Enrollment Agreement
and General Release
I, ___________________________________________, wish to participate in the Dianetics Seminar.
Dianetics (from Greek Dia "through." and nous "soul") is a study of the research and writings of L. Ron Hubbard. It delineates fundamental principles of the mind and spirit. Through Mr. Hubbard's application of these discoveries, it became apparent that Dianetics dealt with a beingness that defied time — the human spirit — originally denominated the "I" and subsequently the "thetan." Mr. Hubbard continued his research, eventually mapping the path to full spiritual freedom of the individual.
Dianetics is a forerunner and substudy of the Scientology religion which addresses only the "thetan" (spirit), which is senior to the body, and its relationship to and effects on the body. While the Church is free, as all churches are, to engage in spiritual healing, its primary goal is increased spiritual awareness for all. For this reason, neither Dianetics nor Scientology is offered as, nor professes to be, physical healing, nor is any claim made to that effect. Individuals who desire treatment of physical or mental illness are not accepted at this seminar but, instead, require a competent medical examination for physical conditions, by qualified specialists, before addressing their spiritual cause.
The written and audio-visual material presented at the Dianetics Seminar is part of L. Ron Hubbard's religious literature and works and is not a statement of claims made by the author, publisher, any Church of Scientology or Hubbard Dianetics Foundation. It is a record of Mr. Hubbard's observations and research into life and the nature of man.
The attainment of the benefits and goals of Dianetics and Scientology requires each individual's dedicated participation, as only through one's own efforts can it be achieved — including the techniques taught and practiced in the course of this seminar.
This seminar is organized and conducted by the _____________ (Church of ...), a self governing and distinct legal entity in every respect. No claim is made by the organizers that a seminar participant will attain a particular result nor shall they be responsible for any personal opinion or belief of any staff member or agent.
With all above in mind and recognizing its meaning, I agree to hold the organizers harmless and that in no event shall they be liable for any damage whatsoever, including claims of expenses or lost earnings, arising from participation in the Dianetics Seminar, and I waive my right to sue or seek legal recourse against them, their employees or agents for any claims, dispute or controversy relating to this Seminar.
Hence, exercising my independent and own free will, I herewith voluntarily sign this Agreement and General Release in order to enroll in the Dianetics Seminar conducted
at _______________________________________ on __/__ and __/__ 200__.
DD MM DD MM
Date: __/__, 200__, at _______________________
DD MM
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Signature of Enrollee
Enrollment Agreement Page 2 of 3
and General Release
_________________________________________
Printed Full Name
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Address — Number & Street
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Address — City, State, ZIP Code
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E-Mail Address
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Signature of Parents/Guardian if a Minor
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Home Address
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Signature of Witness
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Printed Full Name
ACCEPTANCE:
Having reviewed this Enrollment Agreement and General Release and in reliance upon, and conditioned upon, the truthfulness of the representation and agreements made herein, the ________________ (Church of Scientology of ...) hereby accepts Mr./Mrs./Ms. ____________________
as a participant in a Dianetics Seminar.
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Signature
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Printed full Name
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Title