ecclesiastical bodies. Including, as necessary, final submission ofthe
dispute to the International justice Chief of the Mother Church - Church ofScientology International
- ("IJC") or his designate.
Any dispute, claim or controversy which still remains unresolved after submission to the IjC shall
be submitted to Binding Religious Arbitration In accordance with the published arbitration
procedures of Church of Scientology international, which provide that:
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 third arbitrator within
the fifteen (15) day period, then the IjC shall choose such arbitrator. Consistent with the Intent that
the arbitration be conducted In accordance with Scientology principles ofjustice and fairness, and
consistent with the ecclesiastical nature of the procedures and the dispute, dalm or controversy to
which such procedures relate, all arbitrators sheill be Scientologists In good standing with the
Mother Church.

IN ACCORDANCE WriH 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 DETERiW^ATlON. MOREOVER, I UNDERSTAND AND AGREE THAT BY SIGNING AND
SUBMOTING THIS APPLICATION/AGREEMENT, I AM WAIVING ANY RIGHT WHICH I MAY HAVE TO
HAVE SUCH DISPUTES, CLAIMS OR CONTROVERSIES DECIDED IN A COURT OF LAW, BEFORE A
JUDGE OR A JUDGE AND JURY.
10.1 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 ecclesiastical policies
specifically Including Scientology Policy Directive 13 March 1996, Return of Donations,(which Is
available upon request) and procedures of the Claims Verification Board, a return of donations may
be obtained through my strict compliance with those published policies and procedures. I further
acknowledge and agree that such procedures require my direct participation to the exclusion of any
third parties. Including, but not limited to, attorneys, and that such returns of donations are
exclusively within the ecclesiastical authority of the Claims Verification Board and at the sole
discretion of the Church. I further understand, acknowledge and agree that any violation of or
deviation from such published policies or this paragraph by me voids any possibility of my receiving
a return of donation.

11.1 understand, acknowledge and agree 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 I obtained from my prior service. I further
understand and acknowledge (ij that while the Church holds out the posslbllify of a better life
through adherence to Its beliefs and practices. Individual spiritual advancement Is not always an
easy or comfortable task, and (II) that my success In Scientology ultimately depends on my own
ability, strength and determination to overcome the shortcomings and harmftjl patterns of my past.
12.1 understand, acknowledge and agree 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 actiyltles particularly uncornfortable or distressful
to me. Knowing this, I am voluntarily partlclpatlng'ih the Service with Imovyledge of the general
activities Involved and I HEREBY AGREE TO ACCEPT AW AnD ALL KNOWN OR UNI^GVVN RISKS
OFINJURY, LOSS, OR DAMAGE. ^ ^ ^
13.1 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 mypresentand future
cdndltlon In life, and attest that I have no record of being committed In an Institution for menial or
emotional disorders, nor do I have a criminal record for,a felony offense. I am not connected with
any person (such as marital or familial ties) of known antagonism.Ip splritual treatmoit 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 been a party to 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
pcirtlclpate In the Service to achieve spiritual betterment, and I truly believe 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 possible personal gain from the Service.
14.This application for permission to participate In the Service will become a legally binding
agreement between myself and the Church only 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 iadlltles provided for such purpose:
1.1, 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 Church, the successors and assigns of L. Ron Hubbard, Religious
Technology Center and Its principals, the Church of Scientology International, and any affiliated
Exhibit 3
4.Scientology applied religious philosophy contains pastoral counseling 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 ofthe 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 ofthe benefits and
goals of Scientology religious philosophy requires each individual's dedicated pcuticipation, as only
through his own efforts can he achieve these. Accordingly, the Church makes no claims as to the
potential benefits which may be experienced by an individual from participation In the Service.
5.1 have seen the film "Orientation" and I am now informed and aware that Scientology is a
religion, its teachings are religious and its claims are religious in nature. I further understand that if I
desire to participate in Scientology services, I do so being fiiiiy aware that these are religious
services and that I am participating in them under the ecclesiastical principles of the Scientology
religion.
6.The many Scientology Churches, Missions and organizations ail over the world are each totally
and legally independent from one another, connected only by ecciesiasticai bonds. Accordingly, the
Service is being offered under the exclusive supervision and control of the above-named Church.
7. 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.
8. In connection with the Service, the Church may compile a folder containing its notations of my
spiritual progress, known as a "Preciear Folder"(PC Folder), as well as other ecclesiastical files
containing notations regarding my spiritual progress. The contents of the folders ^e kept
confidential from persons who lack the ecclesiastical authority to gain access to such documents,
including the person whom the files concern, and are subject to the priest-penitent privilege. I
understand that as a condition of being accepted for participation in the Service, I am giving up any
and ail rights of ownership, possession and control,-copying and viewing of the PC Folder and other
files concerning myself, both with respect to the files themselves and the infarmation contained
therein.

9.1 understand and acknowledge that because of constitutional prohibitions which forbid
goyernrriental interference with religious services or dispute resolution procedures, that in the
eWnt I have any dispute, claim or controversy with the Church including, but not limited to any
dispute, claim or controversy arising under this Application/Agreement or in connection with my
participation in the Service, which cannot be resolved informally by direct communlcatlqn,
resolution of that dispute, claim or controvert may be pursued solely through the Internal
procedures of the Church's Ethics,justice and Binding Religious Arbitration tstem. Moreover, I
hereby expressly agree that any controversy arising under this Application/Agreement or In
connection!with mypaTtidpation in the'Service shall be resolved by such Binding Religious
Arbitration. I understand and acknowledge that the Church's religious dispute resolution procedure
includes application to senior ecciesiasticai 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 stiii remains unresolved after submission to the IjC shall
be submitted to Binding Religious Arbitration in accordance with the published arbitration
procedures of Church of Scientology International, which provide that:
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 third arbitrator within
the fifteen (15) day period, then the IjC shall choose such arbitrator. Consistent with the intent that
the arbitration be conducted in accordance with Scientology principles of justice eind fairness, and
consistent with the ecciesiasticai nature of the procedures and the dispute, claim or controvert to
which such procedures relate, 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
SUBMrmNG THIS APPLICATION/AGREEMENT, I AM WAIVING ANY RIGHT WHICH I MAY HAVE TO
HAVE SUCH DISPUTES, CLAIMS OR CONTROVERSIES DECIDED IN A COURT OF LAW, BEFORE A
JUDGE OR A JUDGE AND JURY.
10.1 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 ecclesiastical policies
specifically Including Scientology Policy Directive 13 March 1996, Return of Donations,(which Is
available upon request) and procedures of the Claims Verification Board, a return of donations may
be obtained through my strict compliance with those published policies and procedures. I further
acknowledge and agree that such procedures require my direct participation to the exclusion of any
third parties. Including, but not limited to, attorneys, and that such returns of donations are
exclusively within the ecclesiastical authority of the Claims Verification Board and at the sole
discretion of the Church. I further understand, acknowledge and agree that any violation of or
deviation from such published policies or this paragraph by me voids any possibility of my receiving
a return of donation.

11.1 understand, aclmowledge and agree 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 I 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 or comfortable task, and (11) that my success In Scientology ultimately depends on my own
ability, strength and determination to overcome the shortcomings and harmful patterns of my past.
12.1 understand, acknowledge and agree 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
OFINJURY, LOSS, ORDAiVlAGE. ,
13.1 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 In life, and attest that I have no record of being committed In an Institution for mentai or
emotional disorders, nor do I have a criminal record for a felony offense. I am not connected with
any person (such as marital or famlllahtlesi) ofJmown antagonlsm to 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 been a party to 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 In the Service to achieve spiritual betterment, and I truly believe 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 possible personal gain from the,Service.
14. This application for permission to participate In the Service will become a legally binding
agreement between myself and the Church only 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:
1.1, 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 Church, the successors and assigns of L. Ron Hubbard, Religious
Technology Center and Its principals, the Church of Scientology International, and any affiliated
Exhibit 4
4. Scientology applied religious philosophy contains pastoral counseling 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 ίη its services. The mission of the Church of
Scientology is to help the individual achleve greater self-confίdence and personal lntegrlty, thereby
enabling him to trust and respect himself and his fellow man. The attainment of the benefίts and
goals of Scientology religious philosophy requires each individual's dedicated participation, as only
through his own efforts can he achieve these. Accordingly, the Church makes no daims as to the
potential benefits which may be experienced by an individual from partldpation in the Service.
5. 1have seen the film 'Όrientation" and 1am now informed and aware that Scientology ls a
religion, its teachings are religious and its claims are religious ίη nature. Ι further understand that if Ι
desire to participate in Scientology services, 1do so being fully aware that these are religious
services and that 1am participating ίη them under the ecclesiastical principles of the Sdentology
religion.
6. The many Scientology Churches, Missions and organizations all over the world are each totally
and legally independent from one another, connected only by ecclesiastlcal bonds. Accordlngly, the
Service is being offered under the exclusive supervision and control of the above-named Church.
1. The Service may include the use of a religious artifact l<nown as the 'Έ-Meter," for the pήmary
purpose of locating and resolving problems and difficulties which are spiritual in nature. 1
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 ls not
intended or effective for the dlagnosis, treatment or prevention of any dlsease, or for the
lmprovement of health or any bodlly function.
8. ln connection with the Service, the Church may compile a folder containing its notations of my
spiήtual progress, i<nown as a "Preclear Folder" (PC Folder), as well as other ecclesiastical Ales
containing notations regardlng my spiritual progress. The contents of the folders are kept
confidential from persons who lacl< the ecclesiastical authority to gain access to such documents,
including the person whom the Ales concern, and are subject to the priest-penitent privilege. 1
understand that as a condition of being accepted for participation in the Service, 1am glving up any
and all rights of ownerst:ip, possession and control, copying and viewing of the PC Folder and other
Ales concerning myself, both with respect to the Ales themselves and the information contained
therein.
9. 1understand and acknowledge that because of constitutional prohibitions which forbld
governmental interference with religlous services or dispute resolution procedures, thaf ίη the
event 1 have any dispute, daim or controversy with the Church includlng, but not limited to any
dispute, claim or controversy arising under this Application/Agreement or in connectlon with my
particlpation in the Service, which cannot be resolved informally by direct communicatlon,
resolution of that dispute, claim or controversy may be pursued solely through the internal
procedures of the Church's Ethics, Justlce and Binding Rellglous Arbitratlon system. Moreover, 1
hereby expressly agree that any controversy arising under this Application/ Agreement or ίη
connectlon with my participation in the Service shall be resolved by such Binding Religious
Arbitration. Ι understand and acknowledge that the Church's religious dispute resolution procedure
includes application to senior ecclesiastical bodies, including, as necessary. Anal submlsslon of the
dispute to the lnternational justice Chief of the Mother Church - Church of Sclentology Jnternational
- ('Ί)C") or his designate.
Any dlspute, claim or controversy which still remains unresolved after submission to the IJC shall
be ?Ubmitted to Binding Rellgious Arbitration ίη accordance with the published arbitratlon .
procedures of Church of Scientology lnternational, which provide that:
a. 1shall 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. Jf the Church has not designated an arbitrator within Afteen ( 15) days, then the IJC shall
designate the second arbitrator.
c. The two arbitrators so designated shall select a third arbitrator within Afteen ( 15) days after the
designation of the second arbitrator. lf the arbitrators are unable to deslgnate a third arbitrator' within
the fifteen ( 15) day period, then the IJC shall choose such arbitrator. Consistent with the intent that
the arbitration be conducted in accordance with Scientology principles of justice and fairness, and
consistent with the ecclesiastical nature of the procedures and the dispute, claim or controversy to
which such procedures relate, all arbitrators shall be Scientologists in good standing with the
Mother Church.
ΙΝ ACCORDANCE WITH ΤΗΕ RELIGIOUS NATURE OF ΤΗΕ SERVICES το ΒΕ PROVIDED. 1
ACKNOWLEDGE. UNDERSτAND AND AGREE ΤΗΑτ ΙΝ ΝΟ ΕVΕΝΓ SHALL ΑΝΥ DΙSΡιπΕ, CLAIM OR
CONTROVERSY ARISING οιπ OF ΜΥ PARTICIPATION ΙΝ ΤΗΕ SERVICE ΒΕ SUBMΠTED το Α COURτ
FOR JUDICIAL DETERMINATION. MOREOVER, 1 UNDERSτAND AND AGREE ΤΗΑτ ΒΥ SIGNING AND
SUBMIΠING τΗΙS APPLICATION/AGREEMENΓ, 1 ΑΜ WAIVING ΑΝΥ RIGHr WHICH 1 ΜΑΥ HAVE το
HAVE SUCH DISPUTES, CLA\MS OR CONTROVERSIES DEC\DED ΙΝ Α COURτ OF LAW, BEFORE Α
JUDGE OR Α JUDGE AND JURY.
1Ο. 1further understanq, acknowledge and agree that the Church is under no duty whatsoeνer to
return any portion of any religious donation received from me. However, 1 further understand and
acknowledge that under certain circumstances proνided for in the published ecclesiastical polides
specifically including Sdentology Policy Directiνe 13 March 1996, Return of .Donations. (which is
available upon request} and procedures of the Claims Verifιcation Board, a return of donations may
be obtained through my strict compliance with those published policies and procedures. 1 further
acknowledge and agree that such proc.edures require my direct participation to the exclusion of any
third parties, including, but not limited to, attorneys, and that such returns of donations are
exclusively within the ecclesiastical authority of the Claims Verifιcation Board and at the sole
discretion of the Churc.h. 1 further understand, acknowledge and agree that any violation of or
deviation from such published pollcies or this paragraph by me voids any possibility of my recelvlng
a return of donation.
11. 1 understand, acl<.nowledge and agree that 1 am applying for the Serνice with the intentlon of
self-improvement and spirltual advancement. Accordingly. before Ι go on to a further serνlce, it is
essential that Ι am completely satisfied with the resύlts 1obtained from my prior serνlce. 1 further
understand and ac.l<.nowledge (ί) that while the Church holds out the possibility of a better \lfe
through adherence to its beliefs and practices, indlvidual spiritual advancement is not always an
easy or comfortable task, and (il) that my success in Sciento\ogy ultimately depends on my own
ability, strength and determination to overcome the shortcomings and harmful patterns of my past.
11. 1understand, ac.l<nowledge and agree that the Serνice is designed to giνe spiritual ald, is not
medica\ treatment, nor is lt deslgned to proνide any physical gains. 1am also aware that Ι should
not participate in the Serνic.e if 1 have a physical or emotional c.ondition whic.h wou\d be aggraνated
by participation in the Serνice or mal<e the Serνlce actiνities particularly uncomfortab\e or dlstressful
to me. Knowing this, Ι am νoluntarily participating in the Serνic.e with l<.nowledge of the general
actiνities involνed and 1 HEREBY AGREE ΤΟ ACCEPT ΑΝΥ AND ALL ΚΝΟWΝ OR UNΚNOWN RISΚS
OF INJURY, ιoss. OR DAMAGE.
13. 1acl<.nowledge that 1am making this application to be permitted to partidpate ln the Serνice on
my own determinism, recognizing that 1am persona\ly responsible for my present and future
condition in life, and attest that 1 have no record of being committed in an instltution for mental or
emotional disorders, nor do 1haνe a c.riminal record for a felony offense. 1am not c.onnected with
any person (such as marital or familial ties) of known antagonism to spiritual treatment or
Scientology. nor have 1 or any member of my immediate family ever threatened to sue, embarrass
or attack Scientology, nor haνe 1 or any of my immediate family eνer been a party to such an attack.
1 further attest that 1am not attempting to investigate Scientology as a representative of the news
media, a governrnent body or other organization, entity or person. Rather, 1 am applylng to
participate in the Serνice to achieve spiritual betterment, and Ι truly believe that persons can be
helped to gain greater understanding and happiness in life, and 1am applying honestly and in good
faith to deriνe all possible personal gain from the Serνice.
14. This application for permission to participate in the Serνice will become a legally binding
agreement between myself and the Churc.h only upon its acceptance by the Church. In determinlng
whether to accept this application, the Church will rely on the representations and promises which 1
have made herein.
AS FURTHER CONSIDERA"ΠON for being permitted by the Church to partic.ipate in the Serνice and
use its facillties and other facilities provided for such purpose:
ΟΝ BEHALF OF MYSELF AND ΟΝ BEHALF OF ΜΥ HE\RS, DISTRIBUTEES, LEGAL
1. \,
REPRESENTATIVES AND ASSIGNS, AGREE ΝΟτ το ΜΑΚΕ CLAIMS AGAINsτ. SUE. ΑΠΑCΗ ΤΗΕ
PROPERΊY OF, OR PROSECUTE the Church, the successors and assigns of L. Ron Hubbard, Religious
Technology Center and its principals, the Church of Scientology lnternational, and any affillated
Exhibit 5
Exhibit 6
Exhibit 8
L&j
ο~~ο/Λ
&k~ &/;l~ !fntρ,/}r~
~~ώ α6 '{k {5~1)

J~

1. Ι, Chr ;·SSι"e_Cσ (Νι.\\ , recognize, acknowledge and agree that 1am exciusively
responsible for my present and future condition in Iife and for the choices and decisions 1 make affecting my life. With
that in mind, and solely of my own volition and in the independent exercise of my own free will , 1am voluntarily
signing and submitting to CHURCH OF SCIENTOLOGY CC... \ ο±. . (hereinafter "the
Church") this RELIGIOUS SERVICES ENROLLMENT APPLICATION, AGREEMENT AND GENERAL RELEASE (hereinafter
"thls Contract") so that, upon its acceptance by the Church, 1may participate in Religious Services of the Scientology
reiigion under the terms, conditions, covenants, waivers and releases 1agree to by signing this Contract.

Ζ. This Contract is my statement of my personal , self-determined desire to participate in the Religious Services of
the Scientology religion. By signing this Contract, 1recognize, acknowledge and agree that:

a. Scientology is a religion, the Church is a church of the Scientology religion, and all the services and activities
of the Scientology religion are exclusively religious in nature. C3:2.
b. The Scientology religion is 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 ''Jogos," 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," meaning "through ," and "nous," meaning "soul, " and thus means "through soul. " ..Gb:,_,
c. The Founder of the Scientology reiigion is American author and philosopher L. Ron Hubbard (hereinafter
"LRH" ), whose 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. The writings and recorded spoken words
of LRH on the subjects of Scientology and Dianetics present a guide intended to assist persons to become more aware
of themselves as persons, restoring trust and respect for self and others. They are not a statement of claims by the
Church , by any other Scientology church or organization, or by LRH. ~

d. The term "Religious Services," as used in this Contract, means and refers to the beiiefs and practices set
forth in the writings and spoken words of LRH on the subjects of Dianetics and Scientology published with the
identifying S and double triangle or Dianetics triangle symbol, and all services or appiication of the principles of Mr.
Hubbard provided to me by the ministers or staff of the Church and all other Scientology churches and organizations,
inciuding without limitation: "auditing," which is Scientoiogy's unique form of reiigious counseiing encompassing all
services on the Scientology Classification, Gradation and Awareness Charts which includes, without limitation, all
leveis, rundowns, grades, assists, reviews, repairs, seminars, co-audits; ail Scientology congregational services of any
description; "training," which is the study of the scripture of the Scientology religion on the road to achieving spiritual
freedom and saivation and includes without Iimitation all services identified on the Scientology Classification,
Gradation and Awareness Chart, all courses, internships and cramming; the appiication of Scientology Ethics and
justice technology, which are both exclusively religious components of the practice of the Scientology religion; the
study and the appiication of the principles contained in the administrative writirigs of LRH used within the Church; and
any and all other services or use of the technology of L. Ron Hubbard, without limitation, provided to me by the
ministers or staff of the Church and all other Scientology churches and organizations.

e. Neither the Church nor any other Scientology church or organization which espouses, presents, propagates
or practices the Sdentology religion makes any claim:

1. that the nature or purpose of Scientology, or of Dianetics, or of the writings and recorded spoken
words of LRH, is contrary to what is stated in this Contract;

11. that the application of any Scientology or Dianetics technology or practice will have any particular
effect on me or any other person; or

111. that. <1-ΠΥ particular ~esult m~y be forthcoming from my participation in any_~cientology Religious
Service. 1speqfica\ly. a~~q9~l~.dg~~ttφt 1r'!ye .r~Ί:i.;and"φaμ..yηders(anct_ ?.,cίentqlogy··.P,olicy Directive 13 March
1996, Statements by Staff Members, which states clearly that if any' indi\ίidual staffmember of any Scientology .
church or organization mak~s any claim~_ about the results. whid) -φay b~-fρrthcoming from my partidpation in :
any Scientology Religi~1;1~_-S~~.L~e~ (ι!)y~μψ d~m~ ~e.,t~e p~~f.~opi,niOrts·and beliefs of that staff member :
only, and are not dairiΊs rnade by theChu~ch or any other'Scieή.t<?logy chίιrch or organ~tion. ~

3. Ι have seen tqe,fllrn,"9ri.eρ~tiqiι;~ . ί!Jl~'t ~nρw_ infψm~d,cWcl aware aι:ιd fully uπc\~rs~rid, that Scientology is a .
religion, that its te.!chirigs are religious and fu~i'it~ζdaims are· r~Ιigi6us in nat~re. 1am further informed and aware and
fully underst~nd th~ w,~en 1participate in Sciel1tology seryices, Ι am paι:tidpating in religious services unςler the
!
eα:l~siasti~l,,prin~iples,pf the S~ien~olρgy, r~li~i9p~ aι:n aίso infσrmec;! aήd ~Yf.aΓe, anq ,fully u~derstaria that φe Church
and ·arι other Scien'tology churches are separate, distinct legal corporations eaCh indepehdently op~ri\tihg ahd .
responsible for its own corporate and ecclesiastical affair~.

4•... This Contract Js my commitinent th~t 1desϊr~ to partΪtJpate ίη Scientόlogy Religious SeΓΙJices eΧdusively for
sρ,irJtilιi1 pui:poses in accordanς.e wi.th φe be,liefs and prCΙctices. of theScientology religion. S.clentόlogy Religious
S~rvί~~s are designed to give spiritual aid, not medic.iltreatrn~9t~Ho,w:ever;-ψeS,cientology religionteaches that the
_spίrit ς<1n-\)e ~cιved and thatthe spiri~ ~lonemay save;όr heal φe boςly, and Sι:ientology.Religious Services are ...
iQ!~n9~d to save t~e spirit. By signiήg thjs ,Cόntract, 1recognize, acknqwledge cίήd agree that: - . . .

a. Scientology ·Religious Services are not inteήded and are not ύsed for diagnosing iιilίηents of the body or for
-~n,gagif!g in the teaching or. ρrCΙctice. of any ιnedical art~ or sι:iences. . . . . . .. ~

b. lt is exclusively my resporisibility to see to my physiCal and medieal well-being, and under hό drcumstanc~
qoes th~ Churct) ρr cιny ρther $.ς.ientρlogy φurς:h or qrganization which espouses, presents, propagates or practices
. the Sci~ntology religion.have any respof!sibility whatsoev~~ in that regard. .· · . _ . C'C

. . ~· . 1hi\Ve nqt cor:ne to the Church, nor. do 1seek to participate in Scientology Religious Services, solely to be
Cure~t°'9f any physieal illness, ailment or C()Πdition. .
~. ·~··· . .. . -
-- . .-. .. c c__
.

