Green Ridge Resident Application

Please read the information provided below to ensure that mistakes are not made on the application which will result in denial of the application or a pending notice:

• Be advised that this application is for non-members of the St. Christina facilities. If you wish your character to work at a St. Christina building (including the medical building) you must fill out a Staff Application.
  
• Do not alter the application code in any way.
  
• If you choose to use colors on the application for different voices, please choose darker colors that will not hurt the eyes of the staff who have to review the application.
  
• Make sure that you have fully familiarized yourself with all STC information, rules and regulations, and the required character creation reading for the type of character you are making.
  
• Please post your application as a new topic in the application process board provided.
  
• Once your application has been posted, please be patient. Please do not approach staff members to ask about when your application will be reviewed.

If you have questions about this application, please read the walk-through posted below this application.

---

Please use blue or black ink when filling out this registration form. Please answer all questions to the best of your ability. For further information or guidance, please contact a member of the Green Ridge town administration team at the number provided in our guide brochure.

Full Name: Lastname, Firstname

Age: 13 - 100
DOB: mm/dd/yyyy
Gender: Male/Female
Address: Street Address
City: City
State: State
Ethnicity: Caucasian/Hispanic/African American/Asian etc.
Height: Approximately.
Weight: Approximately.
Eye Color:
Hair Color:
Distinguishing Marks: Birthmarks, piercings, tattoos, moles, etc.


Medical History:

Please list any and all allergies and age of onset below:
Answer Here

Are you aware of any ongoing medical issues?:
Answer Here

If yes, list age of diagnoses by medical professionals, or age of onset below:
Answer Here

If you are receiving treatment for an ongoing medical complaint, please list prescriptions, strength of dose, frequency of dose, and other treatment plans below:
Answer Here

Do you smoke tobacco, consume alcohol, or use street drugs? If yes, please list number of packs per day, number of drinks per day and/or names of consumed drugs below:
Answer Here

Please list any known ongoing medical issues of any dependents below. Please note to which dependent each issue belongs:
Answer Here



Green Ridge Residential Registration:

Please list your chosen address within Green Ridge below:
Answer Here

Please list any other persons residing with you at this chosen address, who are not dependents or spouse:
Answer Here

Please list any dependents who reside with you. Please include ages and relationship to yourself:
Answer Here

Please list your marital status. Single/Married/Divorced/Widowed. If married, please list name of spouse and note if he/she intends to reside with you at this address:
Answer Here

Please list any large taxable material possessions below, such as motor vehicles or other property of substantial value that will be relocating to Green Ridge Island with you:
Answer Here

Are you a citizen or a permanent (Green Card) resident of the United States of America?:
Answer Here



Employment Registration (Optional):

This section is for those of age sixteen or older who plan to find employment on Green Ridge Island. If you do not meet the criteria, please move to the next section.

Do you plan to find employment on Green Ridge Island? If so, which position(s) are you applying for, and where?:
Answer Here

Do you possess necessary qualifications for the position(s) for which you are applying? If yes, please list official qualifications below:
Answer Here

Please list your three most recent employment positions and locations of employment below:
Answer Here

Do you possess any other skills that you feel may benefit your ability to perform in the position(s) for which you are applying? Examples include extra languages, history of customer service and work in the care industries, etc. If yes, please list skills below:
Answer Here

How do you feel your previous employment will benefit your ability to perform in the position(s) for which you are applying?:
Answer Here



Education Registration (Optional):

This section is for Green Ridge Island residents under the age of eighteen. All resident under the age of eighteen who do not possess a high school diploma, GED, or reside at St. Christina's Psychiatric Rehabilitation Center are required to complete this education registration. Those who do not meet these criteria, please disregard this section and move to the next.

