Introductory Religious Service Enrollment Application,Agreement and General Release
(here after referred to as "the Church"), Church of Scientology of (hereinafter referred to as "the Church") ” (Name)

1. Case Supervision

Any personal spiritual progress will be directed by a Case Supervisor who will determine which Scientology services and courses are appropriate for me. The Case Supervisor will have access to all my ecclesiastical records including Preclear (PC) folders and worksheets.

2. Religious Nature of Services

I recognize and acknowledge that all services provided by the Church are exclusively religious in nature and are based on the religious scriptures and teachings of L. Ron Hubbard as published with the Scientology cross and double triangle symbol.

3. Ecclesiastical Files

All ecclesiastical records, PC folders, worksheets and other documents created during my religious services are the exclusive property of the Church and are kept confidential under ecclesiastical law and clergyman-penitent privilege.

4. Waiver of Rights

I voluntarily waive any and all rights to access, view, copy or possess my ecclesiastical records, understanding that this is required by religious doctrine and ecclesiastical law for the protection of my spiritual progress.

5. Confidentiality Agreement

I agree to maintain absolute confidentiality regarding all aspects of Scientology religious technology, ecclesiastical procedures, and any information received during religious services.

6. General Release

In consideration for receiving religious services, I hereby release the Church, its officers, directors, employees, agents, and representatives from any and all claims, demands, actions, or causes of action arising out of or related to my participation in religious services.

DECLARATION: I have read and understand this agreement and voluntarily accept its terms as a condition of receiving Scientology religious services.


Signature Section

Date: ___________________________

Signature: ___________________________

Printed Name: ___________________________

Address: ___________________________


Parent/Guardian (if under 18):

Signature: ___________________________

Printed Name: ___________________________

Relationship: ___________________________


Witness:

Signature: ___________________________

Printed Name: ___________________________


Church Representative:

Church of Scientology

By: ___________________________

Title: ___________________________

Total Contracts: 36
Categories: 8
Organization: Sea Org & Staff
Status: LEAKED