~d~ · While the registrar can assist me in arranging fora competerit meι;lical examination and appropriate ·, ·
treatrhent by a· qualifled medical practitioner before 1participate ίη any Scientology Religious Services, it is solely my
. responsibili~ to take whatever steps are necessary tό demonstrate that 1have no diagnosable ormedically trea.table .
Qlη.~~~~s.• ailments, ,or coηdition5- that are not uncter cor_nρetent medical care. before 1begin participating in any
AG~e~tplogy Religious Service. Thereafter, any physical illnes~. ailment or condition 1may hav~ that has been treated
~ :Ή .~.§<;{i~lly inay then be addressed spiritually by the appli~tion of the tenets of the Scientology religion, subject to the
3~ :,.~"!~rι;i),~ 1~f this Contract. . _ . . . . ·. s::c._
::-Η: ·:~~ 1know that 1should not paiticipate ·in any Scientology Religious Service if 1have a physical or mental ·
-- -c-ondition which might be aggravated or which rnight make'myparticipation in the service uncomfortable or
di.~~re~~fu~ to me, and 1agree to accept and assume any a~d all known o.r unknovvn risks of injury, loss, or damag_>.. ,,...
resulting froriΊ. my.choices
_,• . ··-
and .decisjons in tl)at
.
regard.
- .
.. .
._.L-L.._.
_._

ϊΙi ·.::. ;:;' Scientology Religious Service may entail the u5e of a'rellgious artifact ι<nown as the _ .
· :r ,.[-Ni€ter" for the purρ0se· of Ιόcating and resolving problems an9 difficulties which are spiήtual in nature. 1
'. Urid~tsfand that; by itSelf, the E-Meter does nothίng, but serves only a5 a guide to Scientology ministers to a5sist
~hiqners in ιoca.tlng areas όf spiήtιiaι distre5-s or travail, cιήd th~t it is not intended or:effective foΓ"the diagnos~ /
· t(~atrτient or prevention' bf any disease, or fur tfι'e iinprovement of health or any bodily f:unctiori. . · · · _·,-~-.
·_
i.t #Ι:•ί;(~~ \""'"•' •: - 'c .:. •. .•; ,-: ;• ,:, '"•".•, )··~,· "<Γ :. •/•~,·:•;,;'•,,, <, •: ,;· ",,•' Ό";,Λ" :·· • ο.,-· Λ: :- :·,, ;'

g. · Scientology·is unaltetably φposed, as a matter of religious 'belief, tυ the practlce of psychiatry; ahd >
espouses a5 a reltgious belief thatthέ! study .of'the·rnind and the healing Όf mentally caιised ills·shόiJld not be ·...•...
.:afienated from religion .or condonecί ίη nol!lreligidus fields. I aπιlή full agreement' With thls religioίis belΓef. '1 dό not
; ' .,' baleve ίη or·subscrlbe to_pS.ychlatήc labelsfor: individίιals.· · lt is' my sttongly held religious belief that cilί mentaί' .. :.
pmblerns· are spiήtuaιin nature· and that:there)is•ήo sάch:thing as 'a•mentcilly-incompetent'person ·"' 6nl}"th0se ·.: ·· ·
suffeήng from spiήtual upset of one kind or another dramatized by an individual. 1reject all psychiatήc labels and
intend for this Contract to dearly memorialize my desire to be helped exdusiνely through religious, spiήtual means
and not through any form of psychiatήc treatment, specifically including inνoluntary commitrnent based on so-called
lack of competence. Under no circumstances, at any time, do 1wish to be denied my ήght to care from members of
my religion to the exdusion of psychiatήc care or psychiatήc directed care, regardless of what any psychiatήst,
medical person, designated member of the state or family member may assert supposedly on my behalf. If
drcumstances should eνer aήse in which goνernment, medical, or psychiatήc offidals or personnel or famlly members
or friends attempt to compel or coerce or commit me for psychiatήc eνaluation, treatrnent or hospitalization, 1fully
desire and fully expect that the Church or Scientologists will intercede on my behalf to oppose such efforts and/or
extήcate me from that predicament so my spiήtual needs may be addressed in accordance with the tenets of the ~
Sdentology religion free from psychiatήc interνention. ~
5. This Contract memorializes my intention to participate in Scientology Religious Serνices only for puφoses of self-
improνement and spiήtual adνancement. By signing this Contract, 1recognize, acknowledge and agree that:

a. Achieνing the benefits and goals of the Scientology religion requires my dedicated partidpation, because
only through my own efforts can 1achieνe those benefits and goals. ~
b. Before Ι go on to any further serνice, it is essential that 1am completely satlsfied with my expeήence with
my prior serνice. While Scientology holds out the possibility of a better life through adherence to lts beliefs and
practices, indiνidual spiritual adνancement is not always an easy or comfortable task, and my success in Sdentology
ultimately depends on my own ability, strength and determination to oνercome the shortcomings and harmful
patterns of my past. By agreeing to proceed with further serνices, 1acknowledge complete satisfaction with all
serνices 1haνe participated in preνiously. · CC...
c. Νο Scientology church is under any duty or obligation whatsoeνer to return any portion of any religious
donation Ι make. Howeνer, 1haνe read Sdentology Policy Directiνe 13 March 1996, Return of Donations, and
understand that under certain drcumstances identified in published ecdesiastical policies such as that Scientology
Policy Directiνe, a return of donations may be obtained through my stήct compliance with those published polides
and procedures relating to the Claims Veήfication Board. 1further understand, acknowledge and agree that:

1. such procedures require my direct participation to the exdusion of any third parties, induding, but not
limited to, attorneys;

11. returns of donations are exdusiνely within the ecdesiastical authoήty and sole discretion of the Claims
Veήfication Board;

111. any νiolation of, or deνiation from, such published polides by me νoids any possibility of my receiνing
a return of a donation; and

Ιν. should 1, at any time, eνer request a refund or repayment of donations, such refund or repayment will
be giνen if and only if 1haνe followed the exact procedures of the Claims Veήfication Board and this Contract, and
that in exchange for refund or repayment of such donations as determined by the Clalms Verification Board, 1execute
a complete release, quitdaim and waiνer of daims as proνided by an authoήzed Church representatiνe. ..b!::..._
d. ln connection with my participation in Sdentology Religious Serνices, the Church may compile a folder
containing its notations of my spiήtual progress, known as a "Preclear Folder" or "PC Folder," as well as other
ecdesiastical files containing notations regarding my spiήtual progress. ΑΙΙ of my PC Folders and other ecclesiastical
files containing notations regarding my spiήtual progress, as well as all contents thereof, are the sole and exdusiνe
property of Church of Scientology lnternational. As a matter of religious belief and of ecdesiastical doctrine and law,
such folders and files, and the contents of such folders and files, are kept confidential from all persons who lack the
ecdesiastical authority to gain access to such materials, induding me, are subject to all applicable clergyman-penitent
priνileges, and are nelther comprehensible nor meant to be understood by anyone whose training and expertise ίη
their interpretation is not recognized and sanctioned by Church of Sdentology lnternational.

1. As a condition of being accepted for partidpation in Scientology Religious Serνices, 1foreνer abandon,
surrender, waiνe, and relinquish without limitation any and all ήghts of ownership, possession, custody, control,
access, copying, and νiewing of my PC Folder or Folders and all other ecdesiastical files containing any notations
regarding my spiritual progress, both with respect to the folders and files themselνes and the information
contained ίη them.

11. The abandonment, surrender, waiνer, and relinquishment to which 1refer ίη the immediately preceding
subparagraph ίs unconditional and irreνocable and applies equally to anyone acting or purporting to be acting on
my behalf or for my benefit, whether 1am aliνe or dead, whether 1am disabled or lncapacitated, and under any
and all circumstances foreseen or unforeseen, in perpetuity, without exception or liΠ1itation.

111. Should 1or anyone acting or purpόrting to be acting on my behalf or for my benefit ever seek access to
any of my PC Folders or any other ecclesiastical file containing any notations. regarding my spiritual progress, 1
intend for the submission of this Contract to the presidihg judicial officer to be a comp\ete and sufficient basis for
the immediate denial of whatever access is being sought with prejudice to any other Όr .further effort to breacli
the abso\ute confidentiality of those materials or the exdusive ήght of Church of Scientology lnternational to
preserve their absolute confidentiality. C}z.._
e. lt is both an unalterable religious belief and a matter of ecclesiastical custom of the Scientology religion that
my personal spiritual progress will be directed by a minister known as a Case Supervisor who determines which
Religious Services are appropriate for my personal spiritua\ progress and the sequence in which 1will participate in
such Religious Services. As a matter of religious belief, 1acknowledge that my Case Supervisor will make the decisions
regarding the appropriate course of my spiritual progress, and 1will abide by the decisions and direction of my Case
Supervisor in guiding my spiritual progress. ΑΙΙ Religious Services in which 1participate hereafter at the direction of
my Case Supervisor are subject to the terms of this Contract.

6. This Contract memorializes my freely given consent to be bound exclusively by the discipline, faith, internal
organization, and ecclesiastical rule, custom, and law of the Sdentology religion in all matters relating to Scientology
Religious Services, in a\l my dealings of any nature with the Church, and in all my dealings of any nature with any
other Scientology church or organization which espouses, presents, propagates or practices the Scientology religion.
By signing this Contract, 1recognize, acknow\edge and agree that:

a. My freely given consent to be bound exclusively by the discipline, faith, internal organization, and
ecclesiastical rule, custom, and law of the Scientology religion in all matters relating to Scientology Religious Services,
in all my dealings of any nature with the Church, and in a\\ my dealings of any nature with any other Scientology
church or organization which espouses, presents, propagates or practices the Scientology religion means that 1am
forever abandoning, surrendering, waiving, and relinquishing my right to sue, or otherwise seek legal recourse with
respect to any dispute, claim or controversy against the Church, all other Scientology churches, all other organizations
which espouse, present, propagate or practice the Scientology religion, and all persons employed by any such entity
both in their personal and any official or representational capacities, regardless of the nature of the dispute, claim or
controversy. ~
b. The abandonment, suπender, waiver, and relinquishment to which 1refer in the immediately preceding
subparagraph is unconditional and irrevocable and applies equal\y to anyone acting or purporting to be acting on my
behalf or for my benefit, whether 1am alive or dead, whether 1am disabled or incapacitated, and under any and all
circumstances foreseen or unforeseen, in perpetuity, without exception or limitation. --CfZ:
c. Should 1or anyone acting or purporting to be acting on my behalf ever sue, or otherwise seek legal recourse
with respect to any dispute, claim or controversy against the Church, any other Scientology church, any other
organization which espouses, presents, propagates or practices the Scientology religion, or any person employed by
any such entity, regardless of the nature of the dispute, claim or controversy, 1intend for the submission of this
Contract to the presiding judicial officer to be a complete and sufficient basis for the immediate dismissal of any and
all such proceedings with prejudice to further proceedings of any l<ind. L::.fJ_
d. ln accordance with the discipline, faith, internal organization, and ecclesiastical rule, custom, and \aw of the
Scientology religion, and in accordance with the constitutiona\ prohibitions which forbid governmental interference
with religious services or dispute resolution procedures, shou\d any dispute, claim or controversy arise between me
and the Church, any other Scientology church, any other organization which espouses, presents, propagates or
practices the Scientology religion, or any person employed by any such entity, which cannot be resolved informally by
direct communication, 1will pursue resolution of that dispute, claim or controversy so\e\y and exdusively through
Scientology's internal Ethics, justice and binding religious arbitration procedures, which include application to senior
ecclesiastical bodies, including, as necessary, final submission of the dispute to the lnternational justice Chief of the
Mother Church of the Scientology religion, Church of Scientology lnternational ("IJC") or his or her designee. ~

e. Any dispute, claim or controversy which still remains unreso\ved after review by the IJC shal\ be submitted
to binding religious arbitration in accordance with the arbitration procedures of Church of Scientology lnternational,
which provide that:

i. 1will submit a request for arbitration to the IJC and to the person or entity with whom 1have the
dispute, claim or controversy;

11. in my request for arbitration, 1will designate one arbitrator to hear and reso\ve the matter;
111. within fifteen (15) days after receiving my request for arbitration, the person or entity with whom 1have
the dispute, claim or controversy will designate an arbitrator to hear and resolve the matter. lf the person or
entity with whom Ι have the dispute, daim or controversy does not designate an arbitrator within that fifteen (15)
day peήod, then the IJC will designate the second arbitrator;

Ιν. the two arbitrators so designated will select a third arbitrator within fifteen ( 15) days after the
designation of the second arbitrator. lf the arbitrators are unable to designate a third arbitrator within the fifteen
(15) day peήod, then the IJC will choose the third arbitrator;

ν. consistent with my intention that the arbitration be conducted in accordance with Sdentology
principles, and consistent with the ecclesiastical nature of the procedures and the dispute, claim or controversy
to ~hich those procedures relate, it is my specific intention that all such arbitrators be Scientologists in good
standing with the Mother Church. ~
f. The Church and all other Scientology churches and organizations which espouse, present, propagate or
practice the Scientology religion are each separate, distinct legal corporations, and each such entity is independently
responsible for its own management and is independently responsible for its own corporate and ecclesiastical / ' ,,,.,
affairs. ~

7. This Contract is my good faith application to participate in Scientology Religious Services. By signing this
Contract, 1promise, covenant, and represent that:

a. Ι am applying to participate in Scientology Religious Services to achieve spiήtual betterment because 1truly
believe that persons can be helped to gain greater understanding and happiness in life. ~

b. 1am applying honestly and in good faith to deήve all possible personal gain from Scientology Religious
Services. .C..C....
c. 1have no record of being committed in an institution for mental or emotional disorders.

d. 1have no criminal record that includes a felony offense.

e. 1am not connected with any person, such as by maήtal or familial ties, of known antagonism to spiritual
treatment or to Scientology. ~

f. Neither 1nor any member of my immediate family has ever sued, embaπassed or attacked, or threatened to
sue, embarrass or attack, Scientology. cc_
g. 1am not attempting to investigate Scientology as a representative of any news media, government agency
or entity, or any other organization, entity or person. ~

8. This Contract will become a legally binding agreement between me and the Church upon its acceptance by the
Church or upon my commencing my participation in a Sdentology Religious Service, whichever occurs first. ln
determining whether to accept this Contract, 1acknowledge that the Church will rely on the acknowledgements,
agreements, representations and promises which 1have made herein.

9. As further consideration for the Church 's permission for ιπε to participate in. Sdentology Religious Services and
for me to use its facilities and other facilities provided for such purposes:

a. 1, on behalf of myself and on behalf of my heirs, distήbutees, legal representatives and assigns, agree not to
make daims against, sue, attach the property of, or prosecute the Church, the successors and assigns of L. Ron
Hubbard, Church of Spiritual Technology, Religious Technology Center, the Church of Scientology lnternational, any
and all Scientology-affiliated churches, missions, corporations, associations, partnerships, trusts, religious orders or
organizations, or, in any and all capacities and as individuals, their officers, directors, trustees, agents, servants,
successors, heirs, executors or representatives, or the owners, managers, employees, agents or representatives or
associates of, any fadlities conducting Scientology Religious Services (hereinafter collectively "the Releasees") for any
physical, mental or emotional injury, property damage, or monetary loss resulting from negligence or other acts,
howsoever caused, of any Releasee or of any employee, agent or contractor of the Church, its affiliates, or othe/ /
Releasee, in any way relatlng to my partidpatlon in Sdentology Religlous Services. ~

b. 1further release and discharge the releasees in any and all capacities and as individuals from all actions,
claims or demands 1, my heirs, distήbutees, guardians, legal representatives or assigns now have or may hereafter
have for any physical, mental or emotional injury, property damage, or monetary loss resulting in any way from my
partidpation in Scientology Religious Services. Ci::-
,._
-,

c. 1further agree to indemnify and save and hoid harmiess the Releasees in any and all capadties and as
individuais, and each of them, from any loss, ilabiiity, damage or cost they may incur due to my participation in
Scientoiogy Religious Services or due to my presence or action in or about the Church premises or the faάlities
providlng such services. ~
d. 1understand, acknowiedge and agree that should any provision or provisions of this Contract be, for any
reason, unenforceable, the baiance shail nonetheless be of fuil force and effect.

e. 1further understand, acknowledge and agree that this Contract contains everything that the Church or
Church representatives and 1have addressed or discussed with respect to Sdentoiogy Religious Services, and that it
constltutes the sole and entire agreement which contains everything that 1have reiied upon in applying to partQe
in Scientology Religious Services and supersedes any and ail verbal discussions 1have had with anyone.

1HAVE CAREFULLY READ THIS CONTRACτ AND FULLY UNDERSτAND ITS CONTENTS AND CONSEQ.UENCES. 1
ALSO UNDERSτAND ΤΗΑτ 1ΑΜ ΝΟΤ ELIGIBLE FOR ΑΝΥ SCIENTOLOGY RELIGIOUS SERVICES UNLESS 1SIGN THIS
CONTRACτ. 1REAΠIRM ΤΗΑτ 1WISH το ΡΑRΠCΙΡΑΠ ΙΝ SCIENTOLOGY RELIGIOUS SERVICES AND ΤΗΑτ THIS
CHOICE ιs ΑΝ INDEPENDENT EXERCISE OF ΜΥ OWN FREE wιιι. 1FULLY UNDERSτAND ΤΗΑτ ΒΥ SIGNING BELOW,
1ΑΜ FOREVER GIVING UP ΜΥ RIGHT το SUE ΤΗΕ CHURCH, ιτs sτAFF AND ΑΝΥ OF ΤΗΕ HEREINABOVE
REFERENCED RELEASEES FOR ΑΝΥ INJURY OR DAMAGE SUFFERED ΙΝ ΑΝΥ WAY CONNECΠD WITH SCIENτOLOGY
RELIGIOUS SERVICES •
1sign this Religious Services Enrollment Application, Agreement and General Release on this !:Σ_ day of
'°') >c(._ , 20Q1 lntending to be legally bound by ίt, and request that 1be permitted to partiάpate in
Sdentoiogy Religious Services.

c'°"'~ ~R 9j
(SIGNATURE OF APPLICANT)
Cbrι~SiJι Chc rύl \ \
(Pήnted Fuil Name)
ι~ Ι\ )Jι ιλ.\ι\:ί~ f\ί,ι(, -:tl:-(C(J\ LA., ili . 'ΊαSJ8
(Home Address)

(SIGNATURE OF PARENT OR GUARDIAN, IF APPLICANT ιs Α MINOR)

(Prlnted Fuil Name)

(Home Address)

(SIGNA~~
(Printed Fuil Name)

Having reviewed the above Religlous Services Enroilment Appilcation, Agreement and General Reiease the Church,
in reiiance upon, and conditioned upon, the truth 1promlses, representations and agreements made therein, on this
ζαay of \ZίJJtf , 2~epts /SS. r participation in Scientoiogy Reilgious Services.

CHURCH OF SCIENTOLOGY
/1, ΓCELBRITY CENTRE INTERNATIONAL
By its: _ _.....,~Θ--;o....,Jιj~__._ι~'-+P-,.~-A?
........__,,__-----------
(Titie)

(SIGNATURE)_r-O-~~"'-~""'"""',R,.,_,,.._.1" " ι.,.,. . ..."'r:-:;--,.-ιι'--E-~~..ιcce._.A:ι..-....,.<==----==--