Please list your high school grade. Freshman/Sophomore/Junior/Senior:
Answer Here

Please provide the name of your previous high school below:
Answer Here

What are your academic strengths?:
Answer Here

What are your academic weaknesses?:
Answer Here

What was your previous Grade Point Average?:
Answer Here

Are you interested in extracurricular activities such as sports, art clubs, maths clubs, etc? If yes, explain below:
Answer Here



Legal History:

Be advised that answers to this section will not affect your eligibility for relocation to Green Ridge. The information you provide will not be diverged to third parties.

Do/did you ever abuse controlled substances, including but not limited to prescription medications, street drugs or alcohol? If yes, please explain below:
Answer Here

Have you ever been convicted of a crime? If yes, please list conviction, age of conviction and circumstances below:
Answer Here

If you answered yes to the above, please list sentences connected to these convictions below:
Answer Here

Have you ever knowingly committed a crime for which you were not convicted or sentenced? If yes, please explain below:
Answer Here



Personal Interview:

Why have you chosen to relocate to Green Ridge Island? Please explain below:
Answer Here

Green Ridge Island houses a psychiatric rehabilitation hospital, and as such, living and working amongst those with mental health issues would be typical practice. Are you comfortable with this?:
Answer Here

Do you agree to abide by all Green Ridge Island laws and regulations upon relocation?:
Answer Here

Finally, please tell us a little about yourself. Where did you grow up, and what was it like? What were your prior relationships with significant others/family or friends like? What instances have lead to your current choice in career and/or relocation? What events in your life do you feel have shaped who you are today? Include any information you feel that is pertinent about yourself and your situations:
Answer Here


Resident Signature:

By opting to relocate to Green Ridge Island and the town of Green Ridge, you hereby agree to abide by all Green Ridge Island laws and the instructions of Green Ridge Security, Green Ridge Town Officials, and St. Christina Facility administrators. You hereby waive rights granted to you by the state of Oregon or any other state belonging to the United States of America or to any other country or county. You acknowledge that Green Ridge Island, the town of Green Ridge and the St. Christina facilities are not subject to any state laws. You acknowledge that any personal property transported to Green Ridge Island becomes the responsibility of GR Biotech and its subsidiaries. You hereby waive your right to register to vote in any states within the continental United States, within the states of Alaska and Hawaii, and within any US territories. You waive your right to representation by any political parties or persons within the aforementioned US locations or other countries. You acknowledge that you are legally bound not to disclose information regarding Green Ridge laws, protocols or procedures of any kind with persons not residing on Green Ridge Island. You acknowledge that visitors to Green Ridge Island become the sole responsibility of the undersigned, and are subject to the same laws, protocols and procedures as Green Ridge island residents during their stay. You acknowledge that visitors to Green Ridge Island are subject to surveillance by Green Ridge officials and employees, and may be removed from the island without notice. You acknowledge that any minors under the age of thirteen (13) that are claimed as dependents remain the sole responsibility of the undersigned, and are subject to the same laws, protocols and procedures as all Green Ridge Island residents. GR Biotech and its Subsidiaries reserve the right to add to or amend these terms of service at any time.

Please sign and date below:

Firstname Lastname mm/dd/yyyy

---

Player Nickname:
Chatango Screename:
Character Play-By


APPLICATION CODE:

Code:


[center][img]http://img220.imageshack.us/img220/8407/greenridgelogobase.png[/img]
_____________________________________________________________
[font=garamond][size=22][color=#555555][b] -Resident Registration- [/b][/color][/size][/font][/center]

[font=garamond][size=16][color=#555555][b]Please use blue or black ink when filling out this registration form. Please answer all questions to the best of your ability. For further information or guidance, please contact a member of the Green Ridge town administration team at the number provided in our guide brochure.[/b][/color][/size][/font]
[center]_____________________________________________________________

((Character Photograph Goes Here))[/center]

[font=garamond][size=20][b]Full Name:[/b] [u] Lastname, Firstname
[/u][/size][/font]
[b]Age:[/b] 13 - 100
[b]DOB:[/b] mm/dd/yyyy
[b]Gender:[/b] Male/Female
[b]Address:[/b] Street Address
[b]City:[/b] City
[b]State:[/b] State
[b]Ethnicity:[/b] Caucasian/Hispanic/African American/Asian etc.
[b]Height:[/b] Approximately.
[b]Weight:[/b] Approximately.
[b]Eye Color:[/b]
[b]Hair Color:[/b]
[b]Distinguishing Marks:[/b] Birthmarks, piercings, tattoos, moles, etc.

