The Russian original is available from :
http://info.sandy.ru/socio/public/rpec/cult_documents/scient_docs/declar_and_renunc_staff.html
or here's a copy.

I,
______________________________________
residing at address
______________________________________
______________________________________

do apply for my admission into the Hubbard Humanistic Center for active employment in the capacity of permanent staff in the G.Ts.H. located at address: Moscow, 31 Budennova Pr. (hereinafter referred to as "Center") for a period of five (5) years or two and a half (2.5) years (underline the period of your choice). Acceptance of my application is based on the following data.

DATA

1. (for minors) I obtained consent of my parents or guardians for the obligation described here and to participate in the work at the Center. That consent has been given is expressed by my signature at the bottom of this Application, Declaration and Renunciation of Claim (hereinafter referred to as "Application").

2. I have never undergone punishment for a criminally punishable offense of the law in any jurisdiction.

3. I have never undergone psychiatric treatment.

4. I have never undergone electric, insulin or any other type of shock or psychiatric operations on the brain.

5. I have never been a distributer of drugs.

6. I have never filed a lawsuit against the Center nor any other Scientology organization, nor have I made a claim in any government agency against the Center, against any member of the center or against any Scientology organization.

7. I have never been a runaway member of Center of Moscow organization personnel. This means that I have never abandoned any post in any Scientology organization without permission in accordance with Center instructions and I have never broken my oath as a member of the Moscow organization's religious fraternity of the Church of Scientology
OR
I ran away in the past as described above, but later on, when I renounced my action, I was sorry and I was received back into the Scientology Church after having done the appropriate amends.

8. I have never had relations to any type of intelligence service and do not have any ties to any. This applies to my own past as it does to my present family ties.

9. My parents or guardians do not show antagonism towards the Scientology religion or any organization connected with Scientology's applied religious philosophy.

10. I am not joining the organization with the goal of collecting information for the mass media (television, radio, press and other means of distributing information).

11. I don't have any personal debts, the amount of which is great enough that an effort to recover it would interfere with carrying out my obligations regarding the Center or serve as a reason to refuse these obligations.

12. I have not undergone treatment for mental disorders that include a voluntary or involuntary stay in a psychiatric hospital, including conscious or unconscious treatment in such a hospital.

13. I do not belong to any secret department of the government or military.

14. My wife (husband) does not express objections about my work in the Center.

15. I am not using drugs at the present time.

(Exceptions to the above may be made only after submission of application to higher authority of the Church and after receipt from it of unconditional approval. This written approval needs to be given in OHS(tm) by signing this application.)

I UNDERSTAND AND AGREE THAT THE INFORMATION I STATE ON THIS APPLICATION IS ABOUT RELIGIOUS INITIATION INTO SCIENTOLOGY ITSELF AND ITS ACTIVITIES OF SPIRITUAL REALIZATION AND CREATION OF A BETTER WORLD.

SIGNED ________________________

I ALSO UNDERSTAND THAT ALL EMPLOYEES OF THE CHURCH, INCLUDING ME, ARE MEMBERS OF A RELIGIOUS ORGANIZATION AND THEY WORK IN ACCORD WITH THEIR RELIGIOUS ORGANIZATIONS, AND NOT ON A BASIS OF COMMERCIAL AND FINANCIAL MOTIVES.

SIGNED ________________________

EVERY EMPLOYEE CONSIDERS HIMSELF A VOLUNTEER WHO CREATES A BETTER WORLD AND HE UNDERSTANDS THAT HE IS NOT A HIRED WORKER AND, THEREFORE, DOES NOT PURSUE COMMERCIAL AND FINANCIAL GAIN.

SIGNED ________________________

I confirm that this application binds me as a member of a religious organization to follow church, moral and ethical instructions, rules, standards and practices of the Scientology philosophy, as well as administrative instructions and procedures of the Church.

I agree to maintain the confidentiality of all communications (written or verbal), all documents, all files, all address lists and other materials (hereinafter referred to as "materials") not intended to be sold to the public, or to make use of what I may find out or what I may deal with as a result of my work in the capacity of staff member at the Center or any other Scientology organization. I also agree not to remove materials from my location of work, and to not reveal any information to any person without advance written consent of the Church.

I agree that any claim, dispute or clash occurring within the limits of this application or connected with any Scientology or Dianetics (r) service or activity in which I take part need to first be addressed in written form to the Principal Interurban Court, which settles matters in accordance with the religious doctrines of the Center, including procedures of Scientology justice. I understand that in case of a disagreement with a court decision, I may have recourse to other Church procedures as prescribed in Center instructions. UNDER NO CIRCUMSTANCES ARE SIMILAR CLAIMS OR DISPUTES SUBJECT TO TRANSFER TO CONSIDERATION BY A COURT OF LAW, AS THE PARTIES UNDERSTAND THAT THESE ISSUES HAVE RELIGIOUS CHARACTER.

I understand and agree that my participation in the work of the Center as permanent staff is founded upon the following:

1. HOURS OF WORK AND OVERTIME WORK. The organization work day is during the day hours, and the Dianetics Fund of Hubbard works the evening hours with days off. It is expected of a staff member that he will study in his free time and will assist in performing additional work.

2. VACATION. Twenty-four (24) working days a year after eleven (11) months of continuous, active work as organization permanent staff.

3. HOSPITAL LIST. Based on the current state of pay benefits, according to the disability.

4. PENSION. The Center does not pay supplemental pensions or any other type of pension benefits (The Center makes payments to the government pension fund in the manner prescribed by the laws of the Russian Federation).