Exhibit 9
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(Dc:r
~~~o1Jc.·
$~ $~ Jn1ωr~
TW ~~c ~ώα6 '{kf5~:J

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1. 1, ~'{)
55 ~ cίλ( f\.t \ \ ' recognize, acknowledge and agree that 1am exclusively
responsible for my present and future condition in life and for the choices and decisions 1mal<e affecting my life. With
that in mind, and solely of my own volition and in the independent exercise of my own free will , 1am voluntarily
signing and submitting to CHURCH OF SCIENTOLOGY C-C.. .::L (hereinafter "the
Church") this RELIGIOUS SERVICES ENROLLMENT APPLICATION, AGRHMENT AND GENERAL RELEASE (hereinafter
"this Contract") so that, upon its acceptance by the Church, 1may participate in Religious Services of the Scientology
religion under the terms, conditions, covenants, waivers and releases 1agree to by signing thίs Contract.

Ζ. Thίs Contract ίs my statement of my personal , self-determίned desire to particίpate ίn the Relίgίous Services of
the Scientology relίgίon . By sίgnίng this Contract, 1recognize, acknowledge and agree that:

a. Scίentology ίs a religίon , the Church ίs a church of the Scientology relίgion , and all the servίces and actίvίtίes
of the Scίentology relίgion are exclusively relίgίous ίn nature. ~
b. The Scientology relίgion ίs devoted to the study and handlίng of the human spirit in relatίonship to itself,
unίverses and other life. The word "Scientology" comes from the Latίn "scίo," meaning 'Ίαιοwίng in the fullest sense
of the word, " and the Greek 'Ίogos, " meaning "study of. " Dianetίcs spίrίtual healίng technology is part of the
Scientology relίgion and ίs the study of what the soul ίs doίng to the body. The word ''Dίanetics" is from the Gre~ ~
" dίa ," meanίng "through," and "nous, " meanίng "soul, " and thus means "through soul. " ~1

c. The Founder of the Scientology religίon ίs American author and philosopher L. Ron Hubbard (hereίnafter
"LRH"), whose wrίtings and recorded spol<en words on the subjects of Scientology and Dίanetίcs are a record of hίs
observatίons and research into the nature of the human spίrit and condition . The writings and recorded spol<en words
of LRH on the subjects of Scientology and Dίanetics present a guίde intended to assίst persons to become more aware
of themselves as persons, restorίng trust and respect for self and others. They are not a statement of claims by th71 n
Church , by any other Scientology church or organization, or by LRH . ~

d. The term "Relίgίous Servίces ," as used in this Contract, means and refers to the belίefs and practices set
forth ίn
the wrίtίngs and spoken words of LRH on the subjects of Dίanetίcs and Scientology published with the
ίdentίfyίng S and double trίangle or Dίanetίcs trίangle symbol , and all services or applίcation of the prίncίples of Mr.
Hubbard prov ίded to me by the mίnίsters or staff of the Church and all other Scientology churches and organίzatίons ,
ίncludίng without limitation: " audίting , " which is Scientology's unίque form of religious counseling encompassing all
services on the Scientology Classificatίon , Gradation and Awareness Charts which includes, without limίtation , all
levels, rundowns, grades, assists, revίews , repaίrs, semίnars , co-audits; all Scίentology congregatίonal services of any
descrίptί on ; " traίnίng ," whίch ί s the study of the scrίpture of the Scientology relίgίon on the road to achίevίng spirίtual
freedom and salvatίon and includes without lίmίtatίon all services identified on the Scientology Classification,
Gradatίon and Awareness Chart, all courses, internships and crammίng ; the applicatίon of Scίentology Ethics and
]ustίce technology, which are both exclusίvely religίous components of the practίce of the Scientology religίon ; the
study and the applίcation of the prίncίples contained ίn the administrative wrίtίngs of LRH used withίn the Church; and
any and all other services or use of the technology of L. Ron Hubbard, wίthout limίtatίon , provίded to me by the
ministers or staff of the Church and all other Scientology churches and organizations.

e. Neither the Church nor any other Scientology church or organization which espouses, presents, propagates
or practices the Scientology religion makes any claim:

1. that the nature or purpose of Scientology, or of Dianetics, or of the writings and recorded spoken
words of LRH, is contraιy to what is stated in this Contract;

11. that the application of any Scientology or Dianetics technology or practice will have any particular
effect on me or any other person; or

111. that any particular result may be forthcoming from my participation ίn any Scientology Religious
Service. 1specifically acknowledge that 1have read and that 1understand Scientology Policy Directive 13 March
1996, Statements by Staff Members, which states clearly that if any individual staff member of any Scientology
church or organization makes any claims about the results which may be forthcoming from my participation ίη
any Scientology Religious Service, any such claims are the personal opinions and beliefs of that staff member
only, and are not claims made by the Church or any other Scientology church or organization. ~
3. 1have seen the film "Orientation" and 1am now informed and aware and fully understand that Scientology is a
religion, that its teachings are religious and that its claims are religious in nature. 1am further informed and aware and
fully understand that when 1participate in Scientology services, 1am participating ίn religious services under the
ecclesiastical principles of the Scientology religion. 1am also informed and aware and fully understand that the Church
and all other Scientology churches are separate, distinct legal corporations each independently operating and
responsible for its own corporate and ecclesiastical affairs.

4. This Contract is my commitment that 1desire to participate in Scientology Religious Services exclusively for
spiήtual purposes in accordance with the beliefs and practices of the Scientology religion. Scientology Religious
Services are designed to give spiritual aid, not medical treatment. However, the Scientology religion teaches that the
spiήt can be saved and that the spiήt alone may save or heal the body, and Scientology Religious Services are
intended to save the spirit. By signing this Contract, 1recognize, acknowledge and agree that:

a. Scientology Religious Services are not intended and are not used for diagnosing ailments of the body or for
engaging ίn the teaching or practice of any medical arts or sciences. C C_
b. It ίs exclusively my responsibility to see to my physical and medical well-being, and under no circumstance
does the Church or any other Scientology church or organization which espouses, presents, propagates or practices
the Scientology religion have any responsibility whatsoever ίn that regard. ..C.C-.
c. 1have not come to the Church, nor do 1seek to participate ίn Scientology Religious Services, solely to be
cured of any physical illness, ailment or condition. QG
d. While the registrar can assist me ίn arranging for a competent medical examination and appropriate
treatment by a qualified medical practitioner before 1participate in any Scientology Religious Services, it is solely my
responsibility to take whatever steps are necessaιy to demonstrate that 1have no diagnosable or medically treatable
illnesses, ailments, or conditions that are not under competent medical care before 1begin participating ίn any
Scientology Religious Service. Thereafter, any physical illness, ailment or condition 1may have that has been treated
medically may then be addressed spiritually by the application of the tenets of the Scientology religion, subject to the
terms of this Contract. -G.f;... .
e. Ι know that 1should not participate in any Scientology Religious Service if 1have a physical or mental
condition which might be aggravated or which might make my participation ίη the service uncomfortable or
distressful to me, and 1agree to accept and assume any and all known or unknown ήsks of injuιy, loss, or damage
resulting from my choices and decisions in that regard. ζJ2. .
f. Scientology Religious Service may entail the use of a religious artifact known as the
"E-Meter" for the purpose of locating and resolving problems and difficulties which are spiritual in nature. 1
understand that, by itself, the E-Meter does nothing, but serves only as a guide to Scientology ministers to assist
parishioners in locating areas of spiήtual distress or travail, and that it is not intended or effective for the diagnos~ )"
treatment or prevention of any disease, or for the improvement of health or any bodily function. ~V

g. Scientology ίs unalterably opposed, as a matter of religious belief, to the practice of psychiatιy, and
espouses as a religious belief that the study of the mind and the healing of mentally caused ills should not be
alienated from religion or condoned ίn nonreligious fields. 1am in full agreement with this religious belief. 1do not
believe in or subscribe to psychiatric labels for individuals. It is my strongly held religious belief that all mental
problems are spiritual in nature and that there is no such thing as a mentally incompetent person -- only those
suffeήng from spiήtual upset of one kind or another dramatizec\ by an individual. 1reject all psychiatήc labels and
intend for this Contract to dearly memoήalize my desire to be helped exdusiνely through religious, spiήtual means
and not through any form of psychiatric treatment, specifically including inνoluntaιy commitment based οη so-called
lack of competence. Under ηο drcumstances, at any time, do 1wish to be denied my ήght to care from members of
my religion to the exdusion of psychiatric care or psychiatήc directed care, regardless of what any psychiatήst,
medical person, designated member of the state or family member may assert supposedly οη my behalf. lf
drcumstances should eνer aήse ίη which goνernment, medical, or psychiatήc officials or personnel or family members
or friends attempt to compel or coerce or commit me for psychiatήc eνaluation, treatment or hospitalization, 1fully
desire and fully expect that the Church or Scientologists will intercede οη my behalf to oppose such efforts and/or
extήcate me from that predicament so my spiritual needs may be addressed ίη accordance with the tenets of the
Scientology religion free from psychiatric interνention. cC
5. This Contract memorializes my intention to partidpate ίη Scientology Religious Serνices on\y for purposes of self-
improνement and spiritual adνancement. By signing this Contract, 1recognize, acknowledge and agree that:

a. Achieνing the benefits and goals of the Scientology religion requires my dedicated partidpation, because
only through my own efforts can Ι achieνe those benefits and goals. C..C~
b. Before Ι go οη to any further serνice, ίt is essential that 1am completely satisfied with my expeήence with
my pήor serνice. While Sdentology ho\ds out the possibility of a better life through adherence to its beliefs and
practices, indiνidual spiήtual adνancement is not always an easy or comfortable task, and my success ίη Sdentology
ultimately depends οη my own ability, strength and determination to oνercome the shortcomings and harmful
patterns of my past. By agreeing to proceed with further serνices, 1acknowledge complete satisfaction with all
serνices 1haνe participated ίη preνiously. ~•

c. Νο Scientology church is under any duty or obligation whatsoeνer to return any portion of any religious
donation 1make. Howeνer, 1haνe read Scientology Policy Directiνe 13 March 1996, Return of Donations, and
understand that under certain drcumstances identified ίη published ecclesiastical polides such as that Sdentology
Policy Directiνe, a return of donations may be obtained through my stήct comp\iance with those published polides
and procedures relating to the Claims Veήfication Board. 1further understand, acknowledge and agree that:

1. such procedures require my direct partidpation to the exdusion of any third parties, induding, but not
limited to, attorneys;

11. returns of donations are exdusiνely within the ecdesiastical authoήty and sole discretion of the Claims
Verification Board;

111. any νiolation of, or deνiation from, such published polides by me νoids any possibility of my receiνing
a return of a donation; and

Ιν. should 1, at any time, eνer request a refund or repayment of donations, such refund or repayment will
be giνen if and only if 1haνe followed the exact procedures of the Claims Veήfication Board and this Contract, and
that ίη exchange for refund or repayment of such donations as determined by the Claims Veήfication Board, 1execute
a complete re\ease, quitdaim and waiνer of claims as proνided by an authorized Church representatiνe. ~.

d. Ιη connection with my participation ίη Sdentology Religious Serνices, the Church may compile a fo\der
containing its notations of my spiritual progress, known as a "Predear Folder" or "PC Folder, • as well as other
ecclesiastical files containing notations regarding my spiήtual progress. ΑΙΙ of my PC Fo\ders and other ecc\esiastical
files containing notations regarding my spiήtual progress, as well as al\ contents thereof, are the so\e and exdusiνe
property of Church of Sdentology lnternational. As a matter of religious belief and of ecc\esiastical doctήne and \aw,
such folders and files, and the contents of such fo\ders and files, are kept confidential from all persons who lack the
ecdesiastical authoήty to gain access to such mateήals, induding me, are subject to all applicable dergyman-penitent
pήνileges, and are neither comprehensible nor meant to be understood by anyone whose training and expertise ίη
their interpretation is not recognized and sanctioned by Church of Scientology lnternational.

1. As a condition of being accepted for partidpation ίη Scientology Religious Serνices, 1foreνer abandon,
suπender, waiνe, and relinquish without limitation any and all ήghts of ownership, possession, custocly, control,
access, copying, and viewing of my PC Folder or Folders and all other ecdesiastical files containing any notations
regarding my spiήtual progress, both with respect to the folders and files themselνes and the information
contained \η them.

11. The abandonment, surrender, waiνer, and relinquishment to which 1refer ίη the immediately preceding
subparagraph is unconditional and iπeνocable and applies equally to anyone acting or purporting to be acting οη
my behalf or for my benefit, whether 1am aliνe or dead, whether 1am disabled or incapacitated, and under any
and all circumstances foreseen or unforeseen, in perpetuity, without exception or limitation.

iii. Should 1or anyone acting or purporting to be acting on my behalf or for my benefit ever seek access to
any of my PC Folders or any other ecclesiastical file containing any notations regarding my spiritual progress, Ι
intend for the submission of this Contract to the presiding judicial officer to be a complete and sufficient basis for
the immediate denial of whatever access is being sought with prejudice to any other or further effort to breach
the absolute confidentiality of those materials or the exclusive right of Church of Scientology lnternational to
preserve their absolute confidentiality. ~

e. lt is both an unalterable religious belief and a matter of ecclesiastical custom of the Scientology religion that
my personal spiritual progress will be directed by a minister known as a Case Supervisor who determines which
Religious Services are appropriate for my personal spiritual progress and the sequence in which Ι will participate in
such Religious Services. As a matter of religious belief, 1aclmowledge that my Case Supervisor will mal<e the decisions
regarding the appropήate course of my spiritual progress, and 1will abide by the decisions and direction of my Case
Supervisor in guiding my spiritual progress. ΑΙΙ Religious Services in which 1participate hereafter at the direction of
my Case Supervisor are subject to the terms of this Contract.

6. This Contract memorializes my freely given consent to be bound exclusively by the discipline, faith, internal
organization, and ecclesiastical rule, custom, and law of the Scientology religion in all matters relating to Scientology
Religious Services, in all my dealings of any nature with the Church, and in all my dealings of any nature with any
other Scientology church or organization which espouses, presents, propagates or practices the Scientology religion.
By signing this Contract, 1recognize, acknowledge and agree that:

a. My freely given consent to be bound exclusively by the discipline, faith, internal organization, and
ecclesiastical rule, custom, and law of the Scientology religion ίn all matters relating to Scientology Religious Services,
in all my dealings of any nature with the Church, and in all my dealings of any nature with any other Scientology
chutch or organization which espouses, presents, propagates or practices the Scientology religion means that Ι am
forever abandoning, surrendering, waiving, and relinquishing my right to sue, or otherwise seek legal recourse with
respect to any dispute, claim or controversy against the Church, all other Scientology churches, all other organizations
which espouse, present, propagate or practice the Scientology religion, and all persons employed by any such entity
both ίn their personal and any official or representational capacities, regardless of the nature of the dispute, clai!Jl..OΓ(
controversy. (._,, •

b. The abandonment, surrender, waiver, and relinquishment to which 1refer in the immediately preceding
subparagraph ίs unconditional and irrevocable and applies equally to anyone acting or purporting to be acting on my
behalf or for my benefit, whether 1am alive or dead, whether 1am disabled or incapacitated, and under any and all
circumstances foreseen or unforeseen, in perpetuity, without exception or limitation. ~ •

c. Should 1or anyone acting or purporting to be acting on my behalf ever sue, or otherwise seek legal recourse
with respect to any dispute, claim or controversy against the Church, any other Scientology church, any other
organization which espouses, presents, propagates or practices the Scientology religion, or any person employed by
any such entity, regardless of the nature of the dispute, claim or controversy, 1intend for the submission of this
Contract to the presiding judicial officer to be a complete and sufficient basis for the immediate dismissal of any and
all such proceedings with prejudice to further proceedings of any kind. ~•
d. ln accordance with the discipline, faith, internal organization, and ecclesiastical rule, custom, and law of the
Scientology religion, and in accordance with the constitutional prohibitions which forbid governmental interference
with religious services or dispute resolution procedures, should any dispute, claim or controversy arise between me
and the Church, any other Scientology church, any other organization which espouses, presents, propagates or
practices the Scientology religion, or any person employed by any such entity, which cannot be resolved informally by
direct communication, 1will pursue resolution of that dispute, claim or controversy solely and exclusively through
Scientology's internal E.thics, justice and binding religious arbitration procedures, which include application to senior
ecclesiastical bodies, including, as necessaιy, final submission of the dispute to the lnternational justice Chief of the /"'
Mother Church of the Scientology religion, Church of Scientology lnternational ("IJC") or his or her designee. Δ.._Υ

e. Any dispute, claim or controversy which still remains unresolved after review by the IJC shall be submitted
to binding religious arbitration in accordance with the arbitration procedures of Church of Scientology lnternational,
which provide that:

Ι. 1will submit a request for arbitration to the IJC and to the person or entity with whom 1have the
dispute, claim or controversy;

11. in my request for arbitration, 1will designate one arbitrator to hear and resolve the matter;
111. within fifteen (15) days after receiving my request for arbitration, the person or entity with whom / have
the dispute, clairn or controversy will designate an arbitrator to hear and resolve the matter. If the person or
entity with whorn 1have the dispute, claim or controversy does not designate an arbitrator within that fifteen (15)
day peήod, then the I]C will designate the second arbitrator;

Ιν. the two arbitrators so designated will select a third arbitrator within fifteen (15) days after the
designation of the second arbitrator. lf the arbitrators are unable to designate a third arbitrator within the fifteen
(15) day period, then the IJC will choose the third arbitrator;

ν. consistent with my intention that the arbitration be conducted in accordance with Scientology
principles, and consistent with the ecclesiastical nature of the procedures and the dispute, claim or controversy
to which those procedures relate, it is my specific intention that all such arbitrators be Scientologists in good
standing with the Mother Church. Cζ

f, The Church and all other Scientology churches and organizations which espouse, present, propagate or
practice the Scientology religion are each separate, distinct legal corporations, and each such entity is independently
responsible for its own rnanagement and is independently responsible for its own corporate and ecclesiastical
affairs. bζ-.

7. This Contract is rny good faith application to participate in Scientology Religious Services. By signing this
Contract, 1promise, covenant, and represent that:

a. 1am applying to participate in Scientology Religious Services to achieve spiritual betterment because Ι truly
believe that persons can be helped to gain greater understanding and happiness in life. ~

b. 1am applying honestly and in good faith to derive all possible personal gain from Scientology Religious
Services. c,C,,.
c. 1have no record of being committed in an institution for mental or emotional disorders.

d. 1have no cήrninal record that includes a felony offense.

e. 1am not connected with any person, such as by maήtal or familial ties, of known antagonism to spiritual
treatment or to Scientology. _..ct:
f, Neither 1nor any member of my immediate family has ever sued, embarrassed or attacked, or threatened to
sue, embarrass or attack, Scientology. -bb_
g. 1am not atternpting to investigate Scientology as a representative of any news media, government agency
or entity, or any other organization, entity or person. ~

8. This Contract will become a legally binding agreement between me and the Church upon its acceptance by the
Church or upon my commencing my participation in a Scientology Religious Service, whichever occurs first. ln
determining whether to accept this Contract, 1acknowledge that the Church will rely on the acknowledgements,
agreements, representations and promises which 1have made herein.

9. As further consideration for the Church's permission for me to participate ίn Scientology Religious Services and
for me to use its facilities and other faάlities provided for such purposes:

a. 1, on behalf of rnyself 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 Church, the successors and assigns of L. Ron
Hubbard, Church ofSpiritual Technology, Religious Technology Center, the Church ofScientology lnternational, any
and all Scientology-affiliated churches, missions, corporations, associations, partnerships, trusts, religious orders or
organizations, or, in any and all capacities and as individuals, their officers, directors, trustees, agents, servants,
successors, heirs, executors or representatives, or the owners, rnanagers, employees, agents or representatives or
associates of, any facilities conducting Scientology Religious Services (hereinafter collectively "the Releasees") for any
physical, mental or emotional injury, property damage, or monetary loss resulting from negligence 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 Scientology Religious Services. Cb
b. 1further release and discharge the releasees in any and all capacities and as individuals from all actions,
claims or demands 1, my heirs, distributees, guardians, legal representatives or assigns now have or may hereafter
have for any physical, mental or emotional injury, property damage, or monetaιy loss resulting in any way from my
participation in Scientology Religious Services. [L(__, ,,,,
c. Ι further agree to indemnify and save and hold harmless the Releasees ίη any and all capacities and as
individuals, and each of them, from any loss, liability, damage or cost they may incur due to my participation ίη
Scientology Religious Services or due to my presence or action ίη or about the Church premises or the faciliti(--
providing such services. ~C..
d. Ι understand, acknowledge and agree that should any provision or provisions of this Contract be, for any
reason, unenforceable, the balance shall nonetheless be of full force and effect.

e. Ι further understand, acknowledge and agree that this Contract contains everything that the Church or
Church representatives and 1have addressed or discussed with respect to Scientology Religious Services, and that it
constitutes the sole and entire agreement which contains everything that 1have relied upon ίη applying to parte{e _
ίη Scientology Religious Services and supersedes any and all verbal discussions 1have had with anyone.

1HAVE CAREFULLY READ THIS CONTRACT AND FULLY UNDERSTAND ITS CONΠNTS AND CONSEQUENCES. 1
ALSO UNDERSTAND ΤΗΑΤ 1ΑΜ ΝΟΤ ELIGIBLE FOR ΑΝΥ SCIENTOLOGY RELIGIOUS SERVICES UNLESS 1SIGN THIS
CONTRACT. 1REAΠIRM ΤΗΑΤ 1WISH ΤΟ ΡΑRΠCΙΡΑΠ ΙΝ SCIENTOLOGY RELIGIOUS SERVICES AND ΤΗΑΤ THIS
CHOICE IS ΑΝ INDEPENDENT EXERCISE OF ΜΥ OWN FREE wιιι. 1FULLY UNDERSTAND ΤΗΑΤ ΒΥ SIGNING BELOW,
1ΑΜ FOREVER GMNG UP ΜΥ RIGHT ΤΟ SUE ΤΗΕ CHURCH, ITS STAFF AND ΑΝΥ OF ΤΗΕ HEREINABOVE
REΠRENCED RELEASEES FOR ΑΝΥ INJURY OR DAMAGE SUFFERED ΙΝ ΑΝΥ WAY CONNECΠD WITH SCIENTOLOGY
RELIGIOUS SERVICES .
1sign this Religious Services Enrollment Application, Agreement and General Release οη this _\_ day of
....::....4'-"L.!.....Δ<L---• 20~
intending to be legally bound by it, and request that 1be permitted to participate ίη
Sdentolo Rellgio~ Serν":es. ' ~

(SIGN~l~λ~
(Pήnted Full Name)

\.S\\ ~. \}J"κ-\1.e.ι~)\νf ikgb) ί,Α 1 Gι. OJ~8


(Home Address)

(SIGNATURE OF PARENT OR GUARDIAN, IF APPLICANT 15 Α MINOR)

(Printed Full Name)

(Home Address)

(SIGNATURE OF WΠNESS)

~ ΔJe
(Pήnted Full Name)
--
ίη reliance upo(fu
L day of
lf
Having reviewed the above Religious Services Enrollment Application, Agreement and General Release the Church,
itioned upon, the t t ful~(On:!ises, representations and agreements made therein, οη this
, 20QZsiccepts f' ι {} for participation ίη Scientology Religious Services.

CHURCHOFSCIENJΌLOGY C.e..&!~ ~
...... ~,//,)
By its: ~ ~vc
= (Title)

(SIGNATURE) ~ , L f;tl.Ad..ι!. Ak
Exhibit 10
t. 1, Ch( ';>S \ϊ:. (Q.,( (\{) \ \ ,recognize, acl<nowledge and agree that 1am exclusively
responsible for my present and future condition in life and for the choices and decisions 1make affecting my life. With
that in mind, and solely of my own volition and in the indepel).dent\exercise of my own free will, 1am voluntarily
signing and submitting to CHURCH OF SCIENTOLOGY L, L _ (hereinafter "the
Church") this RELIGIOUS SERVICES ENROLLMENT APPLICATION, AGREEMENT AND GENERAL RELEASE (hereinafter
"this Contract") so that, upon its acceptance by the Church , 1may participate in Religious Services of the Scientology
religion under the terms, conditions, covenants, waivers and releases 1agree to by signing this Contract.

2. This Contract is my statement of my personal, self-determined desire to participate in the Religious Services of
the Scientology religion . By signing this Contract, ι · recognize , acl<nowledge and agree that:

a. Scientology is a religion, the Church is a church of the Scientology religion, and all the services and activities
of the Scientology religion are exclusively religious in nature. _Q_
b. The Scientology religion is 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 'Ίmowing in the fullest sense
of the word," and the Greel< 'Ίogos," 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," meaning "through," and "nous," meaning "soul," and thus means "through soul. " ( _c._
c. The Founder of the Scientology religion is American author and philosopher L. Ron Hubbard (hereinafter
"LRH") , whose 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 . The writings and recorded spoken words
of LRH on the subjects of Scientology and Dianetics present a guide intended to assist persons to become more aware
of themselves as persons, restoring trust and respect for self and others. They are not a statement of claims by the
Church, by any other Scientology church or organization, or by LRH. _ς{___

d. The term "Religious Services," as used in this Contract, means and refers to the beliefs and practices set
forth in the writings and spol<en words of LRH on the subjects of Dianetics and Scientology published with the
identifying S and double triangle or Dianetics triangle symbol , and all services or application of the principles of Mr.
Hubbard provided to me by the ministers or staff of the Church and all other Scientology churches and organizations,
including without limitation: "auditing," which is Scientology's unique form of religious counseling encompassing all
services on the Scientology Classification, Gradation and Awareness Charts which includes, without limitation, all
levels, rundowns, grades, assists, reviews, repairs, seminars, co-audits; all Scientology congregational services of any
description; "training," which is the study of the scripture of the Scientology religion on the road to achieving spiritual
freedom and salvation and includes without limitation all services identified on the Scientology Classification ,
Gradation and Awareness Chart, all courses, internships and cramming; the application of Scientology·Ethics and
justice technology, which are both exclusively religious components of the practice of the Scientology religion; the
study and the application of the principles contained in the administrative writings of LRH used within the Church; and
any and all other services or use of the technology of L. Ron Hubbard, without limitation, provided to me by the
/

ministers or staff of the Church and all other Scientology churches and organizations.

e. Neither the Church nor any other Scientology church or organization which espouses, presents, propagates
or practices the Scientology religion mal<es any claim :

1. that the nature or purpose of Scientology, or of Dianetics, or of the writings and recorded spoken
words of LRH , is contrary to what is stated in this Contract;

ίί. that the application of any Scientology or Dianetics technology or practice will have any particular
effect on me or any other person; or

111. 'that any particular result may be forthcoming from my participation in any Scientology Religious
Service. l specifically aclrnowledge that l have read and that l understand Scientology Policy Directive 13 March
1996, Statements by Staff Members, which states clearly that if any individual staff member of any Scientology
church or organization makes any claims about the results which may be forthcoming from my participation in
any Scientology Religious Service, any such claims are the personal opinions and beliefs of that staff membe/
only, and are not claims made by the Church or any other Scientology church or organization. ~

3. l have seen the film 'Όrientation " and l am now informed and aware and fully understand that Scientology is a
religion, that its teachings are religious and that its claims are religious in nature. l am further informed and aware and
fully understand that when 1 participate in Scientology services, l am participating in religious services under the
ecclesiastical principles of the Scientology religion. 1am a\so informed and aware and fully understand that the Church
and all other Scientology churches are separate, distinct legal corporations each independently operating and
responsible for its own corporate and ecclesiastical affairs.

4. This Contract is my commitment that l desire to participate in Scientology Religious Services exclusively for
spiritual purposes in accordance with the beliefs and practices of the Scientology religion. Scientology Religious
Services are designed to give spiritual aid, not medical treatment. However, the Scientology religion teaches that the
spirit can be saved and that the spirit alone may save or hea\ the body, and Scientology Religious Services are
intended to save the spirit. By signing this Contract, 1recognize, aclrnowledge and agree that:

a. Scientology Religious Services are not intended and are not used for diagnosing ailments of the body or_for_
engaging in the teaching or practice of any medical arts or sciences. α
b. lt is exclusively my responsibility to see to my physical and medical well-being, and under no circumstance
does the Church or any other Scientology church or organization which espouses, presents, propagates or practices.
the Scientology religion have any responsibility whatsoever in that regard . {._,(

c. l have not come to the Church, nor do l seel<to participate in Scientology Religious Services, solely to be
cured of any physical illness, ailment or condition. ___LL.
d. While the registrar can assist me in arranging for a competent medical examination and appropriate
treatment by a qualified medical practitioner before l participate in any Scientology Religious Services, it is solely my
responsibility to take whatever steps are necessary to demonstrate that 1have no diagnosable or medically treatable
illnesses, ai\ments, or conditions that are not under competent medical care before 1begin participating in any
Scientology Re\igious Service. Thereafter, any physical illness, ailment or condition 1may have that has been treated
medically may then be addressed spiritually by the application of the tenets of the Scientology religion , subject to the _
terms of this Contract. CC.
e. l know that 1should not participate in any Scientology Re\igious Service if 1have a physical or mental
condition which might be aggravated or which might mal<e my participation in the service uncomfortable or
distressful to me, and Ι agree to accept and assume any and all l<nown or unlrnown risl<s of injury, loss, or damage
resulting from my choices and decisions in that regard. ~

f. Scientology Religious Service may entail the use of a religious artifact l<nown as the
'Έ-Meter" for the purpose of locating and resolving problems and difficulties which are spiritual in nature. 1
understand that, by itself, the E-Meter does nothing, but serves only as a guide to Scientology ministers to assist
parishioners in locating areas of spiritual distress or travai\ , and that it is not intended or effective for the diagnosis,
treatment or prevention of any disease, or for the improvement of hea\th or any bodi\y function. {,C ~

g. Scientology is unalterably opposed, as a matter of religious belief, to the practice of psychiatry, and
espouses as a religious belief that the study of the mind and the healing of mentally caused ills should not be
alienated from religion or condoned in nonreligious fields. 1am in full agreement with this religious belief. 1do not
believe in or subscribe to psychiatric labels for individuals. lt is my strongly held religious belief that all mental
problems are spiritual in nature and that there is no such thing as a mentally incompetent person -- only those
.. suffering fτom spiritual upset of one kind or another dramatized by an individual. 1reject all psychiatric labels and
intend for this Contract to clearly memorialize my desire to be helped exclusively through religious, spiritual means
and not through any form of psychiatric treatment, specifically including involuntary commitment based on so-called
lacl< of competence. Uήder no circumstances, at any time, do 1wish to be denied my right to care fτom members of
my religion to the exclusion of psychiatric care or psychiatric directed care, regardless of what any psychiatrist,
medical person, designated member of the state or family member may assert supposedly on my behalf. lf
circumstances should ever arise in which government, medical, or psychiatric officials or personnel or family members
or fτiends attempt to compel or coerce or commit me for psychiatric evaluation, treatment or hospitalization, 1fully
desire and fully expect that the Church or Scientologists will intercede on my behalf to oppose such efforts and/or
extricate me fτom that predicament so my spiritual needs may be addressed in accordance with the tenets of the
Scientology religion fτee fτom psychiatric intervention. C. C
5. This Contract memorializes my intention to participate in Scientology Religious Services only for purposes of self-
improvement and spiritual advancement. By signing this Contract, 1recognize, acknowledge and agree that:

a. Achieving the benefits and goals of the Scientology religion requires my dedicated participation, because
only through my own efforts can 1achieve those benefits and goals. U
b. Before Ι go on to any further service, ίt is essential that 1am completely satisfied with my experience with
my prior service. While Scientology holds out the possibility of a better life through adherence to its beliefs and
practices, individual spiritual advancement is not always an easy or comfortable tasl<, and my success in Scientology
ultimately depends on my own ability, strength and determination to overcome the shortcomings and harmful
patterns of my past. By agreeing to proceed with further services, 1acl<nowledge complete satisfaction with all _
services 1have participated in previously. LC..
c. Νο Scientology church is under any duty or obligation whatsoever to return any portion of any religious
donation 1mal<e. However, 1have read Scientology Policy Directive 13 March 1996, Return of Donations, and
understand that under certain circumstances identified in published ecclesiastical policies such as that Scientology
Policy Directive, a return of donations may be obtained through my strict compliance with those published policies
and procedures relating to the Claims Verification Board. 1further understand, acl<nowledge and agree that:

ί. such procedures require my direct participation to the exclusion of any third parties, including, but not
limited to, attorneys;

ίί. returns of donations are exclusively within the ecclesiastical authority and sole discretion of the Claims
Verification Board;

ίίί. any violation of, or deviation from, such published policies by me voids any possibility of my receiving
a return of a donation; and

iν. should 1, at any time, ever request a refund or repayment of donations, such refund or repayment will
be given if and only if 1have followed the exact procedures of the Claims Verification Board and this Contract, and
that in exchange for refund or repayment of such donations as determined by the Claims Verification Board , 1execute
a complete release, quitclaim and waiver of claims as provided by an authorized Church representative. Cλ

d. ln connection with my participation in Scientology Religious Services, the Church may compile a folder
containing its notations of my spiritual progress, known as a "Preclear Folder" or "PC Folder," as well as other
ecclesiastical files containing notations regarding my spiritual progress. ΑΙΙ of my PC Folders and other ecclesiastical
files containing notations regarding my spiritual progress, as well as all contents thereof, are the sole and exclusive
property of Church of Scientology lnternational. As a matter of religious belief and of ecclesiastical doctrine and law,
such folders and files, and the contents of such folders and files, are l<ept confidential fτom all persons who lacl< the
ecclesiastical authority to gain access to such materials, including me, are subject to all applicable clergyman-penitent
privileges, and are neither comprehensible nor meant to be understood by anyone whose training and expertise in
their interpretation is not recognized and sanctioned by Church of Scientology lnternational.

ί. As a condition of being accepted for participation in Scientology Religious Services, 1forever abandon,
surrender, waive, and relinquish without limitation any and all rights of ownership, possession, custody, control ,
access, copying, and viewing of my PC Folder or Folders and all other ecclesiastical files containing any notations
regarding my spiritual progress, both with respect to the folders and files themselves and the information
contained in them .

ί ί. The abandonment, surrender, waiver, and relinquishment to which 1refer in the immediately preceding
subparagraph is unconditional and irrevocable and applies equally to anyone acting or purporting to be acting on
my behalf or for my benefit, whether 1am alive or dead, whether 1am disabled or incapacitated, and under any
and all circumstances foreseen or unforeseen, in perpetuity, without exception or limitation.
., .
111. Should 1or anyone acting or purporting to be acting on my behalf or for my benefit ever seek access to
any of my PC Folders or any other ecclesiastical file containing any notations regarding my spiritual progress, Ι
intend for the submission of this Contract to the presiding judicial officer to be a complete and sufficient basis for
the immediate denial of whatever access is being sought with prejudice to any other or further effort to breach
the absolute confidentiality of those materials or the exclusive right of Church of Scientology lnternational to
preserve their absolute confidentiality. Cg_
e. Ιt is both an unalterable religious belief and a matter of ecclesiastical custom of the Scientology religion that
my personal spiritual progress will be directed by a minister known as a Case Supervisor who determines which
Religious Services are appropriate for my personal spiritual progress and the sequence in which \ will participate in
such Religious Services. As a matter of religious belief, 1acknowledge that my Case Supervisor will make the decisions
regarding the appropriate course of my spiritual progress, and 1will abide by the decisions and direction of my Case
Supervisor in guiding my spiritual progress. ΑΙΙ Religious Services in which 1participate hereafter at the direction of
my Case Supervisor are subject to the terms of this Contract.

6. This Contract memorializes my freely given consent to be bound exclusively by the discipline, faith, internal
organization, and ecclesiastical rule, custom, and law of the Scientology religion in all matters relating to Scientology
Religious Services, in all my dealings of any nature with the Church, and in all my dealings of any nature with any
other Scientology church or organization which espouses, presents, propagates or practices the Scientology religion .
By signing this Contract, 1recognize, acl<nowledge and agree that:

a. My freely given consent to be bound exclusively by the discipline, faith , internal organization, and
ecclesiastical rule, custom , and law of the Scientology religion in all matters relating to Scientology Religious Services,
in all my dealings of any nature with the Church, and in all my dealings of any nature with any other Scientology
church or organization which espouses, presents, propagates or practices the Scientology religion means that 1am
