AGREEMENT FOR SERVICES

Overview: I do hereby apply for services from Symmetry Chiropractic Mission Centers, hereinafter referred to as the “Church.” By signing or affirming this Service Agreement, I hereby affirm that I have read through and agree with its terms. 

Purpose: The Church is organized for educational, spiritual, and beneficent purposes, and in part for worship, and is established under the exclusive jurisdiction of the Bylaws and Ecclesiastical Law of Symmetry Chiropractic Mission Centers, for furthering the upliftment and enlightenment of all people throughout the world, and the betterment of life.

Rights & Responsibilities: By consenting to the Services Agreement provided herein, I understand that I am granted the following rights and benefits, and I agree to the following responsibilities: 

• The right to detailed, informed consent about the services rendered, and what to expect. 
• Full and fair conflict resolution. 
• I understand that supplemental information may be presented to me, from time to time, by the Church and I agree to review this information in its entirety
• Upon request, access to the Church Bylaws. 
• Guarantee that my personal information is secure, and that it will remain within the Church. 
• My association with the Church will remain intact unless and until: (a) I submit, in writing, my desire to withdraw membership; or (b) my membership is terminated by the Church in accordance with its Bylaws. 
• Complaints against the Church must be submitted, in writing, to a Trustee of the Church within three months of the incident at issue. These complaints will be sent to the Tribunal designated by the Church for evaluation and remediation action. 

Mission Statement: Symmetry Chiropractic Mission Centers follow Jesus' example of healing, teaching and service - Lighting up the world, one well-adjusted family at a time, through the disciplines of Christ.

Symmetry Chiropractic Mission Centers holds these spiritual principles:

• John 8: 32 NIV - "Then you will know the truth, and the truth will set you free.” 
• Mark 16 15-19 NIV - "He said to them, “Go into all the world and preach the gospel to all creation. Whoever believes and is baptized will be saved, but whoever does not believe will be condemned. And these signs will accompany those who believe: In my name they will drive out demons; they will speak in new tongues; they will pick up snakes with their hands; and when they drink deadly poison, it will not hurt them at all; they will place their hands on sick people, and they will get well.” 
• John 15 9-12 NIV - "As the Father has loved me, so have I loved you. Now remain in my love. If you keep my commands, you will remain in my love, just as I have kept my Father’s commands and remain in his love. I have told you this so that my joy may be in you and that your joy may be complete. My command is this: Love each other as I have loved you.
• Matthew 9: 35-38 NIV - Jesus went through all the towns and villages, teaching in their synagogues, proclaiming the good news of the kingdom and healing every disease and sickness. When he saw the crowds, he had compassion on them, because they were harassed and helpless, like sheep without a shepherd. Then he said to his disciples, “The harvest is plentiful but the workers are few. Ask the Lord of the harvest, therefore, to send out workers into his harvest field.”

Voluntary Membership: I voluntarily agree to join the Church, an unincorporated private spiritual church governed solely by Ecclesiastical Law, as interpreted by Symmetry Chiropractic Mission Centers, whose members seek to help each other achieve better mental, bodily, and spiritual health, and a good quality of life. Inasmuch as I am associating with the Church and its membership, I am voluntarily changing my capacity from that of a public person to that of a private member. My activities within the Church are a private, contractual matter that I refuse to share with any Local, State, or Federal investigative or enforcement agencies; including but not limited to: the American Medical Association, the Washington Board of Medical Examiners, the Washington Board of Chiropractic Examiners, the Washington Department of Public Safety, the Washington Board of Pharmacy, the Washington Board of Nursing, the Washington Department of Health and Human Services, the Washington Department of Social Services, the local school districts or the local equivalent(s) of the aforementioned state agencies without the express, written permission of the Church. I understand that the Church submits to no authority other than God. I fully agree not to pursue any course of legal action against a fellow member of the Church, unless that member has exposed me to a clear and present danger of substantive evil, and even then, only upon the recommendation and approval of the Church Trustees, which shall not be unreasonably withheld.

I enter into this agreement of my own free will, without any pressure or coercion. I affirm that I do not represent any Local, State, or Federal agency whose purpose is to regulate or to carry out any mission of enforcement, entrapment, or investigation. I have read and understand this document, and my questions have been answered fully, and to my satisfaction. I understand that I can withdraw from this agreement and terminate my membership in this Church at any time, and that my membership can and will be revoked if I engage in abusive, violent, menacing, destructive, or harassing behavior towards any other member.

I declare that, by joining this Church, by contracting for its services, by participating on the Church website(s) and/or their Social Media Group(s) (if any), said behaviors are a clear indication that I have carefully read the whole of this document; I understand it, and I agree with it.

MEMORANDUM OF UNDERSTANDING 

➢ I understand that members, vendors, instructors, counselors, teachers, practitioners, and/or service providers within the Church may or may not be licensed by the governmental board(s) that purport to regulate their activities. I understand that the fellow members of the Church who provide services and care do so in their capacity as an approved Minister of the Church and fellow member, and not in the capacity as a licensed provider. I further understand that within the Church, no doctor-patient relationship exists, only a contractual member-to-member relationship exists. I further understand that it is entirely my own responsibility to consider the advice and recommendations offered to me by my fellow members, and to educate myself as to the efficacy, risks, and desirability of the same; and that the acceptance of the offered or recommended course of action is my own, carefully considered decision. 

