GRILL FLAME VOLUNTEER CONSENT STATEMENT (MELVIN C. RILEY)

• Document Type: CREST
• Collection: STARGATE
• Document Number (FOIA) /ESDN (CREST): CIA-RDP96-00789R002100150050-8
• Release Decision: RIPPUB
• Original Classification: S
• Document Page Count: 2
• Document Creation Date: November 4, 2016
• Document Release Date: December 4, 1998
• Sequence Number: 50
• Content Type: CONT

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Approved For Release 200'4-f0~107 : C~A-RDP96-007898002100150050-8
GRILL FLAME VOLUNTEER CONSENT STATEMENT
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volunteer f'or INSCOM Project Grill Flame. I understand this program involves
graining designed to enhance inherent psychic abilities. I consent to this
graining and willingly volunteer to participate.in INSCOM intelligence
projects using my psychic abilities. I understand this program deals with
mE~ntal perceptive abilities beyond the range of the five corporal senses
arrd for this reason an aspect of mental training is involved. I understand
that the purpose of this training is to teach me how to discipline my
merntal perceptive abilities and focus them on data beyond the range of the
five corporal senses.
I understand that as a volunteer I may withdraw from the program at
any time for any reason. My decision to withdraw from the program will be
accepted without controversy.
I understand that for precautionary and screening reasons that I as
a GRILL FLAME volunteer must have a Class A physical exam to include a
stress EKG prior to beginning training.
NO~PE: Physical examination taken within the past 12 months is acceptable.
WITNESS
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VOLUNTEER
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Approved For Releas~Y~0,0''I`/I~t~7 : CIA-RDP96-007898002100150050-8
 Approved For Release 2001/03/07 :CIA-RDP96-007898002100150050-8
llA7:'Jl l;F,RUTRI,I) BY ~'HE Pt3IVi CY ACT OI'' 1974
(5 U.S.C. 552a)
1. Auth.o.rity: TTa~t:tonal Records Ac-t, !r!F U.S.C. 3102; 1;.0. 9~3y7, Nu.mlaering
System for F'eder~,l Accounts Rcl.ating to Individual Persons, November 2?, 1.943.
2. Pr i nc ipal P~.x?T~ose: To maintain a record of those individuals ti~ho have
or gave r;'.~d J,ecess to GRILL' FLAPS in.forinration through the use of their name
and/or ~'ocil Secu~!-it;~r P1ur.:bcr.
3. Routine U:~es: The Social Security Tdumbe.r is to be used to identify- the
individual, and the information is to be retained st.rirtly z~rithin the Program.
1+, r4andat,ory or Voluntary Discl.osur. e : In.formati.on is disclosed on a
?voluratarjr bavi,^,, but withholding information wi~.l. render it impossible to
,rant a.n individual access to or partic:i.pa,tion in the Prog.ra.tti.
Approved For Release 2001/03/07 :CIA-RDP96-007898002100150050-8