forever abandoning, surrendering, waiving, and relinquishing my right to sue, or otherwise seel< legal recourse with
respect to any dispute, claim or controversy against the Church, all other Scientology churches, all other organizations
which espouse, present, propagate or practice the Scientology religion , and all persons employed by any such entity
both in their personal and any official or representational capacities, regardless of the nature of the dispute, claim ο/ _
controversy. "----!'
-
b. The abandonment, surrender, waiver, and relinquishment to which 1refer in the immediately preceding
subparagraph is unconditional and irrevocable and applies equally to anyone acting or purporting to be acting on my
behalf or for my benefit, whether 1am alive or dead, whether 1am disabled or incapacitated , and under any and all
circumstances foreseen or unforeseen, in perpetuity, without exception or limitation. t..-.(_
c. Should 1or anyone acting or purporting to be acting on my behalf ever sue, or otherwise seel< legal recourse
with respect to any dispute, claim or controversy against the Church, any other Scientology church, any other
organization which espouses, presents, propagates or practices the Scientology religion , or any person employed by
any such entity, regardless of the nature of the dispute, claim or controversy, 1intend for the submission of this
Contract to the·presiding judicial officer to be a complete and sufficient basis for the immediate dismissal of any and
all such proceedings with prejudice to further proceedings of any l<ind. {_,,{

d. ln accordance with the discipline, faith, internal organization, and ecclesiastical rule, custom, and law of the
Scientology religion, and in accordance with the constitutional prohibitions which forbid governmental interference
wi th religious services or dispute resolution procedures, should any dispute, claim or controversy arise between me
and the Church, any other Scientology church, any other organization which espouses, presents, propagates or
practices the Scientology religion, or any person employed by any such entity, which cannot be resolved informally by
direct communication, Ι will pursue resolution of that dispute, claim or controversy solely and exclusively through
Scientology's internal Ethics, justice and binding religious arbitration procedures, which include application to senior
ecclesiastical bodies, including, as necessary, final submission of the dispute to the lnternational justice Chief of the ,
Mother Church of the Scientology religion, Church of Scientology lnternational (" IJC") or his or her designee. ~

e. Any dispute, claim or controversy which still remains unresolved after review by the IJC shall be submitted
to binding religious arbitration in accordance with the arbitration procedures of Church of Scientology lnternational,
which provide that:

ί. 1will submit a request for arbitration to the IJC and to the person or entity with whom 1 have the
dispute, claim or controversy;

ίί. in my request for arbitration, 1will designate one arbitrator to hear and resolve the matter;
ili. within fifteen ( 15) days after receiving my request for arbitration, the person or entity with whom 1have
the dispute, claim or controversy will designate an arbitrator to hear and resolve the matter. lf the person or
entity with whom 1have the dispute, claim or controversy does not designate an arbitrator within that fifteen ( 15)
day period, then the Ι]C will designate the second arbitrator;

ίν. the two arbitrators so designated will select a third arbitrator within fifteen ( 15) days after the
designation of the second arbitrator. lf the arbitrators are unable to designate a third arbitrator within the fifteen
(15) day period, then the l]C will choose the third arbitrator;

ν. consistent with my intention that the arbitration be conducted in accordance with Scientology
principles, and consistent with the ecclesiastical nature of the procedures and the dispute, claim or controversy
to which those procedures relate, ίt is my specific intention that all such arbitrators be Scientologists in good >J
standing with the Mother Church. Cf!..__
f. The Church and all other Scientology churches and organizations which espouse, present, propagate or
practice the Scientology religion are each separate, distinct legal corporations, and each such entity is independently
responsible for its own management and is independently responsible for its own corporate and ecclesiastical
affairs. ~
7. This Contract is my good faith application to participate in Scientology Religious Services. By signing this
Contract, 1promise, covenant, and represent that:

a. 1am applying to participate in Scientology Religious Services to achieve spiritual betterment because 1 truly
believe that persons can be helped to gain greater understanding and happiness in life. G(_
b. 1am applying honestly and in good faith to derive all possible personal gain from Scientology Religious / ·•
Services. '-<:_

c. 1have no record of being committed in an institution for mental or emotional disorders.

d. 1have no criminal record that includes a felony offense.

e. 1am not connected with any person, such as by marital or familial ties, of l<nown antagonism to spiritual
treatment or to Scientology. ~

f. Neither 1nor any member of my immediate family has ever sued, embarrassed or attacked, or threatened to
sue, embarrass or attacl<, Scientology. -b6.
g. 1am not attempting to investigate Scientology as a representative of any news media, government agency
or entity, or any other organization, entity or person. ~

8. This Contract will become a legally binding agreement between me and the Church upon its acceptance by the
Church or upon my commencing my participation in a Scientology Religious Service, whichever occurs first. ln
determining whether to accept this Contract, 1acl<nowledge that the Church will rely on the acknowledgements,
agreements, representations and promises which 1have made herein.

9. As fυrther consideration for the Church's permission for me to participate in Scientology Religious Services and
for me to use its facilities and other facilities provided for such purposes:

a. 1, on behalf of myself and on behalf of my heirs, distributees, legal representatives and assigns, agree not to
mal<e claims against, sue, attach the property of, or prosecute the Church, the successors and assigns of L. Ron
Hubbard, Church of Spiritual Technology, Religious Technology Center, the Church of Scientology lnternational, any
and all Scientology-affiliated churches, missions, corporations, associations, partnerships, trusts, religious orders or
organizations, or, in any and all capacities and as individuals, their officers, directors, trustees, agents, servants,
successors, heirs, executors or representatives, or the owners, managers, employees, agents or representatives or
associates of, any facilities conducting Scientology Religious Services (hereinafter collectively "the Releasees") for any
physical , mental or emotional injury, property damage, or monetary loss resulting from negligence 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 Scientology Religious Services. ~

b. 1fυrther release and discharge the releasees in any and all capacities and as individuals from all actions,
claims or demands 1, my heirs, distributees, guardians, legal representatives or assigns now have or may hereafter
have for any physical, mental or emotional injury, property damage, or monetary loss resulting in any way from my ,
participation in Scientology Religious Services. . ~
c. l further agree to indemnify and save and hold harmless the Releasees in any and all capacities and as
individuals, and each of them, from any loss, liability, damage or cost they may incur due to my participation ίn
Scientology Religious Services or due to my presence or action ίn or about the Church premises or the facilίtίes ,
providίng such services. -Lf:-
d. 1understand, acl<nowledge and agree that should any provision or provisions of this Contract be, for any
reason, unenforceable, the balance shall nonetheless be of full force and effect.

e. l further understand, acknowledge and agree that thίs Contract contains eveιything that the Church or
Church representatives and 1have addressed or discussed with respect to Scientology Religious Services, and that ίt
constitutes the sole and entire agreement which contains eveιything that l have relied upon ίn applying to participate
in Scientology Religious Services and supersedes any and all verbal discussions l have had with anyone. ( / {__..

1HAVE CARIFULLY READ THIS CONTRACT AND FULLY UNDERSτAND ιτs CΟΝΠΝτS AND CONSEQUENCES:I
ALSO UNDERSτAND τΗΑτ 1ΑΜ ΝΟτ ELIGIBLE FOR ΑΝΥ SCIENτOLOGY RELIGIOUS SERVICES UNLESS 1SIGN τΗΙS
CONτRACT. 1RIAFFIRM τΗΑτ 1WISH το PARTICIPAΠ ΙΝ SCIENτOLOGY RELIGIOUS SERVICES AND ΤΗΑτ τuιs
CHOICE IS ΑΝ INDEPENDENτ EXERCISE OF ΜΥ OWN FRIE WILL. 1FULLY UNDERSτAND ΤΗΑτ ΒΥ SIGNING BELOW,
1 ΑΜ FOREVER GIVING UP ΜΥ RIGHτ το SUE ΤΗΕ CHURCH, ιτs sτΑΠ AND ΑΝΥ OF ΤΗΕ HEREINABOVE
REΠRENCED RILEASEES FOR ΑΝΥ INJURY OR DAMAGE SUFFERID ΙΝ ΑΝΥ WAY CONNECTED WITH SCIENτOLOGY
RILIGIOUS SERVICES •

_Ι ,stgn this Religious Services Enrollment Application , Agreement and General Release on this l.:Jctay of
tJΩ Vf,11'\.\?e( , 2~ intending to be legally bound by it, and request that l be permitted to participate ίn

Sden~~~~
(SIGNA OF APPLICANT)

C"'vι»si=CJ Clλr ®' \


(Printed Full Name)
)>')15 ~k: n A\-e__
(Home Address)
.lo':> futΛ~lp_) U-ι . ~ ~"\
(SIGNATURE or PARENToR 6uARDIAN, ιr APPLΙCANT ιs Α MINOR)

(Prίnted Full Name)

(Home Address)

(SIGNATURE OF WΠNESS)

(Printed Full Name)

Having reviewed the above Religious Services Enrollment Application, Agreement and General Release the Church,
in reliance upon, and conditioned upon, the truthful promises, representations and agreements made therein, on this
_ day of , 20_, accepts for participation in Scientology Religious Services.

CHURCH OF SCIENTOLOGY _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
By its:_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
(fitle)
(SIGNATURE) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Exhibit 11
e/MMX>e^

1. I. CKt'SS'M Cjxrnt 11 _, recognize, aciaiowledge and agree that I am exclusively


responsible for my present and future condition in life and for the choices and decisions 1 make affecting my life. With
that in mind, and solely of my own volition and in the independent exercise of my own free will, 1 am voluntarily
signing and submitting to CHURCH OF SCIENTOLOGY Cl <-- (hereinafter "the
Church") this RELIQOUS SERVICES ENROLLMENT APPLICATION, AGREEMENT AND GENERAL RELEASE (hereinafter
"this Contract") so that, upon its acceptance by the Church, I may participate in Religious Services of the Scientology
religion under the terms, conditions, covenants, waivers and releases I agree to by signing this Contract.

2. This Contract is my statement of my personal, self-determined desire to participate in the Religious Services of
the Scientology religion. By signing this Contract, 1 recognize, acknowledge and agree that:

a. Scientology is a religion, the Church is a church of the Scientology religion, and all the services and activities
of the Scientology religion are exclusively religious in nature.
'—c—
b. The Scientology religion is 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 flillest 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," meaning "through," and "nous," meaning "soul," and thus means "through soul."
c. The Founder of the Scientology religion is American author and philosopher L. Ron Hubbard (hereinafter
"LRH"), whose 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. The writings and recorded spoken words
of LRH on the subjects of Scientology and Dianetics present a guide intended to assist persons to become more aware
of themselves as persons, restoring tmst and respect for self and others. They are not a statement of claims by the
Church, by any other Scientology church or organization, or by LRH,

d. The term "Religious Services," as used in this Contract, means and refers to the beliefe and practices set
forth in the writings and spoken words of LRH on the subjects of Dianetics and Scientology published with the
identifying S and double triangle or Dianetics triangle symbol, and all services or application of the principles of A/lr.
Hubbard provided to me by the ministers or staff of the Church and all other Scientology churches and organizations,
including without limitation: "auditing," which is Scientology's unique form of religious counseling encompassing all
sen/ices on the Scientology Classification, Gradation and Awareness Charts which includes, without limitation, all
levels, rundowns, grades, assists, reviews, repairs, seminars, co-audits; ail Scientology congregational services of any
description; "training," which is the study of the scripture of the Scientology religion on the road to achieving spiritual
freedom and salvation and includes without limitation all services identified on the Sdentoiogy Classification,
Gradation and Awareness Chart, all courses. Internships and cramming; the application of Scientology Ethics and
Justice technology, which are both exclusively religious components of the practice of the Scientology religion; the
study and the application of the principles contained in the administrative writings of LRH used within the Church; and
any and all other services or use of the technology of L. Ron Hubbard, without limitation, provided to me by the
ministers or staff of the Qiurch and ail other Scientology churches and organizations.

e. Neither the Church nor any other Scientology church or organization which espouses, presents, propagates
or practices the Scientology religion makes any claim:

i. that the nature or purpose of Scientology, or of Dianetics, or ofthe writings and recorded spoken
words of LRH, is contrary to what is stated in this Contract;

ii. that the application of any Scientology or Dianetics technology or practice will have any particular
effect on me or any other person; or
ill. that any particular result may be forthcoming from my participation in any Scientology Religious
Service. 1 specifically acknowledge that 1 have read and that I understand Scientology Policy Directive 13 March
1996, Statements by Staff Members, which states clearly that if any individual staff member of any Scientology
church or organization makes any claims about the results which may be forthcoming from my participation in
any Scientology Religious Service, any such claims are the personal opinions and beliefe of that staff member
only, and are not claims made by the Church or any other Scientology church or organization. U
3. I have seen the film "Orientation" and I am now informed and aware and folly understand that Scientology is a
religion, that its teachings are religious and that its claims are religious in nature. I am further informed and aware and
folly understand that when I participate In Scientology services, I am participating in religious services under the
ecclesiastical principles of the Scientology religion. I am also informed and aware and fully understand that the Church
and all other ^entology churches are separate, distinct legal corporations each Independently operating and
responsible for its own corporate and ecclesiastical affairs.
4. This Contract is my commitment that I desire to participate in Scientology Religious Services exclusively for
spiritual purposes In accordance with the beliefs and practices of the Scientology religion. Scientology Religious
Services are designed to give spiritual aid, not medick treatment. However,the Scientology religion teaches that the
spirit can be saved and that the spirit alone may save or heal the bocfy, and Scientology Religious Services are
intended to save the spirit. By signing this Contract, I recognize, acknowledge and agree that:
a. Scientology Religious Services are not intended and are not used for diagnosing ailments ofthe body or for
engaging in the teaching or practice of any medical arts or sciences.

b. It is exclusively my responslbllify to see to my physical and medical well-being, and under no circumstance
does the Church or any other Scientology church or organization which espouses, presents, propagates or practices
the Scientology religion have any responsibility whatsoever in that regard.
c. I have not come to the Church, nor do I seek to participate in Scientology Religious Services,solely to be
cured ofany physical illness, ailment or condition. C.

d. While the registrar can assist me in arranging for a competent medical examination and appropriate
treatment by a qualified medical practitioner before 1 participate in any Scientology Religious Services, it is solely my
responsibility to take whatever steps are necessary to demonstrate that I have no diagnosable or medically treatable
illnesses, ailments, or conditions that are not under competent medical care before I begin participating in any
Scientology Religious Service. Thereafter, any physical Illness, ailment or condition 1 may have that has been treated
medically may then be addressed spiritually by the application ofthe tenets of the Scientology religion, subject to the
terms of this Contract. C

e. I know that I should not participate in any Scientology Religious Service If I have a physical or mental
condition which might be aggravated or which might make my participation in the service uncomfortable or
distressful to me,and I agree to accept and assume any and all known or unknown risks ofinjury, loss, or damage
resulting from my choices and decisions in that regard.
f. Scientology Religious Service may entail the use ofa religious artifact known as the
"E-Meter" for the purpose oflocating and resolving problems and difficulties which are spiritual in nature. I
understand that, by itself, the E-Meter does nothing, but serves onty as a guide to Scientology ministers to assist
parishioners in locating areas ofspiritual 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.
g. Scientology is unalterably opposed,as a matter of religious belief, to the practice of psychiatry, and
espouses as a religious beliefthat the study ofthe mind and the healing of mentally caused ills should not be
alienated from religion or condoned in nonreilgious fields.!am in full agreement with this religious belief. I do not
believe in or subscribe to psychiatric labels for individuals. It is my strongly held religious belief that all mental
problems are spiritual in nature and that there is no such thing as a mentally incompetent person ~ only those
suffering from spiritual upset of one kind or another dramatized ty an Individual. I reject all psychiatric labels and
Intend for this Contract to deady memorialize my desire to be helped exdush/ely through religious, spiritual means
and not through any form of psychiatric treatment, speciflcal^ Indudlng Involuntaiy commitment based on so<alled
lack ofcompetence. Under no drcumstances, at any time, do 1 wish to be denied my right to care from members of
my religion to the exdusion of psychiatric care or psychiatric directed care, r^ardless of what any psychiatrist,
medical person,designated member of the state or femlly member may assert supposedly on my behalf. If
drcumstances should ever arise In which government, medical, or psychiatric ofhdals or personnel or family members
or friends attempt to compel or coerce or commit me for psychiatric evaluation, treatment or hospltallzatlon, 1 fiilly
desire and folly expect that the Church or Sdentologlsts will Intercede on my behalf to oppose such efforts and/or
extricate me from that predicament so my spiritual needs may be addressed In accordance with the tenets of the
Sdentology religion free from psychiatric Intervention. ^I
5. This Contract memorializes my Intention to partldpate In Sdentology Religious Services only for purposes of self-
Improvement and spiritual advancement. By signing this Contract, 1 recognize, acknowledge and agree that:
a. Achieving the benefits and goals ofthe Sdentology religion requires my dedicated partldpatlon, becau^ ^
only through my own efforts can 1 achieve those benefits and goals. /(
b. Before 1 go on to any further service. It Is essential that 1 am completely satisfied with my experience with
my prior service. While Sdentology holds out the possibility of a better life through adherence to Its beliefs and
practices. Individual spiritual advancement Is not always an ea^ or comfortable task, and my success In Sdentology
ultimately depends on my own ablllly, strength and determination to overcome the shortcomings and harmful
patterns of my past. By agreeing to proceed with further services, 1 acknowledge complete satisfaction with all
sen/Ices 1 have partldpated In previously. /
c No Sdentology church Is under any duly or obligation whatsoever to return any portion of any religious
donation I make. However, 1 have read Sdentology Policy Directive 13 A/larch 1996, Retum of Donations, and
understand that under certain drcumstances Identified In published ecdesiastlcal polldes such as that Sdentology
Policy Directive, a retum of donations may be obtained through my strict compliance with those published polldes
and procedures relating to the Claims Verification Board. 1 further understand, acknowledge and agree that:
i. such procedures require my direct partldpatlon to the exdusion of any third parties, Indudlng, but not
limited to, attorneys;

li. returns of donations are exduslvely within the ecclesiastical authority and sole dlsaetlon of the Claims
Verification Board;

III. any violation of, or deviation from,such published polldes ly me voids any possibility of my receiving
a return of a donation; and

Iv. should 1, at any time, ever request a refund or repayment of donations,such refond or repayment will
be given if and only If 1 have followed the exact procedures of the Clcdms Verification Board and this Contract, and
that in exchange for refond or repayment ofsuch donations as determined by the Oalms Verification Board, 1 execute
a complete release, qultdalm and waiver of dalms as provided by an authorized Church representative.
d. In connection with my partldpatlon In Sdentology Religious Services, the Church may compile a folder
containing Its notations of my spiritual progress, known as a "Predear Folder" or "PC Folder," as well as other
ecdesiastlcal files containing notations regarding my spiritual progress. All of my PC Folders and other ecdesiastlcal
files containing notations regarding my spiritual progress, as well as all contents thereof, are the sole and exduslve
property of Church of Sdentology Intematlonal. As a matter of religious belief and of ecdesiastlcal doctrine and law,
such folders and files, and the contents of such folders and files, are kept confidential from all persons who lack the
ecdesiastlcal authority to gain access to such materials, Indudlng me,are subject to all applicable dergyman-penltent
privileges, and are neither comprehensible nor meant to be understood by anyone whose training and expertise In
their Interpretation Is not recognized and sanctioned by Church ofSdentology Intematlonal.
i. As a condition of being accepted for partldpatlon In Sdentology Religious Services, 1 forever abandon,
surrender, waive, and relinquish without limitation any and all rights of ownership, possession, custocty, control,
access, copying, and viewing of my PC Folder or Folders and ail other ecdesiastlcal files containing any notations
regarding my spiritual progress, both with respect to the folders and files themselves and the Information
contained In them.

II. The abandonment,surrender, waiver,and rellnqulshment to which 1 refer In the Immediately preceding
subparagraph Is unconditional and Irrevocable and applies equally to anyone acting or purporting to be acting on
my behalf or for my benefit, whether 1 am alive or dead, whether I am disabled or incapadtated, and under any
and all drcumstances foreseen or unforeseen, in perpetuity, without exception or limitation.
ill. Should I or anyone acting or purporting to be acting on my behalf or for my benefit ever seek arrp«;«; to
any of my PC Folders or any other ecclesiastical file containing any notations regarding my spiritual progress, 1
intend for the submission of this Contract to the presiding judicial officer to be a complete and sufficient basis for
the Immediate denial of whatever access Is being sought with prejudice to any other or llirther effort to breach
the absolute confidentiality ofthose materials or the exclusive right of Church ofScientology international to
preserve their absolute confidentiality. /
—■ L,
e. It Is both an unalterable religious belief and a matter of ecclesiastical custom of the Scientology religion that
my personal spiritual progress will be directed by a minister known as a Case Supervisor who determines which
Religious Services are appropriate for my personal spiritual progress and the sequence In which I will participate In
such Religious Services. As a matter of religious belief, I acknowledge that my Case Supervisor will make the decisions
regarding the appropriate course of my spiritual progress, and I will abide by the decisions and direction of my Case
Supervisor In guiding my spiritual progress. All Religious Services In which I participate hereafter at the direction of
my Case Supervisor are subject to the terms of this Contract.
6. This Contract memorializes my Ireely given consent to be bound exclusively by the discipline, faith. Internal
organization, and ecclesiastical rule, custom, and law of the Scientology religion In all matters relating to Scientology
Religious Services, In all my dealings of any nature with the Church, and in all my dealings of any nature with any
other Scientology church or organization which espouses, presents, propagates or practices the Scientology religion.
By signing this Contract, I recognize, acknowledge and agree that:
a. My freely given consent to be bound exclusively by the discipline, faith. Internal organization, and
ecclesiastical rule, custom, and law of the Scientology religion In all matters relating to Scientology Religious Services,
In all my dealings of any nature with the Church, and In all my dealings of any nature with any other Scientology
church or organization which espouses, presents, propagates or practices the Scientology religion means that 1 am
forever abandoning, surrendering, waiving, and relinquishing my right to sue, or otherwise seek legal recourse with
respect to any dispute, claim or controverty against the Church, all other Scientology churches, all other organizations
which espouse, present, propagate or practice the Scientology religion, and all persons employed by any such entity
both In their personal and any official or representational capacities, regardless of the nature of the dispute, claim or
controvert. r y
b. The abandonment, sunender, waiver, and relinqulshment to which 1 refer In the immediately preceding
subparagraph Is unconditional and irrevocable and applies equally to anyone acting or purporting to be acting on my
behalf or for my benefit, whether I am alive or dead, whether I am disabled or Incapacitated, and under any and all
circumstances foreseen or unforeseen. In perpetuity, without exception or limitation. C^ C_^
c. Should I or anyone acting or purporting to be acting on my behalf ever sue, or otherwise seek legal recourse
with respect to any dispute, claim or controversy against the Qiurch, any other Scientology church, any other
organization which espouses, presents, propagates or practices the Scientology religion, or any person employed by
any such entity, regardless of the nature of the dispute, claim or controvetty, I Intend for the submission of this
Contract to the preslding judicial officer to be a complete and sufficient basis for the Immediate dismissal of any and
all such proceedings with prejudice to further proceedings of any kind. ^y
d. In accordance with the discipline, faith. Internal organization, and ecclesiastical rule, custom, and law of the
Scientology religion, and In accordance with the constitutional prohibitions which forbid governmental Interference
with religious services or dispute resolution procedures, should any dispute, claim or controvettyr arise between me
and the Church, any other Scientology church, any other organization which espouses, presents, propagates or
practices the Scientology religion, or any person employed by any such entity, which cannot be resolved Informally by
direct cominunlcatlon, 1 v^ll pursue resolution of that dispute, daim or controvert solely and «duslvely through
Sdentology s Internal Ethics, justice and binding religious arbitration procedures, which Indude application to senior
ecdeslastlcal bodies, Induding, as necessary, final submission of the dispute to the International justice Chief of the •
Mother Church of the Sdentology religion. Church of Sdentology International ("IjC") or his or her deslgnee. / (_
e. Any dispute, dalm or controverty which still remains unresolved after review by the IjC shall be submitted
to binding religious arbitration In accordance with the arbitration procedures of Church of Sdentology International
which provide that:

I. 1 will submit a request for arbitration to the IjC and to the person or entity with whom 1 have the
dispute, dalm or controversy;
II. In my request for arbitration, 1 will designate one arbitrator to hear and resolve the matter;
IM. witWn fifteen (15)days after receiving my request for arbitration, the peison or entity with whom I have
the dispute, cialm or controverqr will designate an arbitrator to hear and resoive the matter. If the peison or
entity wth whom I have the dispute, claim or controvert does not designate an arbitrator within that fifteen (15)
day period, then the iJC will designate the second arbitrator;
Iv. the two arbitrators so designated will select a third arbitrator within fifteen(15)days after the
designation ofthe second arbitrator. If the arbitrators are unable to designate a third arbitrator within the fifteen
(15)day period, then the IJC will choose the third arbitrator;
V. consistent with my intention that the arbitration be conducted in accordance with Scientology
principles, and consistent with the ecclesiastical nature ofthe procedures and the dispute, daim or controversy
to which those procedures relate, it Is my spedflc Intention that all such arbitrators be Sdentologists in good
standing with the Mother Church. 2^^
ft The Church and aii other Sdentoiogy churches and organizations which espouse, present, propagate or
practice the Sdentoiogy religion are each separate, distinct legal corporations, and each such entity is independently
responsible for its own management and is independently responsible for its own corporate and ecdesiastical
Ate. jj_
7. This Contract is my good faith application to partldpate in Sdentoiogy Religious Services. By signing this
Contract, 1 promise, covenant,and represent that:
a. 1 am applying to partldpate in Sdentoiogy Religious Services to achieve spiritual betterment because 1 tmly
believe that persons can be helped to gain greater understanding and happiness In life. ^^
b. I am applying honestly and in good faith to derive all possible personal gain from Sdentoiogy Religious
Services. ^,
c I have no record of being committed In an institution for mental or emotional disorders.

d. 1 have no criminal record that Indudes a felony offense. ^^


e. 1 am not connected with any person,such as by marital or familial ties, of known antagonism to spiritual
treatment or to Sdentoiogy. CJ^
f. Neither 1 nor ar^ member of my Immediate femily has ever sued, embarrassed or attacked, or threatened to
sue, embarrass or attack, Sdentoiogy. ^(
g. ~ 1 am not attempting to investigate Sdentoiogy as a representative ofany news media,government agency
or entity, or any other organization, entity or person. /
8. This Contract will become a legally binding agreement between me and the Church upon Its acceptance b^e
Church or upon my commendng my partldpratlon In a Sdentoiogy Religious Service, whichever occurs first. In
determining whether to accept this Contract, 1 acknowledge that the Church will rely on the acknowledgements,
agreements, representations and promises which I have made herein.

9. As further consideration for the Church's permission for me to partldpate in Sdentoiogy Religious Services and
for me to use Its fedlitles and other fadlltles provided for such purposes:
a. I, on behalf of myselfand on behalfof my heirs, distributees, legal representatives and assigns, agree not to
make dalms against, sue,attach the property of, or prosecute the Church,the successors and assigns of L. Ron
Hubbard, Church of Spiritual Technology, Religious Technology Center, the Church ofSdentoiogy International, any
and all Sdentoiogy-affiliated churches, missions, corporations, assodatlons, partnerships, trusts, religious orders or
organizations, or, in any and all capacities and as Individuals, their officers, directors, trustees, agents,servants,
successors, heirs, executors or representatives, or the owners, managers,employees,agents or representatives or
assodates of, any fadlltles conducting Sdentoiogy Religious Services(hereinafter collectively "the Releasees")for any
physical, mental or emotional Injury, property damage,or monetary loss resulting from negligence or other acts,
lowsoever caused, ofany Releasee or ofany employee,agent or contractor ofthe Church, its affiliates, or other
Releasee, in any way relating to my partidpatlon in Sdentoiogy Religious Services. CL C
b. 1 ftirther release and discharge the releasees In any and all capadtles and as Individuals from all actions,
daims or demands I, my heirs, distributees, guardians, legal representatives or assigns now have or may hereafter
have for any physical, mental or emotional injuiy, property damage,or monetary loss resulting In any way from ipy,
partidpatlon in Sdentoiogy Religious Services. / C
V.,. V.
c. I liuther agree to indemnify and save and hold harmless the Releasees in any and all capacities and as
individuais, and each ofthem,from any ioss,iiabilify, damage or costth^ may incur due to my participation in
Scientoiogy Reiigious Services or due to my presence or action in or about the Church premises or the fecilities /
providing such services. //
d. i understand, acknowiedge and agree that shouid any provision or provisions ofthis Contract be,for any
reason, unenforceabie, the baiance shaii nonetheiess be offoii force and effect.

'■O
e. i further understand, adoiowiedge and agree that this Contract contains everything that the Church or
Church representatives and I have addressed or discussed with respect to Scientoiogy Reiigious Services, and that it
constitutes the sole and entire agreement which contains everything that I have reiied upon in appiying to participate
in Scientology Religious Services and supersedes any and aii verbai discussions I have had with anyone. /
I HAVE CAREHILLY READ THIS CONTRACT AND HILLY UNDERSTAND ITS CONTENTS AND CONSEQUENCES. I
ALSO UNDERSIAND THAT I AM NOT EUGIBLE FOR ANY SCIENTOLOGY RELIGIOUS SERVICES UNLESS I SIGN THIS
CONTRACT. I REAFFIRM THAT I WISH TO PARHCIPAiE IN SCIENTOLOGY REUGIOUS SERVICES AND THAT THIS
CHOia IS AN INDEPENDENT EXERCISE OF MY OWN FREE WILL I FULLY UNDERSTAND THAT BY SIGNING BELOW,
I AM FOREVER GIVING UP MY RIGHT TO SUE THE CHURCH, ITS SIAFF AND ANY OFTHE HEREINABOVE
RIUERENCED RELEASEES FOR ANY INJURY OR DAMAGE SUFFERED IN ANY WAY CONNECTED WITH SCIENTOLOGY
RHJGIOUSSQIVICES.

I Sim this Reiigious Sen/ices Enroiiment Appiication, Agreement and Generai Reiease on this l_ day of
^ . 20£S intending to be iegaily bound by it, and request that I be permitted to participate in
Scientology Religious Sen/i(

(SIGNATlJREOFAPPLICANn ^ ^
(Printed Fuil Name)

(Home Address)
L-h.
(SIGNATURE OF PARENT OR GUARDIAN, IF APPLICANT IS A MINOR)

(Printed Full Name)

(Home Address)

(SIGNATURE OF WITNESS)

[Ifrinted Fuil Name)

Having reviewed the above Reiigious Services Enroiiment Appiication, Agreement and Generai Release the Church,
in reliance upon, and conditioned upon, the truthftil promises, representations and agreements made therein, on this
day of 20—, accepts for participation in Scientoiogy Reiigious Services.
CHURCH OF SQENTOLOGY
By its:_
owe)
[SIGNATURE)
Exhibit 12
,/

' :,_

~~ώω ~tkfl~')

J~

ι ι, C,ι\ r .~51( βi~I e(" ι


, recognize, acknowledge and agree that am exdusively
responsible for my present an future conditlon in life and for the choices and decisions 1make affectlng my life. With
that ίη mind, and solely of my own volitlon and ίη the independent exerdse of my own free wlll, 1am voluntarily
signing and submitting to CHURCH OF SCIENTOLOGY CJ::;&. (hereinafter "tbe
Church") this RELIGIOUS SE.RVICES ENROLLMENT APPLICAΠON, AGRE.EMl.NT AND GENERAL RELEASE (hereinafter
"tbls Contract") so that, upon its acceptance by the Church, 1may partidpate ίη Religious Services of the Sdentology
religion under the terms, conditions, covenants, waivers and releases 1agree to by signing this Contract.

2. This Contract is my statement of my personal, self-determined desire to partlcipate ίη the Religious Services of
the Scientology religion. By signing this Contract, l recognize, acknowledge and agree that:

a. Sdentology is a religion, the Church is a church of the Sdentology religion, and all the servlces and ac~
of the Sdentology religion are exdusively religlous ίη nature. _

b. The Sdentology religion ls devoted to the study and handling of the human spirit ίη relationship to ltself,
universes and other l!fe. The word "Sdentology" comes from the Latln "sdo," meaning "knowing ίη the fullest sense of the
word," and the Greek "Iogos," meaning "study of." Dianetlcs spiήtuai healing technology is part of the Scientology religion
and ls the study ofwhat the soul ls doingto the body. The word "Dianetlcs" is from the Greek "dia," meanlng "through,'' and
"nous,'' meaning "soul," and thus means "through soul." c cb
c. The Founder of the Sdentology rel!gion ls Ameήcan author and phllosopher L. Ron Hubbard (herelnafter
"LRH"), whose wήtings and recorded spoken words οη the subjects of Sdentology and Dianetlcs are a record of hls
observations and research lnto the nature of the human spiήt and condition. The wήtlngs and recorded spoken words
of LRH οη the subjects of Sdentology and Dianetlcs present a guide intended to assist persons to become more aware
of themselves as persons, restoήng trust and respect for seif and others. They are not a statement of claims by the
Church, by any other Scientology church or organization, or by LRH. ~
d. The term "Religious Services," as used ίη this Contract, means and refers to the belief'S and practlces set forth
Ιη the wήtings and spoken words of LRH οη the subjects of Dlanetlcs and Sdentology published wlth the ldentlfylng S
and doubie triangle or Dianetics tήangle symbol, and all services or applicatlon of the pήndples of Mr. Hubbard
provided to me by the ministers or staff of the Church and all other Sdentology churches and organizations, induding
wlthout iimitation: "auditing, " which is Sdentology's unique form of religious counseling encompasslng all services οη
the Scientoiogy Ciassification, Gradation and Awareness Charts which indudes, without limitation, all levels,
rundowns, grades, assists, reviews, repairs, seminars, co-audits; all Sdentoiogy congregatlonai services of any
descήption; "training," which is the study of the scήpture of the Scientology religion οη the road to achieving spiήtual
freedom and salvation and indudes wlthout limitation all servlces identified οη the Scientology Ciassification,
Gradation and Awareness Chart, all courses, lntemshlps and σamrning; the application of Scientology Ethics and
Justice technology, which are both exdusiveiy religious components of the practice of the Sdentoiogy rellgion; the
study and the appllcation of the pήnciples contained ίη the adminlstrative writings of LRH used wlthin the Church; and
any and all other services or use of the technology of L. Ron Hubbard, wlthout limitation, provided to me by the
ministers or staff of the Church and all other Sdentology churches and organizations. U,_
\

e. Neither the Church nor any other Scientology church or organization which espouses, presents, propagates
or practices the Sdentology religion makes any daim:

1. that the nature or purpose of Scientology, or of Dianetics, or of the writings and recorded spoken
words of LRH, is contrary to what is stated ίη this Contract;

U. that the application of any Scientology or Dianetlcs technology or practice will have any particular effect
οη me or any other person; or

lll. that any particular result may be forthcoming from my particlpation ίη any Scientology Religious
Service. 1spedfically acknowledge that 1have read and that 1understand Sdentology Policy Directive 13 March
1996, Statements by Staff Members, which states dearly that lf any individual staff member of any Sdentology
church or organization makes any claims about the results which may be forthcoming from my partidpation in
any Scientology Religious Service, any such claims are the personal opinions and belief'S of that staff member
only, and are not claims made by the Church or any other Scientology church or organization. ~
3. 1have seen the film 'Όήentation " and 1am now informed and aware and fully understand that Scientology ls a
religion, that its teachings are religious and that its ciaims are religlous ίη nature. 1am further lnformed and aware and
fuliy understand that when 1partidpate ίη Scientology services, 1am participating ίη religious services under the
ecdesiastical pήnciples of the Scientology religion. 1am also informed and aware and fully understand that the Church
and all other Scientology churches are separate, distinct legal corporations each independently operating and
responslble for its own corporate and ecclesiastical affairs.

4. This Contract is my commitment that 1desire to participate ίη Sdentology Religious Services exdusively for
spiήtual purposes ίη accordance with the belief'S and practices of the Sdentology religion. Sdentology Religious
Services are designed to glve spiήtual aid, not medical treatment. However, the Sdentology religion teaches that the
spiήt can be saved and that the spirit alone may save or heal the body, and Scientology Religious Servlces are
intended to save the spirit. By signing this Contract, 1recognize, acknowledge and agree that:

a. Scientology Religious Services are not intended and are not used for diagnosing ailments of the body
engaging ίη the teaching or practice of any medical arts or sdences.
C)J
b. lt is exdusively my responsibility to see to my physlcal and medical well-being, and under ηο drcumstance
does the Church or any other Sdentology church or organization whlch espouses, presents, propagates or practices
the Scientology religion have any responsibility whatsoever ίη that regard. -ε:JΟ

c. 1have not ωme to the Church, nor do 1seek to partldpate ίη Sdentology Religious Services, solely to ~ (l
cured of any physical illness, ailment or condition. ---bA6J
d. While the registrar can assist me ίη arranging for a competent medical examination and appropήate
treatment by a qualified medlcal practltioner before 1partidpate Ιη any Scientology Religlous Servlces, lt is solely my
responsibillty to take whatever steps are necessary to demonstrate that 1have ηο diagnosable or medically treatable
illnesses, ailments, or condltions that are not under ωmpetent medlcal care before 1begln participating ίη any
