GRILL FLAME VOLUNTEER CONSENT STATEMENT (STEPHEN C. HORTON)

• Document Type: CREST
• Collection: STARGATE
• Document Number (FOIA) /ESDN (CREST): CIA-RDP96-00789R002100150061-6
• Release Decision: RIPPUB
• Original Classification: S
• Document Page Count: 2
• Document Creation Date: November 4, 2016
• Document Release Date: December 4, 1998
• Sequence Number: 61
• Content Type: CONT

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Approved For Release 2001/~03~107 : ~IA-RDP96-007898002100150061-6
GRILL FLAME VOLUNTEER CONSENT STATEMENT SGFOIA3
volunteer for INSCOM Project Grill Flame. I understand this program involves
training designed to enhance inherent psychic abilities. I consent to this
training and willingly volunteer to participate in INSCOM intelligence
projects using my psychic abilities: I understand this program deals with
mental perceptive abilities beyond the range of the five corporal senses
_ -_..__
and 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
mental perceptive abilities and focus them on data beyond the range of the
five corparal 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.
NOTE: Physical examination taken within the past 12 months is acceptable.
WITNESS VULULV'1't' Wit[
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Approved For Release 20 ~~~31t~'T~'a;~G~A-RDP96-007898002100150061-6
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 Approved For'Release 2001/03/07 :CIA-RDP96-007898002100150061-6
llA`l'A RE,~UIRLD BX `!SHE pF;I`iACY ACT Or' 197+
(5 U.S.C. 552a)
:L . Autb.ority : Platianal Records Act , ~41E U . S . C . 3102 ; E . 0 . 9397 , Numiierin~;
Syste~:r f'ar i~'ec~eral Accounts Relating to Individual Pe;?sons , November 22 , 1.9~}3.
2. Principal purpose: To maintain a record of those individus,ls rho have
or h='~~~e h~~d u.~=cess to GRILL' FLAI'~ informration thrau~;h. the use of their na~rne
end/ar ~ ~ci^1 Secu~~`ity P;umber.
3. Pontine Usea: mhe Social Security I7umbe.r is to be used to identify 'the
individual, and. the information is to be retained strictly t~rithin the Program.
1~, r4anciatar;~ or VoJ_untary Discl.o:::ur.e: Information is disclosed on a
volur.~tary basis>, but withholding i.nfar.ma-t,ian wi11. render it impossible to
grant a.n ind.iviciual acce.> to or par ticl.pa:tion in the Proz;ram.
Approved For Release 2001/03/07 :CIA-RDP96-007898002100150061-6