5. GRANTING OF MONETARY COMPENSATION. Staff members of the Center work according to their religious commitment and conviction, and not for monetary compensation or other traditional, commercial or financial motives or incentives. Nevertheless, the Center, in accordance with this application, grants staff members some monetary compensation. Granting of this compensation does not imply and does not represent compensation for work performed by the applicant. It is intended for creation of a suitable atmosphere in which religious and spiritual awareness may better develop. The amount of the financial compensation depends on the financial state in which the Church finds itself.

6. INSTRUCTION. Staff members are subject to existing politics [sic] in which they might introduce amendments, changes and additions. Permanent staff study and take exams on their knowledge of instructions, bulletins and directives related to their activities and other such instructions, bulletins and directives as may be required from time to time. Staff may be dismissed in accordance with instructions.

7. BREAKING AGREEMENT. If a permanent staff member who has received free service or a 50% discount (off the public price) breaks the contract, is discharged from completing the contract or undermines his reputation as a member of the Scientology organization, he is to be dismissed in accordance with instructions as a result and is declared to be a "freeloader," and he must immediately remit the Center's penalty for the infringement of agreement in accordance with the spiritual instructions of the Center. These terms do not follow traditional, commercial interests, but represent an application of Church ethics.

8. ETHICAL CONDUCT. It is expected of permanent staff of the Center, as it is of members of a religious organization, that they will adhere to high ethical standards of personal conduct in accordance with the instructions of the Center and its doctrines. Permanent staff of the Center are guided by the Center's ethical rules, which were created to make people more ethical, productive and happy.

9. FULFILLING AGREEMENT. The Church does not keep any verbal promise or any other condition which is not embraced in this application. The present application forms the full text of the Center's agreement with the permanent staff member and does not promise him any actual auditing, training, post or other benefit.

10. CONTACT WITH PEOPLE NOT IN GOOD STANDING. During the time of my work in the capacity of permanent staff, I pledge not to intentionally communicate in any way with former parishioners of the Center or of any other Scientology organization who are not in good standing, be they expelled or declared suppressive persons.

DISCHARGE OF CLAIM

WITH THE INTENTION of receiving permission from the Center to be a member of the Scientology religious organization, and be an active permanent staff member of the Center, as stated in this application,

A. BY THESE PRESENTS I AGREE THAT MY HEIRS, CO-HEIRS, GUARDIANS, PROXIES AND LEGAL SUCCESSORS WILL NOT FILE A LEGAL CLAIM AGAINST THE Center or its affiliated branches (churches, missions, corporations, associations and companies) or against successors of L. Ron Hubbard, or against their mediators, employees, directors, proxies, agents, successors, heirs, legal executors or representatives and/or holders, managers, workers, agents or representatives (hereinafter referred to as "Released from Claims" - RC), WILL NOT SERVE ON THEM IN CIVIL COURT, WILL NOT DEMAND THAT ARREST WILL BE IMPOSED UPON THEIR PROPERTY for trauma or damages (occurring as a result of negligence or other action by the RC or by any workers, agents or contractors of the Center, its branches or other RC) connected with them or their appearance with my membership in the Scientology religious organization, my stay in the organization's accommodations or interactions with the RC.

B. BY THESE PRESENTS I RELEASE FROM CLAIM AND RELEASE THE RC from all actions and demands that I, my heirs, co-heirs, guardians, proxies and legal successors may have had, have now or will have in the future as a consequence of trauma or damages incurred during the time of my membership in the Scientology organization, my active engagement in the capacity of permanent staff or my interactions with the RC.

C. I ALSO AGREE NOT TO EXPOSE TO DANGER, TO CARE FOR AND NOT INFLICT HARM on the RC or on each of them individually to any kind of harm, liability, detriment or expense which may happen as a result of the RC's negligence or as a result of (a) my breach of any obligation stated in this application, (b) my breach of required responsibility to me by the Center and/or RC, (c) my activity in the Center or my conduct in the company of people having a relationship with the Center and/or with the RC, regardless of whether that activity or conduct is related to this Application or not, (d) any statement made by me in this Application which is false at the present time or proves to be false in the future, (e) my membership in the Scientology organization or active involvement in the capacity of permanent staff or interaction with the RC.

I HAVE CAREFULLY READ THE FOREGOING POINTS ON DISCHARGE OF CLAIM AND COMPLETELY UNDERSTAND THEM.

SIGNED ________________________

I REALIZE THAT THIS APPLICATION REPRESENTS AN OBLIGATION TO DISCHARGE FROM CLAIM AND NOT TO PROVOKE A CASE IN COURT AND TO GUARANTEE AGREEMENT BETWEEN ME AND THE CENTER AND/OR ITS BRANCHES AND/OR OTHER PEOPLE. I UNDERSTAND AND AGREE THAT BY SIGNING THIS DOCUMENT, I WILL BE BOUND BY ITS TERMS.

SIGNED ________________________

CONCLUSION

I verify that I have read and completely understand the Application. Before authenticating this with my signature, I completely understood its contents and all the consequences of my agreement and release from claim. I am joining the staff of the organization, I am becoming a member of a religious organization in accordance with my own free choice, exclusively to assist in obtaining the religious goals and principles of the Scientology religion and the Center, and not for financial advantage, auditing or training. I was given a possibility to consult with people who I selected at my discretion to discuss the issues with regards to this Application. I understand that I am executing this agreement, I accept this obligation and I give official oath to work on the staff in the course of all periods which were noted above. In accordance with the principles of the Center, I represent that I have not passed one word in the Application which I did not completely understand.

Date ______________

Signature ________________________

Signature of Parent or Guardian for Minors ________________________

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