Sdentology Religious Service. Thereafter, any physical illness, ailment or condition 1may have that has been treated
medically may then be addressed spiήtually by the applicatlon of the tenets of the Scientology rellgion, subject ~
terms of this Contract.

e. Ι know that 1should not partidpate ίη any Sdentology Religious Service if 1have a physlcal or mental
condition which might be aggravated or which might make my partidpation ίη the service unωmfortable or distressful
to me, and 1agree to accept and assume any and all known or unknown ήsks of injury, loss, or damage resulting fr~ΓJ!­
my choices and decisions ίη that regard. ~

f. Scientology Religious Service may entail the use of a religious artifact known as the "E-Meter" for the
purpose of locating and resolving problems and difficulties which are spiήtual ίη nature. 1understand that, by itself, the
E-Meter does nothing, but serves only as a guide to Sdentology ministers to assist paήshloners ίη iocatlng areas of
spiήtual distress or travail, and that it is not intended or effective for the diagnosis, treatment or preventlon of any
disease, or for the improvement of health or any bodily function. ~
g. Sdentology is unalterably opposed, as a matter of religious belief, to the practice of psychiatry, and
espouses as a religious belief that the study of the mind and the healing of mentally caused ills should not be alienated
from religion or ωndoned ίη nonreligious fields. 1am ίη full agreement with this rellgious bellef. 1do not belleve in or
subscribe to psychiatήc labels for individuals. It is my strongly held rellgious belief that all mental problems are
spiritual ίη nature and that there is ηο such thing as a mentally incompetent person - only those suffering from
spiήtual upset of one kind or another dramatized by an indivldual. 1reject all psychiatric labels and intend for this
Contract to dearly memoήalize my desίre to be helped exdusively through relίgίous, splήtual means and not through
any form of psychίatric treatment, speclfically includlng lnvoluntaιy commitment based οη so-called lack of
competence. Under ηο cίrcumstances, at any tlme, do 1wish to be denίed my ήght to care from members of my
religion to the exdusion of psychίatήc care or psychίatήc dίrected care, regardless of what any psychiatήst, medical
person, designated member of the state or famlly member may assert supposedly οη my behalf. If drcumstances
should ever aήse !η which govemment, medical, or psychiatήc officials or personnel or family members or fήends
attempt to compel or coerce or commit me for psychiatήc evaluatlon, treatment or hospίtalization, 1fully desire and
fully expect that the Church or Sdentologists will intercede οη my behalf to oppose such efforts and/or extήcate me
from that predicament so my spiritual needs may be addressed ίη acωrdance with the tenets of the Sάentology ,..,(L
relίgion free from psychiatήc interventlon. ~

5. This Contract memoήalizes my intentlon to partidpate !η Scientology Relίgious Services only for purposes of
self-improvement and spiήtual advancement. By signing this Contract, 1recognize, acknowledge and agree that:

a. Achieving the benefits and goals of the Sάentology relίgion requires my ded!cated partlcίpatίon,
only through my own efforts can 1achieve those benefits and goals.
beca(},P
b. Before Ι go οη to any further service, it is essential that 1am completely satisfied with my expeήence with
my pήor service. While Sdentology holds out the possibllity of a better lίfe through adherence to its belίefs and
practlces, ίndividual spiήtual advancement is not always an easy or comfortable task, and my success ίη Sdentology
ultlmately depends οη my own ability, strength and determinatlon to overcome the shortcomings and harmful
pattems of my past. By agreeing to proceed with further services, 1acknowledge complete satlsfactlon with all r fl
services 1have participated ίη previously. _L,.Δ2

c. Νο Sάentology church is under any duty or oblίgation whatsoever to retum any portion of any religious
donation 1make. However, 1have read Scientology Polίcy Dlrectlve 13 March 1996, Retum of Donatlons, and understand
that under certain circumstances identlfied ίη published ecdesiastical polίdes such as that Scientology Polίcy Dlrectlve, a
retum of donations may be obtained through my stήct compllance with those publίshed polίcies and procedures relating
to the Ciaims Veήficatlon Board. 1further understand, acknowiedge and agree that:

1. such procedures require my direct partldpatlon to the exdusion of any third partles, induding, but not
lίmited to, attomeys;

n. retums of donations are exdusively within the ecdesiastlcal authoήty and sole discretlon of the Ciaims
Veήfication Board;

nι. any violation of, or deviatlon from, such publίshed polldes by me voids any possibility of my receMng
a retum of a donation; and

Ιν. should 1, at any tlme, ever request a refund or repayment of donations, such refund or repayment will
be given Ιf and only ίf 1have followed the exact procedures of the Ciaims Verίfication Board and thίs Contract, and
that ίη exchange for refund or repayment of such donatlons as determined by the Ciaims Veήfication Board, 1execute
a complete release, qultdaim and waiver of claims as provided by an authorized Church representatlve. ~

d. Ιη connectlon wίth my partldpation Ιη Sάentology Relίgious Servlces, the Church may complle a folder
containing its notations of my spiήtual progress, known as a "Predear Folder" or "PC Folder, " as well as other ecdesiastlcal
files contalnlng notatlons regarding my spiritual progress. All of my PC Folders and other ecdesiastlcal files containlng
notatlons regardlng my spiήtual progress, as well as all contents thereof, are the sole and exdusive property of Church of
Scientology Intemational. As a matter of religious belief and of ecdesίasticai doctήne and law, such folders and files, and
the contents of such folders and files, are kept confidentίal from all persons who lack the ecdesiastical authoήty to gain
access to such mateήals, indudίng me, are subject to all applicable dergyman-penitent pήvlleges, and are nelther
comprehenslble nor meant to be understood by anyone whose trainίng and expertίse !η their interpretation ls not
recognίzed and sanctioned by Church of Sdentoiogy lntematlonal.

Ι. As a condition of being accepted for partiάpatlon in Sdentology Relίgious Services, 1forever abandon,
surrender, waive, and reiinquish wίthout lίmίtation any and all ήghts of ownershίp, possesslon, custody, control,
access, copyίng, and vίewing of my PC Folder or Folders and all other ecdesiastίcal files containίng any notatlons
regarding my spίritual progress, both with respect to the folders and files themselves and the information contained
ίη them.

n. The abandonment, suπender, waiver, and relinqulshment to whίch 1refer ίη the ίmmedίately precedίng
subparagraph ίs uncondίtlonal and ίπevocable and applίes equally to anyone actlng or purporting to be actlng οη my
behalf or for my benefit, whether 1am alive or dead, whether 1am dίsabled or incapaάtated , and under any and ail
drcumstances foreseen or unforeseen, !η perpetuity, without exception or lίmitation .
ΙU. Should Ι or anyone actlng or puιportlng to be actlng οη my behalf or for my benefit eνer seek access to
any of my PC Foldeιs or any other ecdeslastlcal flle contalnlng any notatlons regardlng my splήtual progress, Ι
lntend for the subrnlsslon of this Contract to the presldlng Judldal olllcer to be a complete and suffident basis for
the lmmedlate denlal of whateνer access is belng sought wlth prejudlce to any other or further etrort to breach
the absolute confldentlallty of those mateήals or the excluslve ήght of Church of Sdentology Intematlonal to
preserνe thelr absolute confldentlallty.

e. lt is both an unalterable rellglous bellef and a matter of eccleslastlcal custom of the Sdentology rellglon that
my peιsonal splήtual progress will be dlreded by a mlnister known as a Case Superνisor who determlnes whlch
Rellglous Seιvlces are appropήate for my personal splήtual progress and the sequence Ιη whlch Ι wlll partldpate Ιη
such Rellglous Seιvlces. As a matter of rellglous bellef, 1acknowledge that my Case Supeινlsor wlll make the dedslons
regard1ng the appropήate course of my splήtual progress, and 1wlll ablde by the declslons and dlrectlon of my Case
Superνisor Ιη guldlng my splritual progress. ΑΙΙ Rellglous Serνlces Ιη whlch 1partldpate hereafl:er at the dlrectlon of my
Case Superνisor are subJect to the tenns of this Contract.

6. 1hls Contract memoήallzes my ITeely glven consent to be bound excluslvely by the disdpllne, faith, lnternal
organlzatlon, and eccleslastlcal rule, custom, and Iaw of the Sdentology rellglon Ιη all matters re1atlng to Sdentology
Rellglous Seιvlces, Ιη all my deallngs of any nature wlth the Church, and Ιη all my deallngs of any nature wlth any other
Sdentology church or organlzatlon whlch espouses, presents, propagates or practlces the Sdentology rellglon. By slgnlng
this Contract, 1recognlze, acknowledge and agree that:

a. My fteeJy glven consent to be bound excluslvely by the dlsdpllne, faith, lnternal organlzatlon, and eccleslastlcal
rule, custom,. and law of the Sdentology rellglon Ιη all matters relatlng to Sdentology Rellglous Serνlces, Ιη all my deallngs
of aηΥ nature wlth the Church, and Ιη all my deallngs of any nature wlth any other Sclentology church or organlzatlon
whlch espouses, presents, propagates or practlces the Sdentology rellglon means that 1am forever abandonlng,
suπendeήng, walvlng, and rellnqulshJng my-ήght to sue, or otherwlse seek. legal recourse wlth respect to any dispute,
clalm or controversy agalnst the Church, all other Sdentology churches, all other organlzatlons whlch espouse, present,
propagate or practlce the Sdentology rellglon, and all persons employed by any such entlty both Ιη thelr personal and any
offidal or representatlonal capadtles, ~ess of the nature of the dispute, cla1m or controversy.
b. The abandonment, surrender, walver, and rellnquishment to whlch 1refer Ιη the Ιmmedlately precedlng
subparagraph is uncondltlonal and lπeνocable and applles equally to anyone actlng or puιportlng to be actlng οη my
behalf or for my benefit, whether 1am allve or dead, whether 1am disabled or lncapadtated, and under any and all
clrωmstances foreseen or unforeseen, Ιη perpetulty, wlthout exceptlon or llmltatlon.

c. Should 1or anyone actlng or puιportlng to be actlng οη my behalf eνer sue, or otherwlse seek legal recourse
wlth respect to any dispute, clalm or controνersy agalnstthe Church, any other Sdentology church, any other organlzatlon
whlch espouses, presents, propagates or practlces the Sdentology rellglon, or any person employed by any such entlty,
regardless of the nature of the dispute, clalm or controνersy, l lntend for the subrnlsslon of this Contract to the presldlng
Judldal officer to be a complete and suffident basis for the lmmedlate dismissal of any and all such proceedlngs wlth
prejudlce to further proceedlngs of any klnd.
d. Ιη accordance wlth the disdpllne, faith, lntemal organlzatlon, and eccleslastlcal rule, custom, and Iaw of the
Sdentologyrellglon, and Ιη accordance wlth the constltutlonal prohlbltlons whlch forbld goνemmental lnterference wlth
rellglous serνlces or dlspute resolutlon procedures, should any dlspute, clalm or controνersy aήse between me and the
Church, any other Sdentology church, any other organlzatlon whlch espouses, presents, propagates or practlces the
Sdentology rellglon, or any person employed by any such entlty, whlch cannot be resolved lnfoπnally by dlrect
communlc:atlon, Iwlll pwsue resolutlon of that dlspute, clalm or controversy solely and excluslvely through Sdentology's
Ιnternal Ethlcs, justlce and blndlng rellglous arbltratlon procedures, whlch lnclude appllc:atlon to senlor eccleslastlcal
bodles, lndudlng, as necessaιy, flnal submlsslon of the dispute to the lnternatlonal justlce Chlef of the Mother Church of
the Sdentology rellglon, Church of Sdentology lntematlonal (•ηc") or hls or her deslgnee.
e. Arrj dlspute, clalm or controversy whlch stlll remalns unresolved after reνlew by the IJC shall be submltted
to blndlng rellglous arbltratlon ln accordance wlth the arbltratlon procedures of Church of Sdento\ogy Intematlonal,
whlch proνlde that:
L 1wlll submlt a request for arbltratlon to the IJC and to the person or entlty wlth whom 1have the
dispute, clalm or controνersy;
U. Ιη my request for arbltratlon, 1wlll deslgnate one arbltrator to hear and resolve the matter;

ΙU. wlthln Meen (15) days after recelvlng my request for arbltratlon, the person or entlty wlth whom 1have
the dlspute, clalm or controνersy wlll deslgnate an arbltrator to hear and resolve the matter. If the person or
entity with whom 1have the dispute, daim or controversy does not designate an arbitrator within that fifteen (15)
day period, then the IJC will designate the second arbitrator;

Ιν. the two arbitrators so designated will select a third arbitrator within fifteen (15) days after the
designation of the second arbitrator. lf the arbitrators are unable to designate a third arbitrator within the fifteen
(15) day peήod , then the IJC will choose the third arbitrator:

v. consistent with my intention that the arbitration be conducted ίη acωrdance with Scientology
pήndples, and consistent with the ecclesiastical nature of the procedures and the dispute, claim or controversy to
which those procedures relate, it is my spedfic intention that all such arbitrators be Sdentologists in good
standing with the Mother Church. ~
f. The Church and all other Sdentology churches and organizations which espouse, present, propagate or
practice the Scientology religion are each separate, distinct legal corporations, and each such entity is independently
responsible for its own management and is independently responsible for its own corporate and ecclesiastical rι (2_
affairs. ~

7. This Contract is my good faith application to partidpate in Sdentology Religious Services. By signing this
Contract, 1promise, covenant, and represent that:

a. 1am applying to partidpate ίη Sdentology Religious Services to achieve spiήtual betterment because ,,..... (2._
1truly believe that persons can be helped to galn greater understanding and happiness Ιη life. -LΔL

b. 1am applying honestly and Ιη good faith to derive all possible personal gain from Sclentology Religlouj-, ι(l...
Services. ~

c. 1have ηο record of being committed in an institution for mental or emotlonal disorders.

d. 1have ηο criminal record that indudes a felony offense.

e. 1am not connected with any person, such as by maήtal or familial ties, of known antagonism to spiήtu~ ~
treatrnent or to Sdentology. ~

f. Neither Ι nor any member of my immediate family has ever sued, embarrassed or attacked, or threatened
to sue, embarrass or attack, Sdentology. 4
g. 1am not attempting to infiltrate or investigate Sdentology as a representative of any news media,
govemment agency or entity, or any other organization, entity or person, nor am 1here to disrupt Church activ~

8. This Contract will become a legally bindlng agreement between me and the Church upon lts acceptance by the
Church or upon my commendng my participatlon in a Sdentology Religious Service, whichever occurs first. ln determining
whether to accept this Contract, 1acknowledge that the Church will rely on the acknowledgements, agreements,
representations and promises which 1have made herein.

9. As further consideration for the Church's permission for me to partidpate ίη Sdentology Religious Services and
for me to use its fadlities and other fadlities provided for such purposes:

a. 1, οη behalf of myself and οη behalf of my heirs, dlstήbutees, legal representatives and assigns, agree not to
make daims against, sue, attach the property of, or prosecute the Church, the successors and assigns of L. Ron
Hubbard, Church of Spiήtual Technology, Religious Technology Center, the Church of Sdentology lntemational, any
and all Scientology-affiliated churches, mlssions, corporations, associations, partnerships, trusts, religious orders or
organlzations, or, Ιη any and all capaclties and as indMduals, their offlcers, dlrectors, trustees, agents, servants,
successors, heirs, executors or representatives, or the owners, managers, employees, agents or representatives or
assodates of, any fadlities conducting Sdentology Religious Services (hereinafter collectively "the Releasees") for any
physical, mental or emotional injuιy, property damage, or monetaιy loss resulting from negligence or other acts,
howsoever caused, of any Releasee or of any employee, agent or contractor of the Church, its affiliates, or other
Releasee, ίη any way relating to my partidpation Ιη Sdentology Religious Services. ~
b. 1further release and discharge the releasees ίη any and all capadties and as individuals from all actions,
daims or demands 1, my heirs, distήbutees, guardians, legal representatives or assigns now have or may hereafter
have for any physical, mental or emotional injury, property damage, or monetaιy loss resulting in any way from m~ fί,
participation in Sdentology Religious Services. ----LA.J
c. 1further agree to indemnify and save and hold harmless the Releasees in any and all capacities and as
individuals, and each of them, from any loss, liability, damage or ωst they may incur due to my partiάpatlon ln
f
Scientology Religious Services or due to my presence or actlon in or about the Church premises or the facilities t1
providing such services. -bC:7-
d. 1understand, acknowledge and agree that should any provision or provisions of this Contract be, for any
reason, unenforceable, the balance shall nonetheless be of full force and effect. ~
e. 1further understand, acknowledge and agree that this Contract ωntains everything that the Church or
Church representatives and 1have addressed or discussed with respect to Sάentology Religious Services, and that !t
ωnstitutes the sole and entire agreement which contains everything that 1have relied upon in app!ying to partiά(jf)
in Sάentology Religious Services and supersedes any and all verbal discussions 1have had with anyone.

(Pήnted Ful! Name)


(J to S. Μ{,\~ (\ ~. Ρ1-\ \' l\
(Home Address)
l& α C,ro ) ι}
(SIGNATURE OF PARENT OR GUARDIAN, IFAPPLICANT IS Α MINOR)

(Pήnted Fu!l Name)

(Home Address)

(Pήnted Full Name)

Having reviewed the above Religious Services Enrollment Applicatlon, Agreement and General Release the ~rιJ. in
relian~ upon, and conditioned upon, tlJ_~ truthή.11 promises, representatlons and agreements made therein, on thIF- -
day of-::;Jf}=-L , 20-J...1. accep~h Vιs~ "-~ ,partlάpation in Sάentology Religious Services.

ltem t t3721R-CCJNr--General Enrol1ment Fonn.


Exhibit 13
~~ώαι 'fkfl~1}
J~

1. ι, C.k·.$J'f βιχΙer Ι
. recognize, acknowledge and agree that am exclusively
responsible for my present and future condition in life and for the choices and dedsions 1make affecting my llfe. With
that in mind, and solely of my own volltion and in the lndependent exercise of my own free will, 1am voluntaήly
signing and submitting to CHURCH OF SCIINTOLOGY (hereinafter "tbe
Church") this IU.LIGIOUS SERVICES ENROLLMENT APPLICAΠON, AGREEMENT AND GENERAL IU.LEASE (hereinafter
"thls Contract") so that, upon its acceptance by the Church, 1may participate in Religious Services of the Sclentoiogy
religion under the terms, conditions, covenants, waivers and releases 1agree to by signing this Contract.

Ζ. This Contract is my statement of my personai, self-determined desire to partidpate in the Religious Services of
the Sdentology religion. By signing this Contract, 1recognize, acknowledge and agree that:

a. Scientology is a religion, the Church is a church of the Scientology rellgion, and ail the services and actiνitles
of the Sclentology religion are exdusively religious in nature. -αι.-

b. The Sdentology religion is devoted to the study and handling of the human splrit in relationship to itself,
universes and other life. The word "Scientology" comes from the Latin "sdo," meanlng "knowing in the fullest sense ofthe
word," and the Greek "logos," meaning "study of. " Dianetics spiήtuai heaiing technology is part of the Sdentology religion
and is the study ofwhatthe soul ls doing to the body.The word "Dianetics" is from the Greek "dia, " meaning "througM d
"nous," meaning "soul," and thus means "through soul."

c. The Founder of the Scientology religion is Ameήcan author and philosopher L. Ron Hubbard (hereinafter
"LRH"), whose wήtings and recorded spoken words on the subjects of Sdentoiogy and Dianetics are a record of his
observations and research into the nature of the human spiήt and condition. The wήtings and recorded spoken words
of LRH on the subjects of Sdentology and Dianetics present a guide intended to assist persons to become more aware
of themselves as persons, restoήng trust and respect for self and others. They are not a statement of daims by the
Church, by any other Sdentology church or organization, or by LRH. cΔ
d. The term "Religious Services," as used in thls Contract, means and refers to the beliefs and practices set forth
in the wήtings and spoken words of LRH on the subjects of Dianetics and Sdentology published with the ldentlfying S
and double tήangle or Dianetics tήangle symbol, and ail services or application of the pήndples of Μτ. Hubbard
provided to me by the ministers or staff of the Church and ail other Sdentology churches and organizations, induding
without limitation: "auditing," which is Sdentology's unique form of religious counseling encompassing ail services on
the Sdentology Classification, Gradation and Awareness Charts which indudes, without limitation, ail levels,
rundowns, grades, assists, reviews, repairs, seminars, co-audits; ail Sdentology congregationai services of any
descήption; "training," which is the study of the scήpture of the Sdentology religion on the road to achleving spiήtuai
freedom and saivation and indudes without limitation ail services identified on the Sdentology Classification,
Gradation and Awareness Chart, ail courses, intemships and cramming; the application ofSdentology Ethlcs and
Justice technology, which are both exdusively religious components of the practice of the Sdentology religion; the
study and the application of the pήndples contained in the admlnistrative wήtings of LRH used within the Church; and
any and ail other services or use of the technology of L. Ron Hubbard, without limitation, provided to me by the( {().._
mlnisters or stalf of the Church and ail other Scientoiogy churches and organizations. ~
..
.. '!
e. Neither the Church nor any other Sdentology church or organizatlon which espouses, presents, propagates
or practlces the Sdentology reUglon makes any clalm:

L that the nature or purpose of Sdentology, or of Dlanetlcs, or of the wιitlngs and recorded spoken
words of LRH, ls contraιy to what ls stated Ιη thls Contract;

U. that the appUcatlon of any Sdentology or Dlanetlcs technology or practlce wlll haνe any partlcular effect
οη rne or any other person; or

UL that any partlcular resώt rnay be forthcornlng ftorn rny partldpatlon Ιη any Sdentology Rellglous
Seινice.1speclfic.ally acknowledge that 1haνe read and that 1understand Sdentology Pollςy Dlrectlνe 13 March
1996, Staternents by Staff Mernbers, which states dearly that lf any lndMdual staff rnernber of any Sdentology
church or organizatlon rnakes any clalms about the resώts which rnay be forthcornlng ftorn rny partldpatlon Ιη
any Sdentology Rellglous Seινlce, any such dalrns are the personal oplnlons and beUefs of that staff rnernα;., rn
only, and are not dalrns rnade by the Church or any other Sdentology church or organll.atlon. -U:-2
3. Ι haνe seen the fllrn •ortentatlon" and 1arn now lnforrned and aware and fully understand that Sdentology Ιs a
rellglon, that its teachlngs are rellglous and that its dalrns are rellglous Ιη nature. 1arn further lnforrned and aware and
fully understand that when 1partldpate Ιη Sdentology services, 1arn partldpatlng Ιη rellglous services under the
eccleslastlcal pήndples of the Sdentology reUglon. 1arn also lnforrned and aware and fully understand that the Church
and all other Sdentology churches are separate, dlstlnct legal corporatlons each lndependently operatlng and
responslble for its own corporate and eccleslastlcal alfalrs.
4. This Contract ls rny cornrnitrnent that 1deslre to partldpate Ιη Sdentology Rellglous Seινlces exclusiνely for
splήtual purposes Ιη accordance wlth the beUefs and practlces of the Sdentology rellglon. Sdentology ReUglous
Seινlces are deslgned to glνe splήtual ald, not rnedlcal treatrnent Howeνer, the Sdentology rellglon teaches that the
splήt can be saνed and that the spiήt alone rnay saνe or heal the body, and Sdentology ReUglous Seινlces are
lntended to saνe the splήt. By signlng thls Contract, 1recognize, acknowledge and agree that:
L Sdentology Rellglous Services are not lntended and are not used for dlagnoslng allrnents of the body or for
engaglng Ιη the teach1ng or practlce of any rnedlcal arts or sdences. ~

b. lt Ιs exdusiνely rny responslbUI~ to see to rny physlcal and rnedlcal well-belng, and under ηο circumstance
does the Church or any other Sdentology church or organll.atlon whlch espouses, presents, propagates or practices
the Sdentology rellglon haνe any responslblll~ whatsoeνer Ιη that regard. ~
c. 1haνe not corne to the Church, nor do 1seek to partldpate Ιη Sdentology Rellglous Serνices, solely to be
cured of any physlcal IUness, allrnent or condltlon. ~

d. While the reglstrar can asslst rne Ιη arranglng for a cornpetent rnedlcal exarnlnatlon and appropήate
treatrnent by a qualllied rnedical practltloner before 1partldpate Ιη any Sdentology Rellglous Serνices, lt ls solely rny
responsibili~ to take whateνer steps are necessaιy to dernonstrate that 1haνe ηο diagnosable or rnedically treatable
IUnesses, allrnents, or conditlons that are not under cornpetent rnedlcal care before 1begln partldpatlng Ιη any
Sdentology Rellglous Serνice. lhereafter, any physical Ulness, ailrnent or condltlon 1rnay haνe that has been treated
rnedlcally rnay then be addressed splήtually by the appllcatlon of the tenets of the Sdentology rellglon, subject to the
terrns of thls Contract. ~
e. Ι know that Ι shoώd not partldpate Ιη any Sdentology Religlous Serνice if 1haνe a physlcal or rnental
condltlon which rnight be aggraνated or which rnight rnake rny partldpatlon in the serνice uncornfortable or dlstressful
to rne, and 1agree to accept and assurne any and all known or unknown ήsks of lnjuιy, loss, or darnage resώtlng ftorn
rny cholces and declslons Ιη that regard. ~
f, Sdentology Rellglous Serνice rnay entall the use of a rellglous artlfact known as the ·ε-Meter" for the
purpose of locatlng and resoMng problerns and difficultles which are splήtual Ιη nature. 1understand that, by ltself, the
E-Meter does nothlng, but serνes only as a gulde to Sdentology rninlsters to asslst parlshioners Ιη locatlng areas of
splήtual dlstress or traνall, and that lt ls not lntended or effectiνe for the dlagnosls, treatrnent or preνentlon of any (rfl.ι
dlsease, or for the lrnproνernent of health or any bodlly functlon. -uF
ι. Sdentology ls unalterably opposed, as a rnatter of rellglous beUef, to the practice of psychlatιy, and
espouses as a rellglous bellef that the study of the rnind and the heallng of rnentally caused Uls shoώd not be alienated
ftorn rellglon or condoned Ιη nonrellglous lields. 1arn Ιη full agreernent wlth thls rellglous beUef. 1do not belleνe Ιη or
subscrlbe to psychlatήc labels for lndMduals. lt ls rny strongly held rellglous bellef that all rnental problerns are
splήtual Ιη nature and that there Ιs ηο such th1ng as a rnentally lncornpetent person - only those sufreήng ftorn
splήtual upset of one klnd or another drarnatlzed by an lndMdual. 1reject all psychiatήc labels and lntend for thls
..
v • Contract to dearly memodallze my deslre to be helped exduslνely through reUglous, spldtual means and not through
any fonn of psychlatric treatrnent, speclflc.ally Indudlng Inνoluntaιy c:ommltrnent based on so-c.alled lack of
c:ompetenc:e. Under no drcumstances, at any tlme, do 1wish to be denled my ιight to care ftom members of my
reUglon to the exduslon of psychlatric care or psychlatric dlreded care, regardless of what any psychlatrist, medlc.al
person, deslgnated member of the state or famlly member rnay assert supposedly on my behalf. lf drcumst.anc:es
should eνer adse In whlch goνemment, medlc.al, or psychlatric offidals or personnel or famlly members or fdends
attempt to c:ompel or c:oerc:e or c:ommlt me for psychlatric eνaluatlon, treatrnent or hospltallzatlon, Ι fuliy deslre and
fuliy expect that the Church or Sclentologlsts wlU lnterc:ede on my behalf to oppose such efforts and/or extricate me
ftom that predlcarnent so my spldtual needs rnay be addressed In acc:ordanc:e wlth the tenets of the Sclentologyn Ρ-.
rellglon free ftom psychlatric Inteιventlon. -τ::J"""'"

5. Thls Contract memodallzes my lntentlon to partldpate ln Sclentology Rellglous Seιvic:es only for puιposes of
self-lmprovement and spldtual advanc:ement. By signing thls Contract, 1recognlze, acknowledge and agree that:
a. Achleνlng the beneflts and goals of the Sclentology reUglon requlres my dedlcated partldpatlon, ~
only through my own efforts can 1achleνe those beneflts and goals. ~

b. Before 1go on to any further seιvlc:e, It ls essentlal that 1am c:ompletely satlsfled wlth my expeιienc:e with
my pdor seιvlc:e. Whlle Sclentology holds out the posslbUlty of a better llre through adherenc:e to lts bellefs and
pradlc:es, lndMdual spldtual advanc:ement ls not always an easy or c:omfortable task, and my suc:c:ess ln Sclentology
ultlmately depends on my own ablllty, strength and detennlnatlon to oνerc:ome the shortc:omlngs and haιmftιl
pattems of my past. By agreeing to proc:eed wlth further seιvlc:es, 1acknowledge c:omplete satlsfactlon wlth aU
seιvlc:es 1have partldpated ln prevlously. ~
c. Νο Sclentology church ls under any duty or obllgatlon whatsoeνer to retum any portlon of any reUglous
donatlon 1make. Howeνer, 1have read Sclentology PoUc:y Dlredlνe 13 March 1996, Retum of Donatlons, and undeιst.and
that under c:ertaln clrc:umstanc:es Identlfled In pubUshed eccleslastlc.al polldes such as that Sclentology Pollc:y Dlredlνe, a
retum of donatlons may be obtalned through my strid c:ompllanc:e wlth those publlshed polldes and proc:edures relatlng
to the Qalms Vedflcatlon Boaιd. 1further underst.and, acknowledge and agree that:
L such proc:edures requlre my dlred partldpatlon to the exduslon of any thlrd partles, lndudlng, but not
llmited to, attomeys;

U. retums of donatlons are exduslνely wlthln the eccleslastlc.al authodty and sole dlsaetlon of the Qalms
Vedflcatlon Boaιd;
W. any vlolatlon of, or deνlatlon ftom, such publlshed polldes by me volds any posslbUity of my rec:eiνing
a retum of a donatlon; and
Ιν. should 1, at any tlme, eνer request a refund or repayment of donatlons, such refund or repayment wlD
be glνen if and only lf 1have followed the exact proc:edures of the Qalms Vedflcatlon Board and thls Contract, and
that In exchange for refund or repayment of such donatlons as determlned by the Qalms Verlflcatlon Board, 1exec.ute
a c:omplete release, qultdalm and walνer of dalms as provlded by an authortzed Church representatlve. ~

d. Ιπ c:onnedlon wlth my partldpatlon In Sclentology Rellglous Seιvlc:es, the Church rnay c:ompUe a folder
c:ontalnlng lts notatlons of my spldtual progress, known as a "Preclear Folder" or "PC Folder," as well as other eccleslastlc.al
flles c:ontalnlng notatlons regardlng my spldtual progress. ΑΠ of my PC Folders and other eccleslastlc.al flles c:ontalnlng
notatlons regardlng my spidtual progress, as well as aU c:ontents thereof, are the sole and exduslνe property of Church of
Sclentology Intematlonal. As a matter of rellglous beUef and of eccleslastlc.al doddne and law, such foldeιs and flles, and
the c:ontents of such folders and flles, are kept c:onfldentlal ftom all persons who lack the eccleslastlc.al authodty to gain
ac.cess to such matedals, indudlng me, are subjed to aU appllc:able dergyman-penltent prlνlleges, and are nelther
c:omprehenslble nor meant to be undeιstood by anyone whose tralnlng and expertlse In thelr lnteφretatlon ls not
rec:ognlzed and sandloned by Church of Sclentology Internatlonal.
ι. As a c:ondltlon of belng acc.epted for partldpatlon ln Sclentology Rellglous Seιvlc:es, 1forever abandon,
suπender, walνe, and rellnqulsh wlthout llmitatlon any and all ιights of owneιshlp, possesslon, c:ustody, c:ontrol,
acc.ess, c:opylng, and vlewlng of my PC Folder or Folders and all other eccleslastlc.al flles c:ontalnlng any notatlons
regardlng my spldtual progress, both wlth resped to the foldeιs and flles themselνes and the lnfonnatlon c:ontalned
lnthem.
U. The abandonment, suπender, walνer, and rellnqulshment to whlch 1refer In the Ιmmedlately prec:edlng
subparagraph is unc:ondltional and Ιrrevoc:able and applles equally to anyone acting or purportlng to be acting on my
behalf or for my beneflt, whether 1am a\Iνe or dead, whether 1am dlsabled or incapacltated, and under any and all
draπnst.anc:es foreseen or unforeseen, ln peιpetulty, wlthout exc:eptlon or llmltatlon.
W. Shoώd 1or anyone actlng or purporting to be actlng on my behalf or fbr my beneflt eνer seek access to
any of my PC Folders or any other eccleslastlcal flle containlng any notatlons regardlng my splιitual progress, Ι
lntend fbr the subrnlssion of thls Contrad to the presldlng judidal ofRcer to be a complete and suflident basls fbr
the lmmediate denlal of whateνer access ls being sought wlth prejudice to any other or further etrort to breach
the absolute confldentlallty of those mateήals or the exduslνe ιight of Church of Sdentology lntematlonal to
preserve thelr absolute confldentlallty. · Qf....
e. It ls both an unalterable rellglous bellef and a matter of eccleslastlcal custom of the Sdentology rellglon that
my personal splιitual progress wlll be dlrected by a rnlnlster lmown as a Case Supervlsor who determlnes which
Rellglous Serνlces are appropιiate fbr my personal splιitual progress and the sequence Ιπ which Ι wlll partldpate In
such Rellglous Serνlces. As a rnatter of rellglous bellef, 1acknowledge that my Case Superνlsor wlll rnake the dedslons
regarding the approprlate course of my splιitual progress, and 1wlll ablde by the dedslons and diredlon of my Case
Superνlsor ln gulding my splιitual progress. ΑΙΙ Rellglous Serνlces Ιπ which 1partldpate hereafter at the diredlon of my
Case Superνlsor are subject to the terms of thls Contract.

6. Thls Contract memoιiallzes my freely glνen consent to be bound exduslνely by the disdpllne, faith, lntemal
organlzatlon, and eccleslastical rώe, custom, and law of the Sdentology rellglon Ιπ all matters relatlng to Sdentology
Rellglous Serνlces, Ιπ all my deallngs of an.y nature wlth the Church, and Ιπ all my deallngs of any nature wlth any other
Sdentology church or organlzatlon whlch espouses, presents, propagates or practlces the Sdentology rellglon. By slgnlng
thls Contrad, 1recognlze, acknowledge and agree that:

L My freeJy glven consent to be bound exduslνely by the dlsclpllne, faith, lntemal organlz.atlon, and eccleslastlcal
rώe, custom, and law of the Sdentology rellglon Ιπ all matters relatlng to Sdentology Rellglous Seινlces, Ιπ all my deallngs
of any nature wlth the Church, and ln all my deallngs of any nature w1th any other Sdentology church or organlzatlon
which espouses, presents, propagates or practlces the Sdentology rellglon means that 1am fbrever abandonlng,
surrenderlng, walvlng, and rellnqulshlng my rlght to sue, or otherwlse seek legal recourse wlth respect to any dlspute,
dalm or controversy agalnst the Church, all other Sdentology churches, all other organl1.atlons whlch espouse, present,
propagate or practice the Sdentology rellglon, and all persons employed by any such entlty both Ιη thelr personal and any
ofRdal or representatlonal capadtles, regardless of the nature of the dlspute, dalm or controversy. -{!f!>
b. The abandonment, surrender, walνer, and rellnqώshment to which 1refer Ιπ the lmmediately precedlng
subparagraph ls unconditlonal and lrrevocable and applles equally to anyone actlng or purporting to be actlng on my
behalf or fbr my beneflt, whether 1am allνe or dead, whether 1am dlsabled or lncapacltated, and under any and all
c1rcumstances fbreseen or unfbreseen, ln perpetώty, wlthout exceptlon or llrnltatlon. --r}P
c. Shoώd 1or anyone actlng or purportlng to be actlng on my behalf eνer sue, or otherwlse seek legal recourse
wlth respect to an.y dlspute, dalm or controversy agalnst the Church, an.y other Sdentology church, an.y other organlzatlon
whlch espouses, presents, propagates or practlces the Sdentology rellglon, or any person employed by any such entlty,
regardless of the nature of the dlspute, dalm or controversy, l lntend fbr the submlssion of thls Contract to the presldlng
judldal ofRcer to be a complete and suflident basls fbr the lmmedlate dlsrnlssal of any and all such proceedings wlth
prejudlce to further proceedlngs of any klnd. --f:ft;>
cL ln accordance w1th the disdpllne, faith, lntemal organlzatlon, and eccleslastlcal rώe, custom, and law of the
Sdentology reUglon, and Ιη accordance w1th the constltutlonal prohlbltlons which fbrbld governmental lnteιference wlth
rellglous serνlces or dlspute resolutlon procedures, should any dlspute, dalm or controversy aιise between me and the
Church, any other Sdentology church, any other organlzatlon which espouses, presents, propagates or practlces the
Sdentology rellglon, or any person employed by any such entlty, whlch cannot be resolved lnfbrmally by direct
communlcatlon, 1wlll pursue resolutlon of that dlspute, dalm or controversy solely and exduslνely through Sdentology's

bodles, lncludJng. .. necessaιy, Onal suimllsslon άtlιe dlspute to tbe Inrenιallonal ]ustlce ΟιΙeΙ άtlιe Mother
the Sdentology reUglon, Church of Sdentology lntematlonal ("ηC") or hls or her deslgnee.
°'·
\ntemal Ethlcs, justlce and blndlng rellglous arbltratlon procedures, which lndude appllcatlon to senlor ecdeslastlcal

e. Any dlspute, dalm or controversy which stlll remalns unresolved after revlew by the IJC shall be subml '
to blndlng rellglous arbltratlon ln accordance wlth the arbltratlon procedures of Church of Sdentology lntematlonal,
whlch provlde that:
L Ι wlll subrnlt a request fbr arbltratlon to the ηc and to the person or entlty wlth whom 1have the
dlspute, dalm or controversy;
U. ln my request fbr arbltratlon, 1wlll deslgnate one arbltrator to hear and resolve the rnatter;
UΙ. wlthln flfteen (15) days after receMng my request fbr arbltratlon, the person or entlty wlth whom 1have
the dlspute, dalm or controversy wlll deslgnate an arbltrator to hear and resolve the rnatter. lf the person or
..
entlty wlth whom 1have the dispute, dalm or c.ontroversy does not deslgnate an arbltrator wlthln that flfteen (15)
day peήod, then the IJC wlU deslgnate the second arbltrator;
Ιν. the two arbltratoιs so deslgnated wlD select a thlrd arbitrator wlthln flfteen (15) days after the
deslgnatlon of the second arbltrator. If the arbltratoιs are unable to deslgnate a thlrd arbltrator wlthln the flfteen
(15) day peήod, then the ηc wlD choose the thlrd arbltrator;
ν. consistent wlth my intentlon that the arbltratlon be conducted in accordance wlth Scientology
pήndples, and consistent wlth the eccleslastlcal nature of the procedures and the dlspute, clalm or controversy to
whlch those procedures relate, lt ls my speclfic intentlon that all such arbltratoιs be Scientologlsts ln good fι~
standing wlth the Mother Church. .y::::::-
f. The Church and aU other Scientology churches and organlzatlons which espouse, present, propagate or
practlce the Scientology rellglon are each separate, distlnct legal corporatlons, and each such entlty ls lndependently
responslble for its own management and is independently responslble for its own corporate and ecclesiastlcal ι(\_ r
atfalιs. ~

7. Thls Contract ls my good falth applicatlon to partldpate in Scientology Rellglous Serνices. 8y slgning this
Contract, 1promlse, coνenant, and represent that:
a. 1am applying to partldpate in Sdentology Rellglous Seιvlces to achleve splήtual betteπnent because Γ λ
1tru1y beUeve that peιsons can be helped to gain greater undeιstanding and happiness ln Ufe. ~

b. 1am applying honestly and in good falth to deήνe all possible peιsonal galn from Scientology ReBgipυf.)
Seιvlces. -~

c. 1have no record of belng commltted in an lnstltutlon for ment.al or emotlonal dlsordeιs. ~


d. 1have no cήmlnal record that lndudes a felony olfense. ~
e. 1am not coMected wlth any peιson, such as by maήt.al or famllial tles, of lmown antagonlsm to spiή~ η.._
treatrnent or to Scientology. ~

f. Nelther 1nor any member of my immedlate famlly has ever sued, embarrassed or attack.ed, or ~~
to sue, embarrass or attack., Scientology. ~

g. 1am not attemptlng to inflltrate or investlgate Scientology as a representatlνe of any news medla,
goνemment agency or entlty, or any other organlzatlon, entlty or peιson, nor am 1here to disrupt Church ~

8. This Contract wΙU become a legally bindlng agreement between me and the Church upon lts acceptance by the
Church or upon my commendng my partldpatlon in aScientology Rellglous Seιvlce, whlchever occuιs flrst. ln determlnlng
whether to accept this Contract, 1acknowledge that the Church wlD rely on the acknowledgements, agreements,
representatlons and promises which 1have made herein.
9. As further conslderatlon for the Church's permlsslon for me to partldpate in Scientology Rellglous Serνices and
for me to use its facUitles and other facllitles proνlded for such purposes:
a. 1, on behalf of myself and on behalf of my helιs, distήbutees, legal representatlνes and asslgns, agree not to
make daims against, sue, attach the property of, or prosecute the Church, the successors and asslgns of L. Ron
Hubbard, Church of Splήtual Technology, ReUglous Technology Center, the Church of Scientology lntematlonal, any
and aU Scientology-afflllated churches, misslons, corporatlons, assodatlons, partneιships, trusts, rellglous ordeιs or
organlzatlons, or, in any and alI capacltles and as indMduals, thelr officeιs, dlrectoιs, trustees, agents, seιvants,
successoιs, heiιs, executoιs or representatlνes, or the owneιs, manageιs, employees, agents or representatlves or
assodates of, any facUitles conductlng Scientology ReUglous Seιvlces (herelnafter collectlvely "the Releasees") for any
physlcal, ment.al or emotlonal injury, property damage, or monetary Ioss resultlng from negllgence or other acts,
howsoever caused, of any Releasee or of any employee, agent or contractor of the Church, lts afflllates, or other _ {!-..,
Releasee, ln any way relatlng to my partldpatlon in Scientology Rellglous Seιvlces. ~

b. 1further release and dlscharge the releasees ln any and aU capacltles and as indMduals from aU adlons,
daims or demands 1, my helιs, dlstήbutees, guardlans, legal representatlνes or asslgns now have or may hereafter
have li>r "'Υ ~ mental or emodonal ln)wy, pιqierty damιge. or monetaιy loss "'5ύtlng bι η wq liom }
partldpatlon in Scientology Rellglous Serνices.
c. 1further agree to indemnify and save and hold haπnless the Releasees in any and all capacities and as
individuals, and each of them, from any loss, liability, damage or cost they may incur due to my participation in
Sdentology Religious Services or due to my presence or action in or about the Church premises or the faάlities
~~~ ~
d. 1understand, acknowledge and agree that should any provision or provisions of this Contract be, for any
reason, unenforceable, the balance shall nonetheless be of full force and effect. ~