[center]_____________________________________________________________[/center]

[font=garamond][size=20][b]Medical History:[/b][/size][/font]

[b]Please list any and all allergies and age of onset below:[/b]
Answer Here

[b]Are you aware of any ongoing medical issues?:[/b]
Answer Here

[b]If yes, list age of diagnoses by medical professionals, or age of onset below:[/b]
Answer Here

[b]If you are receiving treatment for an ongoing medical complaint, please list prescriptions, strength of dose, frequency of dose, and other treatment plans below:[/b]
Answer Here

[b]Do you smoke tobacco, consume alcohol, or use street drugs? If yes, please list number of packs per day, number of drinks per day and/or names of consumed drugs below:[/b]
Answer Here

[b]Please list any known ongoing medical issues of any dependents below. Please note to which dependent each issue belongs:[/b]
Answer Here

[center]_____________________________________________________________[/center]


[font=garamond][size=20][b]Green Ridge Residential Registration:[/b][/size][/font]

[b]Please list your chosen address within Green Ridge below:[/b]
Answer Here

[b]Please list any dependents who reside with you. Please include ages and relationship to yourself:[/b]
Answer Here

[b]Please list your marital status. Single/Married/Divorced/Widowed. If married, please list name of spouse and note if he/she intends to reside with you at this address:[/b]
Answer Here

[b]Please list any large taxable material possessions below, such as motor vehicles or other property of substantial value that will be relocating to Green Ridge Island with you:[/b]
Answer Here

[b]Are you a citizen or a permanent (Green Card) resident of the United States of America?:[/b]
Answer Here

[center]_____________________________________________________________[/center]


[font=garamond][size=20][b]Employment Registration (Optional):[/b][/size][/font]

[list][size=9]This section is for those of age sixteen or older who plan to find employment on Green Ridge Island. If you do not meet the criteria, please move to the next section.[/size][/list]

[b]Do you plan to find employment on Green Ridge Island? If so, which position(s) are you applying for, and where?:[/b]
Answer Here

[b]Do you possess necessary qualifications for the position(s) for which you are applying? If yes, please list official qualifications below:[/b]
Answer Here

[b]Please list your three most recent employment positions and locations of employment below:[/b]
Answer Here

[b]Do you possess any other skills that you feel may benefit your ability to perform in the position(s) for which you are applying? Examples include extra languages, history of customer service and work in the care industries, etc. If yes, please list skills below:[/b]
Answer Here

[b]How do you feel your previous employment will benefit your ability to perform in the position(s) for which you are applying?:[/b]
Answer Here

[center]_____________________________________________________________[/center]


[font=garamond][size=20][b]Education Registration (Optional):[/b][/size][/font]

[list][size=9]This section is for Green Ridge Island residents under the age of eighteen. All resident under the age of eighteen who do not possess a high school diploma, GED, or reside at St. Christina's Psychiatric Rehabilitation Center are required to complete this education registration. Those who do not meet these criteria, please disregard this section and move to the next.[/size][/list]

[b]Please list your high school grade. Freshman/Sophomore/Junior/Senior:[/b]
Answer Here

[b]Please provide the name of your previous high school below:[/b]
Answer Here

[b]What are your academic strengths?:[/b]
Answer Here

[b]What are your academic weaknesses?:[/b]
Answer Here

[b]What was your previous Grade Point Average?:[/b]
Answer Here

[b]Are you interested in extracurricular activities such as sports, art clubs, maths clubs, etc? If yes, explain below:[/b]
Answer Here

