RELEASE
In consideration of (1) the opportunity provided to me to serve as a member of the staff of Church of Scientology _____________________, (2) the staff stipend and allowances, and (3) the room, board and other amenities I receive in exchange for such service, I _________________________________, of __________________ ____________________________, (County, City, State and Country), on this ___ day of ________, 200_, hereby agree as follows:
I have signed a Covenant Regarding Service as a Religious Worker with Church of Scientology ____________________ and am currently a staff member of this Church. I am also a member of the Sea Organization (“Sea Org”), a religious fraternal order, with its own rituals and traditions that exemplify and foster members’ shared and deeply-held commitment to the Scientology religion.
I affirm that, in signing the Covenant Regarding Service as a Religious Worker, I agreed that any disputes, controversies or claims I may have in connection with my service as a religious worker for the Church will be resolved and, if necessary, adjudicated solely under ecclesiastical law under the authority of the International Justice Chief.
As of the date of my signing this Release, I am not aware of any such dispute, controversy or claim arising out of my service as a religious worker. Nevertheless, in consideration of the benefits recited herein and other valuable consideration, I am hereby releasing the Church from any liability in connection with any and all such disputes, controversies and claims, as set forth below.
Accordingly, on behalf of myself, my heirs, my successors, representatives, agents, employees, attorneys and assigns, I hereby irrevocably and unconditionally release, acquit, and forever discharge Church of Scientology ___________________. Church of Scientology International (“CSI”), Religious Technology Center (“RTC”), Church of Spiritual Technology (“CST”), all other Scientology Churches or Missions (collectively Scientology Organizations) and affiliated organizations, their respective trustees, directors, officers, employees, and agents, individually and in any and all capacities, the successors and assigns of L. Ron Hubbard, and each of them, and their respective successors, representatives, agents, attorneys, assigns, subsidiaries, officers, directors, divisions, trustees, and employees (collectively "Releasees"), individually and in any and all capacities, from any and all claims, damages, causes of action of every kind, whether known or unknown, which I, or anyone claiming under me now have or may hereafter have against Releasees, and each of them, from the beginning of time, to and including the effective date of this Covenant.
The term "any and all claims" as used above, means and includes, but is not limited to, all claims of any kind, whether known or unknown, anticipated or unanticipated, suspected or unsuspected, past or present, contingent or fixed, including, without limitation, claims under: [THE FOLLOWING ARE US LAWS - THIS SECTION IS TO BE ADJUSTED ACCORDINGLY BASED ON THE LAWS OF THE AREA THIS RELEASE WILL BE APPLIED – IT IS LEFT HERE TO GIVE AN EXAMPLE OF HOW IT WAS DONE IN THE US)) (1) Title VII of the Civil Rights Act of 1964 (race, color, religion, sex, and national origin discrimination); (2) 42 U.S.C. §1981 (discrimination); (3) 29 U.S.C. §§621-634 (age discrimination); (4) 29 U.S.C. §206(d)(1) (equal pay); (5) the California Fair Employment and Housing Act (discrimination, including race, color, national origin, ancestry, physical handicap, medical condition, marital status, sex, or age); (6) Executive Order 11246 (race, color, religion, sex, and national origin discrimination); (7) Executive Order 11141 (age discrimination); and (8) §§503 and 504 of the Rehabilitation Act of 1973 (handicap discrimination).
The term "any and all claims" shall be interpreted liberally and as sufficiently comprehensive so that this Covenant precludes any and all disputes, litigation or controversy of any and all descriptions brought by me against any and all Releasees.
I agree and understand that by signing this Covenant, I am releasing all claims, whether known, unknown, foreseen, or unforeseen, obvious or hidden which I may have against any of the Releasees.
I have executed this Release willingly, voluntarily, and without coercion or duress of any kind.
In the event that any portion of this Release is found to be legally unenforceable by a court of competent jurisdiction, this shall not affect the binding nature of the remainder of the provisions in this Release which shall remain in full force and effect.
This Release shall be construed, interpreted, governed, and enforced in accordance with the laws of _________________ without reference to conflicts of law.
I consent to the personal jurisdiction and venue of the Court of ______________________, or any other court of competent jurisdiction in ________________________________________in the event Church of Scientology _________________________ seeks to bring any legal action to enforce the provisions of this release.
By my signature below, I attest that I have read this document thoroughly; I understand the importance of this document and I am willingly signing it. I am aware that this is a release of liability of Church of Scientology ______________________ and/or its affiliated organizations and/or other individuals, and I understand and agree that by placing my signature at the end of this document I shall be bound by its terms.
___________ _______________________________
Date Signature of Applicant
_______________________________
Signature of parent or guardian if a minor
_______________________________
Witness