➢ I understand that my care may be provided by team that includes a variety of experiences and training, and that these members will work collaboratively and share information about my care in order to facilitate a holistic experience.

➢ I understand that Symmetry Chiropractic Mission Centers is outside the jurisdiction and authority of government authorities concerning any and all complaints or grievances against the Church, any Trustee(s), members, or other staff persons. All rights of complaints or grievances will be settled by a Church designee, committee, or tribunal. I agree that I have sought to understand the Church private association and free church designations; I aver that I do understand them, and I have freely determined that this is the course of action I want to take on behalf of myself. Where applicable, I have also made this determination on behalf of my minor children. 

➢ I agree that violation of any of the waivers contained within this membership contract will result in a no contest legal proceeding against me. 

➢ As a participating member of the Church, I understand that images, photographs, or other likenesses of me may be taken. I hereby grant the Church my absolute permission to reuse, copyright, publish, or republish the same.  

➢ As I am voluntarily choosing this method of service providers, I will not hold the Church  or its members financially liable for any particular outcome. 

➢ As a Member, I accept the goals of helping my body function better, and of choosing techniques that are both safe and have a reasonably good chance of success, realizing that no diagnostic technique or treatment is foolproof. I also make this determination on behalf of my minor children, where applicable.  I have the autonomy to choose to forego drugs, surgery, radiation, or other treatments that have been recommended to me by others. I fully accept all risks. I acknowledge and take full responsibility for any serious consequences which may result from my autonomous choices. Other aspects of informed consent may take place in my discussions with the providers, and with my fellow Members of the Church.

➢ I understand that the doctors, physician assistants, nurses, midwives, doulas (where applicable), therapists, and other providers who are fellow Members of the Church are offering me advice, services, and benefits that do not necessarily conform to conventional medical care. I do not expect these benefits to include on-call coverage, hospital care, or the usual and customary care provided by traditional medical physicians. I will choose to receive such primary and specialist care elsewhere.

➢ I understand that my donations, if any, to the Church, are non-refundable. If I am unable to attend a service appointment that has been reserved by my donation, it is my responsibility to communicate my conflict to the Church within a reasonable amount of time, not less than 72 hours prior to the date of the appointment. I understand that the Church may not accommodate my conflict if it is communicated less than 72 hours prior to the start of the appointment; and that conflicts communicated more 72 hours prior to the start of the appointment may be accommodated by the Church, at the Church’s sole discretion. 

➢ I enter into this agreement of my own free will, without any pressure, coercion, or promise of result or cure, and affirm that these pages comprise the entire agreement for my membership in the Church. Payment of any dues, fees, or program costs, where applicable, along with delivery of these signed documents to a representative of the Church, is considered sufficient consideration for the commencement of my membership, the term of which begins with the date affixed below my signature.

CODE OF ETHICS AND CONFIDENTIALITY

In order to encourage and foster open and candid discussion between members, the Trustees and Board of Advisors of Symmetry Chiropractic Mission Centers believes confidentiality must be maintained within this Church. Therefore, it is the policy of the Trustees and Board of Advisors of the Church that each member shall keep confidential any and all information relating to any discussions, or shared on any members-only area of its website, unless the member is given express consent to disclose said information from the Trustees.

While members are free to discuss the result of any actions taken by the Trustees and/or Board of Advisors, disclosing information concerning any Church dealings to non-members is strictly prohibited. Members acknowledge that any violation of this policy could cause harm to the Church, or to Symmetry Chiropractic Mission Centers, and that any violation of this policy could result in loss of membership.

In order to ensure compliance and to protect Symmetry Chiropractic Mission Centers, its Trustees, Board of Advisors, and members from potential legal problems regarding conflicts of interest and violation of fiduciary obligations, the Church endorses and adopts the following statement of policy:

1. Duty of Loyalty

Among the fiduciary obligations of an officer, director, staff member, or committee member of a nonprofit entity is a duty of loyalty to the non-profit entity. This includes supporting, and not opposing, directly or indirectly, or taking any other stance against, the policies and positions duly adopted by the Symmetry Chiropractic Mission Centers Trustees. As members of the Church, you are obligated to maintain this duty of loyalty in all manner of activities, for the duration of your membership. This duty of loyalty is not intended to, nor should it, discourage debate within the community. Such debate is encouraged, and is part of the individual's responsibility in the deliberation process.

1. Confidentiality of Board Discussions and Board Documents

In order to encourage and foster open and candid discussion at its meetings, the Trustees and the Board of Advisors of Symmetry Chiropractic Mission Centers believe that confidentiality must be maintained. Therefore, it is the policy of the Trustees and the Board of Advisors of Symmetry Chiropractic Mission Centers that each member shall keep confidential any and all information relating to the operation of the Church, unless the member is given express, written consent from the Trustees to disclose said information. While all members are free to discuss actions adopted by the Trustees or the Board of Advisors, disclosing or distributing any information concerning any and all aspects of the operations of the Church is strictly prohibited.