e. 1further understand, acknowledge and agree that this Contract contains eveιything that the Church or
Church representatives and 1have addressed or discussed with respect to Scientology Religious Services, and that lt
constitutes the sole and entire agreement which contains eveιything that 1have relied upon in applying to partid~Jl
in Scientology Religious Services and supersedes any and all verbal discussions 1have had with anyone. ~

1HAVI. CARE.FULLY Rf.AD THIS CONTRACT AND FULLY UNDIRSTAND ΠS CONTINTS AND CONSIQUINCIS. I
ALSO UNDIRSTAND ΤΗΑΤ 1ΑΜ ΝΟΤ ILIGIBLI FOR ΑΝΥ SCIINTOLOGY Rf.LIGIOUS SIRVICIS UNLISS 1SIGN THIS
CONTRACT. 1RIAΠIRMΤΗΑΤ1 WISH ΤΟ ΡΑRΠCΙΡΑΠ ΙΝ SCIINTOLOGY Rf.LIGIOUS SIRVICIS AND ΤΗΑΤ THIS
CHOICI IS ΑΝ INDIPINDINT IXIRCISI OF ΜΥ OWN FRII wιιι. ι FULLY UNDIRSTAND ΤΗΑΤ ΒΥ SIGNING
BILOW, 1ΑΜ FORIVI.R GIVING UP ΜΥ RIGIΠ ΤΟ SUI ΤΗΙ CHURCH, ΠS STAFF AND ΑΝΥ OF ΤΗΙ HIRIINABOVI.
Rf.FIRINCID Rf.LIASIIS FOR ΑΝΥ INJURY OR DAMAGI SUΠIRID ΙΝ ΑΝΥ WAY CONNICTID WΠΗ
SCIINTOLOGY Rf.LIGIOUS SIRVICIS .