[center]_____________________________________________________________[/center]


[font=garamond][size=20][b]Legal History:[/b][/size][/font]

[list][size=9]Be advised that answers to this section will not affect your eligibility for relocation to Green Ridge. The information you provide will not be diverged to third parties.[/size][/list]

[b]Do/did you ever abuse controlled substances, including but not limited to prescription medications, street drugs or alcohol? If yes, please explain below:[/b]
Answer Here

[b]Have you ever been convicted of a crime? If yes, please list conviction, age of conviction and circumstances below:[/b]
Answer Here

[b]If you answered yes to the above, please list sentences connected to these convictions below:[/b]
Answer Here

[b]Have you ever knowingly committed a crime for which you were not convicted or sentenced? If yes, please explain below:[/b]
Answer Here

[center]_____________________________________________________________[/center]


[font=garamond][size=20][b]Personal Interview:[/b][/size][/font]

[b]Why have you chosen to relocate to Green Ridge Island? Please explain below:[/b]
Answer Here

[b]Green Ridge Island houses a psychiatric rehabilitation hospital, and as such, living and working amongst those with mental health issues would be typical practice. Are you comfortable with this?:[/b]
Answer Here

[b]Do you agree to abide by all Green Ridge Island laws and regulations upon relocation?:[/b]
Answer Here

[b]Finally, please tell us a little about yourself. Where did you grow up, and what was it like? What were your prior relationships with significant others/family or friends like? What instances have lead to your current choice in career and/or relocation? What events in your life do you feel have shaped who you are today? Include any information you feel that is pertinent about yourself and your situations:[/b]
Answer Here

[center]_____________________________________________________________[/center]

[font=garamond][size=20][b]Resident Signature:[/b][/size][/font]

[list][size=9]By opting to relocate to Green Ridge Island and the town of Green Ridge, you hereby agree to abide by all Green Ridge Island laws and the instructions of Green Ridge Security, Green Ridge Town Officials, and St. Christina Facility administrators. You hereby waive rights granted to you by the state of Oregon or any other state belonging to the United States of America or to any other country or county. You acknowledge that Green Ridge Island, the town of Green Ridge and the St. Christina facilities are not subject to any state laws. You acknowledge that any personal property transported to Green Ridge Island becomes the responsibility of GR Biotech and its subsidiaries. You hereby waive your right to register to vote in any states within the continental United States, within the states of Alaska and Hawaii, and within any US territories. You waive your right to representation by any political parties or persons within the aforementioned US locations or other countries. You acknowledge that you are legally bound not to disclose information regarding Green Ridge laws, protocols or procedures of any kind with persons not residing on Green Ridge Island. You acknowledge that visitors to Green Ridge Island become the sole responsibility of the undersigned, and are subject to the same laws, protocols and procedures as Green Ridge island residents during their stay. You acknowledge that visitors to Green Ridge Island are subject to surveillance by Green Ridge officials and employees, and may be removed from the island without notice. You acknowledge that any minors under the age of thirteen (13) that are claimed as dependents remain the sole responsibility of the undersigned, and are subject to the same laws, protocols and procedures as all Green Ridge Island residents. GR Biotech and its Subsidiaries reserve the right to add to or amend these terms of service at any time. [/size][/list]

[size=18][font=garamond][b]Please sign and date below:[/b][/font][/size]


[list][font=garamond][size=26][i] Firstname Lastname[/i][/size][/font] mm/dd/yyyy

[/list]




[right][size=8] Green Ridge Island and the town of Green Ridge are property of GR Biotech & its Subsidiaries. All rights reserved ® 2011[/size][/right]

[hr]

[b]Player  Nickname:[/b]
[b]Chatango Screename:[/b]
[b]Character Play-By[/b]



Please use blue or black ink when filling out this registration form. Please answer all questions to the best of your ability. For further information or guidance, please contact a member of the Green Ridge town administration team at the number provided in our guide brochure.

