GRILL FLAME VOLUNTEER CONSENT STATEMENT (JOSEPH W. MCMONEAGLE)

• Document Type: CREST
• Collection: STARGATE
• Document Number (FOIA) /ESDN (CREST): CIA-RDP96-00789R002100150075-1
• Release Decision: RIPPUB
• Original Classification: S
• Document Page Count: 1
• Document Creation Date: November 4, 2016
• Document Release Date: December 4, 1998
• Sequence Number: 75
• Publication Date: February 19, 1980
• Content Type: CONT

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Approved For Release ~kr ~ 51
-RDP96-007898002100150075-1
GRILL I'LAME VOLUNTEER CONSENT STATEMENT
SGFOIA3
having attained my eighteenth (18th)-birthday and otherwise having full
capacity to consent, do hereby volunteer to participate in-GRILL FLAME, a DOD
project to determine possible military applications of inherent psychic
abilities.. The following items have been explained to me by .L~, LJQ_~",t^~
~~,~n1l~~ and are set forth on the reverse side of this Agreemenit, T
which I have initialed:
a. The nature, duration, purposes, and expected benefits of the program
in wl-~ich T will be participating;
b. -The methods and means by which the program is to be conducted;. any
methods and .means that are experimental wi11 be identif-ied as such;
c. The inconveniences, hazards, discomforts, risks or other effects on
my health or person which may possibly come from my participation in the
program; and
d. The alternative procedures, if-any, that might be employed to protect.
further my health and well-being. I have been given an opportunity to ask
questions concerning this project and any such questions have been answered
to my full and complete satisfaction. I understand that I may at any time
during the course of this project revoke my consent and withdraw from the
study without prejudice; however, T may be requested to undergo certain
further examinations, if, in the opinion of a quali4fied physician, such
examinations ar.e necessary for my health or well-being.
(DATE)
I was present during the explanation referred to above, as we11 as the
volunteer's opportunity far questions, and hereby witness his/her signature.
I am not a participant in the GRILL FLAME program.
/~
(NAME )
Approved For F~e~ease1~3~~EI~'AN~~'~'~0789R002100150075-1