1sign this Religious Services Enrollment Application, Agreement and General Release on this ~ day of
~ο'1 , 20_& intending to be legally bound by it, and request that 1be peπnitted to participate in
Sdentology Religious Services. c.

(SIGNATURE ~ΝΙ)
~~ /
Clvc SS\e ~ϊ'f.\Ρ C
(Printed Full Name)

(Home Address)

(SIGNATURE OF PARENf OR GUARDIAN, IF APPLICANf 15 Α MINOR)

(Printed Full Name)

(Home Address)

(Pήnted Full Name)

Having reviewed the above Religious Services Enrollment Application, Agreement and General Release the Churchy ~
reliance upon, and conditioned upon, the truthful profi'lises, representations and agreements made therein, on thisς.b
day of ~2 , 20_/2.Acceptsttυ 1~-,5 6-(!or partidpation in Sdentology Religious Services.

CHURCH OF SCIENTOLOGY U124_ Jl .! Δ "=:


By its: _ _ _
~
___..,.c'-"-"bV'----Zv~
< ?Ο
(Πtle)
____
(SIGNATURE)_ _ __,
Γ-~--------------

ltem f 13721R-CCINI'~~ral Enrollment Fonπ .


Exhibit 14
~~ώα~ ~tk~~'
~ .. ./~
c @~
and
1. Ι, , recognize, acknowledge and agree that 1am exdusively
responsible ~ present and future condition ίη life and for the choices and dedsions 1make affecting my life. With
that ίη mind, and solely of my own volltion and ίη the independent exercise of my own free will, 1am voluntaήly
signing and submitting to CHURCH Of SCIINfOLOGY q ~ (hereinafter "tbe
Church") this RILIGIOUS SIRVICE.S INROLLMINf APPLICAΠON, AGRIIMINT AND GINIRAL RILEASI (hereinafter
"thls Contrad") so that, upon its acceptance by the Church, 1may partiάpate ίη Religious Services of the Sάentology
religion under the terms, conditions, covenants, waivers and releases 1agree to by signing this Contract.

Ζ. This Contract is my statement of my personal, self-determined desire to partidpate ίη the Religlous Services of
the Scientology religlon. By signing this Contract, 1recognize, acknowledge and agree that:

a. Scientology is a religion, the Church is a church of the Scientology religion, and all the services and activities
of the Scientology religion are exdusively religious ίη nature. _..!::.!?
b. The Scientology religion is devoted to the study and handling of the human spirit ίη relationship to itself,
universes and other life. The word "Scientology" comes from the Latin "scio," meaning "knowing ίη the fullest sense of the
word," and the Greek "Iogos," meaning "study of." Dianetics spiήtual healing technology is part ofthe Sάentology religlon
and is the study of what the soul is doing to the body. The word "Dianetics" is from the Greek "dia," meaning "through," and
"nous," meaning "soul," and thus means "through soul." _ _c_· ι;,

c. The Founder of the Scientology religion is American author and philosopher L. Ron Hubbard (hereinafter
"LRH"), whose wήtings and recorded spoken words οη the subjects of Sάentology and Dianetics are a record of his
observations and research into the nature of the human spiήt and condition. The wήtings and recorded spoken words
of LRH οη the subjects of Sdentology and Dianetics present a guide intended to assist persons to become more aware
of themselves as persons, restoήng trust and respect for seif and others. They are not a statement of daims by the
Church, by any other Scientology church or organization, or by LRH. L C-

d. The term "Religious Services," as used ίη this Contract, means and refers to the beliefs and practices set forth
in the wήtings and spoken words of LRH οη the subjects of Dianetics and Scientology published with the identifying S
and double tήangle or Dianetics tήangle symbol, and all services or application of the pήnάpies of Mr. Hubbard
provided to me by the ministers or staff of the Church and all other Sdentology churches and organizations, induding
without limitation: "auditing," which is Sάentology's unique form of religlous counseling encompassing all services οη
the Sdentology Classification, Gradation and Awareness Charts which indudes, without limitation, all levels,
rundowns, grades, assists, reviews, repairs, semlnars, co-audits; all Sάentology congregational services of any
descήption; "training," which is the study of the scήpture of the Sάentology religlon οη the road to achieving spiήtual
freedom and salvation and includes without limitation all services identified οη the Sdentology Classification,
Gradation and Awareness Chart, all courses, intemships and cramming; the application of Sάentology Ethics and
Justice technology, which are both exdusively religious components of the practice of the Sdentology religlon; the
study and the application of the principles contained ίη the administrative wήtings of LRH used within the Church; and
any and all other services or use of the technology of L. Ron Hubbard, without limitation, provided to me by the
ministers or staff of the Church and all other Scientology churches and organizations. c_,i)
e. Neither the Church nor any other Sclentology church or organlzatlon which espouses, presents, propagates
or practlces the Sclentology rellglon makes any dalm:
L that the nature or purpose of Sclentology, or of Dlanetlcs, or of the wιitlngs and recorded spoken
words of LRH, ls contraιy to what ls stated Ιη th1s Contraά;

U. that the appllcatlon of any Sclentology or Dlanetlcs technology or practlce wlll haνe any partlcular effect
οη me or any other person; or

ΙU. that any partlcular resώt may be forthcornlng from my partldpatlon Ιη any Sclentology Rellglous
Serνlce.1speclfically acknowledge that 1haνe read and that 1understand Sdentology Pollcy Dlrectlve 13 March
1996, Staternents by Staff Members, which states deaιty that lf any lndMdual staff member of any Sdentology
church or organlzatlon makes any dalms about the resώts which may be forthcomlng from my partldpatlon Ιη
any Sclentology Rellglous Serνlce, any such dalms are the personal oplnlons and bellefs of that staff member
only, and are not dalms rnade by the Church or any other Sclentology church or organlzatlon. ~

3. 1haνe seen the film "Oήentatlon" and 1am now lnfonned and aware and fully understand that Sclentology ls a
rellgion, that lts teachlngs are rellgious and that lts dalms are rellglous Ιη nature. 1am further lnfonned and aware and
fully understand that when 1partldpate Ιη Sclentology serνlces, 1am partldpatlng Ιη rellglous serνlces under the
eccleslastlcal pήndples of the Sdentology rellglon. 1am also lnfonned and aware and fully understand that the Church
and all other Sdentology churches are separate, dlstlnct legal coιporatlons each lndependently operatlng and
responslble for lts own coιporate and eccleslastlcal affalrs.
4. Thls Contract ls my commltment that 1deslre to partldpate Ιη Sclentology Rellglous Serνlces excluslvely for
splήtual puιposes Ιη accordance wlth the bellefs and practlces of the Sclentology rellglon. Sclentology Rellglous
Serνlces are deslgned to glve splήtual ald, not medlcal treatment. However, the Sclentology rellgion teaches that the
splήt c.an be saνed and that the splήt alone rnay saνe or heal the body, and Sclentology Rellglous Serνlces are
lntended to saνe the splήt. By slgnlng thls Contraά, 1recognlze, acknowledge and agree that:
a. Sdentology Rellgious Serνlces are not lntended and are not used for dlagnoslng allments of the body or for
engaglng Ιη the teaching or practlce of any medlcal arts or sdences. _____!:.!}
b. lt ls exduslvely my responslbUlty to see to my physlcal and medlcal weU-belng, and under ηο drcumstance
does the Church or any other Sdentology church or organlz.atlon which espouses, presents, propagates or practlces
the Sdentology rellgion haνe any responslbUity whatsoever Ιη that regard. ~
c. 1haνe not come to the Church, nor do 1seek to partldpate Ιη Sclentology Rellglous Serνices, solely to be
ωred of any physlcal IUness, allment or condltlon.
d. Whlle the reglstrar c.an asslst me Ιη arranging for a competent medlcal examlnatlon and appropήate
treatrnent by a quallfled medlcal practltloner before 1partldpate Ιη any Sclentology Rellglous Serνices, lt ls solely my
responslbUity to take whatever steps are necessaιy to demonstrate that 1haνe ηο dlagnosable or medlcally treatable
Uinesses, allments, or condltlons that are not under competent medlcal care before 1begin partldpatlng Ιη any
Sclentology Rellglous Serνlce. Thereafter, any physlcal Uiness, allment or condltlon 1rnay haνe that has been treated
medlcally may then be addressed splήtually by the appllcatlon of the tenets of the Sclentology rellglon, subject to the
tenns of thls Contract. ---1...12
e. 1know that 1shoώd not partldpate Ιη any Sclentology Rellglous Serνice lf 1haνe a physlcal or mental
condltlon whlch mlght be aggraνated or which mlght make my partldpatlon Ιη the serνlce uncomfortable or dlstressful
to me, and 1agree to accept and assume any and all known or unknown ήsks of lnjuιy, loss, or damage resώtlng from
my cholces and declslons Ιη that regard. C. β

f, Sclentology Rellglous Serνlce rnay entaU the use of a rellgious artlfact known as the "E-Meter" for the
purpose of locatlng and resoMng problems and dlflicultles which are splήtual Ιη nature. 1understand that, by ltself, the
E-Meter does nothlng, but serves only as a guide to Sdentology mlnlsters to asslst paήshloners Ιη locatlng areas of
splήtual dlstress or traνall, and that lt ls not lntended or effectlve for the dlagnosls, treatment or preventlon of any
dlsease, or for the lmprovement of health or any bodlly functlon. ___f!2.
1ο Sclentology ls unalterably opposed, as a matter of rellglous beilef, to the practlce of psychlatιy, and
espouses as a rellglous beUef that the study of the mind and the heallng of mentally caused IUs shoώd not be allenated
from rellglon or condoned Ιη nonrellglous fields. 1am Ιη fuU agreement wlth thls rellglous beUef. 1do not belleve Ιη or
subsaibe to psychlatήc labeis for lndMduals. lt ls my strongly held rellglous bellef that all mental problems are
splήtual Ιη nature and that there ls ηο such thlng as a mentally incompetent person - only those suffeήng from
splήtual upset of one klnd or another dramatlzed by an lndMdual. 1reject all psychlatήc labeis and lntend for th1s
Contract to dearly memorlallze my deslre to be helped exduslνe\y through rellgious, splήtual means and not through
any foπn of psychiatήc treatment, speciflcally lnduding lnvoluntaιy commltrnent based on so-c.alled lack of
competence. Under no clrcumstances, at any tlme, do 1wish to be denled my ήght to care from membeιs of my
rellglon to the exduslon of psychlatήc care or psychlatήc dlrected care, regardless of what any psychlatήst, medlcal
peιson, deslgnated member of the state or famiJy member rnay assert supposed\y on my behalf. lf clrcumstances
should eνer aήse Ιη whlch goνemment, medlcal, or psychlatήc offidals or peιsonnel or family membeιs or fήends
attempt to compel or coerce or commit me for psychlatήc eνaluatlon, treatrnent or hospltallz.ation, 1fully deslre and
fully expect that the Church or Sclentologlsts wιn lntercede on my beha1f to oppose such efforts and/or extήcate me
fιom that predlcament so my spiήtual needs may be addressed ln accordance wlth the tenets of the Sclentology
rellglon &ee fιom psychlatήc lnterventlon. C.. Β

5. Thls Contract memoήallzes my lntentlon to partidpate ln Sclentology Rellglous Services only for purposes of
self-lmprovement and splήtual advancement. By slgnlng this Contract, 1recognlze, acknowledge and agree that:
a. Achleνlng the beneflts and goals of the Sclentology rellgion requlres my dedlcated partidpatlon, because
only through my own efforts can 1achleνe those beneflts and goals. c. σ
b; Before 1go on to any further servlce, lt ls essentlal that 1arn completely satlsfled wlth my expeήence wlth
my pήor servlce. While Sclentology holds out the posslblllty of a better llfe through adherence to lts bellefs and
practlces, indMdual spiήtual advancement ls not always an easy or comfortable task, and my success ln Sclentology
ώtlmately depends on my own abillty, strength and detennlnatlon to oνercome the shortcomlngs and haπnful
pattems of my past. By agreelng to proceed wlth further servlces, 1acknowledge complete satlstactlon wlth all
servlces 1haνe partidpated ln prevlously. _J;J3

c. Νο Sclentology church ls under any duty or obllgatlon whatsoeνer to retum any portion of any rellgious
donatlon 1make. Howeνer, I have read Sdentology Policy Dlrectlve 13 March 1996, Retum of Donatlons, and undeιstand
that under certaln clrcumstances ldentlfled ln pubUshed ecdeslastical poUdes such as that Sclentology Pollcy Dlrectlνe, a
retum of donatlons may be obtalned through my stήct compllance wlth those pubUshed polldes and procedures relatlng
to the Qalms Veήflcatlon Board. 1further undeιstand, acknowledge and agree that:
L such procedures requlre my dlrect partidpatlon to the exduslon of any thlrd parties, lndudlng, but not
Umlted to, attomeys:
U. retums of donatlons are exduslνely wlthln the ecdeslastical authoήty and sole dlscretlon of the Qalms
Veήflcatlon Board:
ΙU. any vlolatlon of, or devlatlon fιom, such publlshed polldes by me volds any posslbllity of my recelvlng
a retum of a donatlon: and
Ιν. should 1, at any tlme, eνer request a refund or repayment of donatlons, such refund or repayment wlll
be glνen lf and only lf 1haνe foUowed the exact procedures of the Qalms Veήflcatlon Board and this Contract, and
that ln exchange for refund or repayment of such donatlons as deteπnlned by the Qalms Veήflcatlon Board, 1execute
a complete release, quitclalm and walver of dalms as provlded by an authorlzed Church representatlve. __r;J3
d. ln connectlon wlth my partidpatlon ln Sclentology Rellglous Services, the Church rnay complle a folder
contalnlng lts notatlons of my splήtual progress, known as a "Preclear Folder" or "PC Folder," as well as other ecdeslastical
flles contalnlng notatlons regardlng my splήtual progress. ΑΙΙ of my PC Foldeιs and other ecdeslastlc.al flles contalnlng
notatlons regardlng my splήtual progress, as well as all contents thereof, are the sole and exduslνe property of Church of
Sdentology lntematlonal. As a matter of rellglous bellef and of ecdesiastlcal doctήne and law, such foldeιs and flles, and
the contents of such foldeιs and flles, are kept confldentlal from all peιsons who Iack the ecdeslastical authoήty to galn
access to such materlals, lnduding me, are subject to all appllcable dergyman-penltent pήvileges, and are nelther
comprehenslble nor meant to be undeιstood by anyone whose tralnlng and expertise Ιn thelr lnterpretatlon Ιs not
recognlzed and sanctloned by Church of Sclentology lntematlonal.
Ι. As a conditlon of belng accepted for partldpatlon Ιn Sclentology Rellglous Services, Ι forever abandon,
surrender, walνe, and rellnqulsh wlthout llmitatlon any and all ήghts of owneιshlp, possesslon, custody, control,
access, copylng, and vlewlng of my PC Folder or Foldeιs and all other ecdeslastical flles contalnlng any notatlons
regardlng my spiήtual progress, both wlth respect to the foldeιs and flles themselνes and the lnfoπnatlon contalned
lnthem.
U. The abandonment, surrender, walνer, and rellnqulshment to whlch 1refer Ιn the lmmediately precedlng
subparagraph ls unconditlonal and lπevocable and applles equally to anyone actlng or purportlng to be actlng on my
behalf or for rny beneflt, whether Ι arn allνe or dead, whether 1arn dlsabled or lncapadtated, and under any and all
clrcumstances foreseen or unforeseen, ln perpetulty, wlthout exceptlon or Umltatlon.
1U. Should 1or anyone actlng or purportlng to be actlng on rny behalf or for rny benefit ever seek access to
any of my PC Folders or any other ec.cleslastlcal 61e contalnlng any notatlons regardlng rny splrltual progress, Ι
lntend for the submlsslon of thls Contract to the presldlng judldal offlcer to be a complete and suffldent basls for
the lrnmedlate denlal of whateνer access ls belng sought wlth prejudlce to any other or further effort to breach
the absolute conΛdentlalii;Y of those materlals or the exduslve rlght of Church of Sdentology Internatlonal to
preseινe thelr absolute conΛdentlalii;Y. CΒ

e. It is both an unalterable religlous belief and a matter of ec.cleslastlcal ωstom of the Sdentology religlon that
my personal splrltual progress wlll be directed by a mlnister known as a Case Supeινisor who deteπnlnes whlch
Religlous Seινices are approprlate for rny personal splrltual progress and the sequence Ιn whlch Ι wlll partldpate Ιn
such Rellgious Seινices. As a rnatter of religlous bellef, 1acknowledge that rny Case Supeινisor wlll make the declslons
regardlng the approprlate course of rny splrltual progress, and 1wιn abide by the declslons and dlrectlon of my Case
Supeινisor ln guldlng rny spirltual progress. ΑΙΙ Religlous Seινices Ιn which 1partidpate hereafter at the dlrectlon of rny
Case Supeινisor are subject to the tenns of thls Contract.

6. Thls Contract memorlalizes rny freely glven consent to be bound exduslvely by the disdpUne, falth, lnternal
organizatlon, and ec.clesiastlcal rule, ωstom, and law of the Sdentology religlon Ιn aU matters relatlng to Sdentology
Religlous Seινices, ln all rny deallngs of any nature wlth the Church, and Ιn aU rny deallngs of any nature wlth any other
Sdentology church or organizatlon whlch espouses, presents, propagates or practlces the Sdentology religion. By s1gnlng
this Contract, 1recognize, acknowledge and agree that:

a. My freely given consent to be bound exduslvely by the dlsdpUne, falth, lntemal organlzatlon, and ec.cleslastlcal
rule, ωstom, and law of the Sdentology religion ln aU matters relatlng to Sdentology ReUgious Services, Ιn all rny deallngs
of any nature with the Church, and in all my deallngs of any nature with any other Sdentology church or organizatlon
whlch espouses, presents, propagates or practlces the Sdentology rellgion means that 1am forever abandonlng,
surrenderlng, walvlng, and relinquishing rny rlght to sue, or otherwise seek legal recourse with respect to any dispute,
dalm or controversy agalnst the Church, all other Sdentology churches, all other organlzatlons whlch espouse, present,
propagate or practlce the Sdentology rellgion, and all persons employed by any such entli;Y both in thelr personal and any
offldal or representatlonal c.apadtles, regardless of the nature of the dispute, dalm or controversy. __ CΒ
b. The abandonment, suπender, walver, and reUnquishment to which 1refer in the lrnmedlately precedlng
subparagraph ls uncondltlonal and lπevocable and appUes equally to anyone actlng or puιportlng to be actlng on my
behalf or for my benefit, whether 1am allve or dead, whether 1am dlsabled or incapacltated, and under any and all
drcumstances foreseen or unforeseen, ln perpetul1;y, wlthout exceptlon or llmitatlon. ____[., β
c. Should 1or anyone actlng or purportlng to be actlng on my behalf ever sue, or otherwise seek legal recourse
wlth respect to any dlspute, dalm or controversy agalnst the Church, any other Sdentology church, any other organlz.atlon
whlch espouses, presents, propagates or practlces the Sdentology religion, or any person employed by any such entl1;y,
regardless of the nature of the dlspute, dalm or controversy, 1lntend for the submlsslon of thls Contract to the presidlng
Judldal offlcer to be a complete and suffldent basis for the lrnmedlate dlsmlssal of any and aU such proceedlngs wlth
preJudlce to further proceedlngs of any klnd. _ _ 1J c
cl. In accordance with the dlsdpline, falth, lntemal organizatlon, and ec.cleslastlcal rule, ωstom, and law of the
Sdentology religlon, and in accordance wlth the constltutlonal prohibltlons which forbld govemmental lnteιference with
rellgious seινlces or dispute resolutlon procedures, should any dispute, dalm or controversy arlse between me and the
Church, any other Sdentology church, any other organization whlch espouses, presents, propagates or practlces the
Sdentology religion, or any person employed by any such entl1;y, whlch cannot be resolved lnformally by dlrect
communicatlon, 1wlll pursue resolutlon of that dispute, dalm or controversy solely and exduslvely through Sdentology's
lnternal Ethlcs, justlce and blndlng rellgious arbitratlon procedures, whlch indude application to senlor ec.cleslastical
bodles, indudlng, as necessaιy, final submlsslon of the dlspute to the lnternatlonal justlce Chief of the Mother Church of
ttιe Sdentoιogy reugιon. etιurch otSdentoιogy 1nternat1ona1 ι·ηc·> or his or her desιgnee. __ c_B
e. Any dispute, dalm or controversy whlch stlll remalns unresolved after review by the ηc shall be submitted
to blndlng rellgious arbltratlon in accordance wlth the arbltratlon procedures of Church of Sdentology Internatlonal,
which provlde that:
Ι. 1wiU submit a request for arbitratlon to the ηc and to the person or entli;Y wlth whom 1have the
dlspute, dalm or controversy;
11. in rny request for arbltratlon, 1wιn designate one arbltrator to hear and resolve the matter;
IU. wlthln 8fteen (15) days after receMng my request for arbltratlon, the person or entii;Y wlth whom 1have
the dlspute, dalm or controversy wiU designate an arbltrator to hear and resolve the matter. If the person or
entl~ wlth whom 1have the dlspute, dalm or controνersy does not designate an arbltrator wlthln that flfteen (15)
day peήod, then the IJC wlll deslgnate the second arbltrator;
Ιν. the two arbltrators 50 deslgnated wιu select a thlrd arbltrator wlthln flfteen (15) days after the
deslgnatlon of the second arbltrator. lf the arbltrators are unable to deslgnate a thlrd arbltrator wlthln the flfteen
(15) day peήod, then the ηc wlll choose the thlrd arbltrator;

ν.conslstent wlth my lntentlon that the arbltratlon be conducted Ιη accordance wlth Sclentology
pήndples, and conslstent wlth the eccleslastlcal nature of the procedures and the dlspute, dalm or controνersy to
whlch those procedures relate, lt ls rny spedflc: lntentlon that aU such arbltrators be Sclentologlsts ln good
standing wlth the Mother Church. __fΞΒ

f, The Church and all other Sclentology churches and organlz.atlons whlch espouse, present, propagate or
practlce the Sclentology rellglon are each separate, dlstlnct legal corporatlons, and each such entl~ ls lndependently
responslble for lts own management and ls lndependently responslble for lts own corporate and eccleslastlcal
affalrs. __fΠ;

7. Thls Contract ls rny good falth appllcatlon to partldpate ln Sclentology Rellglous Serνices. 8y signlng thls
Contract, 1promlse, covenant, and represent that:
a. 1am applylng to partldpate ln Sclentology Rellglous Serνices to achleve splήtual betteπnent because
1truiy belleve that persons can be helped to galn greater understandlng and happlness Ιη llfe. ~ l5
b. 1am applylng honestly and Ιη good falth to deήve aU posslble personal galn from Sclentology Rellglous
Serνlces. __ c_13
c. 1have no record of belng committed Ιη an lnstltutlon for mental or emotlonal dlsorders. __!Ξ:..Β

d. 1have no almlnal rec:ord that lndudes a felony offense. Cf3

e. 1am not connected wlth any person, such as by maήtal or famlllal tles, of known antagonlsm to splήtual
treatment or to Sdentology. __ff3
f, Nelther 1nor any member of rny lmmedlate famlly has ever sued, embarrassed or attacked, or threatened
to sue, embarrass or attack, Sclentology. c43
1ι 1am not atternptlng to lnflltrate or lnvestlgate Sclentology as a representatlve of any news medla,
govemrnent agenc:y or entl~, or any other organlz.atlon, entl~ or person, nor am Ι here to dlsrupt Church adlνltles4J

8. Thls Contract wlU become a legaliy blndlng agreement between me and the Church upon lts aα:eptance by the
Church orupon my commendng mypartldpatlon ln aSclentology Rellglous Serνice, whlchever oc:ωrs flrst. In determlnlng
whether to aα:ept thls Contract, 1acknowledge that the Church wlll rely on the acknowledgements, agreements,
representatlons and promlses whlch 1have made hereln.
9. As further consideratlon for the Church's permlsslon for me to partldpate Ιη Sclentology Rellglous Serνices and
for me to use lts facilltles and other faciUtles provlded for such purposes:
a. 1, on behalf of rnyself and on behalf of rny helrs, dlstήbutees, legal representatlves and asslgns, agree not to
make dalms agalnst, sue, attach the property of, or prosecute the Church, the successors and asslgns of L. Ron
Hubbard, Church of Splήtual Technology, Rellglous Technology Center, the Church of Sclentology lntematlonal, any
and aU Sclentology-afflllated churches, mlsslons, corporatlons, assodatlons, partnershlps, trusts, rellglous orders or
organlz.atlons, or, Ιη any and all capacltles and as lndMduals, thelr officers, dlrectors, trustees, agents, serνants,
suc:cessors, helrs, exec:utors or representatlves, or the owners, managers, employees, agents or representatlves or
assodates of, any facilltles conductlng Sclentology Rellglous Serνices (herelnafter coUectlvely "the Releasees•) for any
physlcal, mental or emotlonal lnjuιy, prope~ damage, or monetaιy loss resultlng from negllgence or other acts,
howsoeνer caused, of any Releasee or of any employee, agent or contractor of the Church, lts afflllates, or other
Releasee, Ιη any way relatlng to my partldpatlon Ιη Sclentology ReUglous Serνlces. 6 Β
b. 1further release and dlscharge the releasees ln any and aU capacltles and as lndMduals from aU actlons,
dalms or demands 1, my helrs, dlstήbutees, guardlans, legal representatlves or asslgns now have or may hereafter
have for any physlcal, mental or emotlonal lnJuιy, prope~ damage, or monetaιy loss resultlng Ιη any way from rny
partldpatlon Ιη Sdentology Rellglous Serνices. _f:l?
c. 1further agree to indemnify and save and hold harmless the Releasees in any and all capaάtles and as
individuals, and each of them, from any loss, liability, damage or cost they may incur due to my participation in
Sάentology Religious Services or due to my presence or action in or about the Church premises or the faάlities
providing such services. ____f:_β'
d. 1understand, acknowledge and agree that should any provision or provisions of this Contract be, for any
reason, unenforceable, the balance shall nonetheless be of full force and effect. __!':::_ β
e. 1further understand, acknowledge and agree that this Contract contains eveιything that the Church or
Church representatives and 1have addressed or discussed with respect to Sάentology Religious Services, and that it
constitutes the sole and entire agreement which contains eveιything that 1have relied upon in applying to participate
in Scientology Religious Services and supersedes any and all verbal discussions 1have had with anyone. __ c._ Γ3

1HAVI CAREFULLY RIAD nus CONTRACτ AND FULLY UNDERSτAND πs CONΠNTS AND CONSIQ.UENCES. 1
AlSO UNDIRSτAND ΤΗΑτ 1ΑΜ ΝΟΤ ILIGIBLI FOR ΑΝΥ SCIINTOLOGY RILIGIOUS SIRVICES UNLISS 1SIGN nus
CONTRACτ. 1RlAFΠRM ΤΗΑτ 1WISH το ΡΑRΠCΙΡΑΠ ΙΝ SCIINTOLOGY RILIGIOUS SIRVICES AND ΤΗΑτ nus
CHOICI IS ΑΝ INDIPINDINT IXIRCISI OF ΜΥ OWN FRII wιιι. 1FULLY UNDIRSτAND ΤΗΑτ ΒΥ SIGNING
BILOW, 1ΑΜ FORIVIR GIVING UP ΜΥ RIGHT το SUE THl CHURCH, πs sτΑΠ AND ΑΝΥ OF THl HIRIINABOVI
RIΠRINCID RILIASIES FOR ΑΝΥ INJURY OR DAMAGI SUFΠRID ΙΝ ΑΝΥ WAY CONNICTID WITH
SCIINTOLOGY RILIGIOUS SIRVICES .

.
1sign this Religious Services Enrollment Application, Agreement and General Release on this Ζ f.t? day of
ND V ftrιS ffi, 20.1.Ζ.. intending to be legally bound by it, and request that 1be permitted to participate in
Sάentology Religious Services

6 - -::::::2 / .
~ ~1>4---L-. ,,•

(Pήnted Full Name)

(Home Address)

(SIGNATURE OF PARENT OR GUARDIAN, IF APPLICANf IS Α MINOR)

(Printed Full Name)

(Pήnted Full Name)

Having reviewed the above Religious Services Enrollment Application, Agreement and General Release the Church-.!9
reliance up~nditioned upon, the truthf41 promises, representations and agreements made therein, on this ~
day of , 20~epts !Ρ__::;,9 e\-)c/C...· for participation in Scientology Religious Services.

::,CH ar scιoooιOGv ~t/y Co ιφ


[Πtle)

(SIGNAnJRE) ~~
ltem f J3721R-CCINT-General Enrollment Form.

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