When the app tells you to use blue or black ink, this is an in character piece of information. You'll be filling out this application as if your character is truly filling out an application. To use blue or black ink is a normal procedure for any legal document. We suggest not changing the font at all!


When we ask you to put a character image, we mean it! Please don't hotlink and please follow the image rules.

Full Name: Lastname, Firstname

Make sure that you're using Last Name and then First Name with proper capitalization.

Age: 13 - 100 We do not allow player characters under the age of 13. And well, 100 may be an exaggeration but you can have elderly characters. People have been on this island for a while, after all.
DOB: mm/dd/yyyy Be wary. Lots of people are pended for mathematical errors here.
Gender: Male/Female Self explanatory.
Address: Street Address This is the street address of your character before they came to Green Ridge. It does not have to be a real address. Make it up if you like.
City: City Must be a real city.
State: State Must be a real state.
Ethnicity: Caucasian/Hispanic/African American/Asian etc. We like variety here! Get creative with it!
Height: Approximately. Self explanatory.
Weight: Approximately. Self explanatory.
Eye Color: Self explanatory.
Hair Color: Self explanatory.
Distinguishing Marks: Birthmarks, piercings, tattoos, moles, etc. When giving your character distinguishing marks, be sure to state where they are. For example, if your character has a tattoo of a phoenix... be sure to state that its on your character's left shoulder or calf or wherever it is!


Medical History:

Please list any and all allergies and age of onset below:
Answer Here

Don't go too crazy here. Who REALLY wants to play a character that is allergic to everything in the world! It wouldn't be any fun and your character would be living in a friggin' bubble. Keep it simple or don't have any at all!

Are you aware of any ongoing medical issues?:
Answer Here

Like above, try to keep it simple. Major medical issues, while fun, will quickly lose their newness and you may fall into a habit of no longer playing them.

If yes, list age of diagnoses by medical professionals, or age of onset below:
Answer Here

When did your character get diagnosed with those medical issues? Just give us a 'not applicable' if they didn't have any medical issues.

If you are receiving treatment for an ongoing medical complaint, please list prescriptions, strength of dose, frequency of dose, and other treatment plans below:
Answer Here

What medications is your character taking and why? When did they start taking them? What is the dosage? Details are your friends. However, we also want you to keep this simple! Don't go nutzo with it. There's no need.

Do you smoke tobacco, consume alcohol, or use street drugs? If yes, please list number of packs per day, number of drinks per day and/or names of consumed drugs below:
Answer Here

Be honest here. Does your character smoke pot? Does your character drink or smoke cigarettes? Tells us and please give it in detail. This will not make it so that your character would not be accepted. GR Biotech wants honesty!

Please list any known ongoing medical issues of any dependents below. Please note to which dependent each issue belongs:
Answer Here

Does your character have children? Here's where you inform us of what is medically wrong with your kiddos and when did said kiddo get sick? Just give us a 'not applicable' if there are no kids.



Green Ridge Residential Registration:

Please list your chosen address within Green Ridge below:
Answer Here

When picking an address, please be sure to follow the rules. Do not request a 6 bedroom house for a single person! That's lame and your character really cannot be that rich. Just sayin'.

Please list any other persons residing with you at this chosen address, who are not dependents or spouse:
Answer Here

Does your character have a partner? A wife? A husband? Maybe a brother or a sister that is an adult? Do you want them to live with you? Post that information here. Again, once you are approved you can request players for these characters if they aren't already played.

Please list any dependents who reside with you. Please include ages and relationship to yourself:
Answer Here

This question ties into the dependents question above. If you listed them up there, list them down here! Remember that dependents UNDER the age of thirteen are considered NPCs. (Please read the rules about NPC characters before you even think of adding NPCs to your character...) Dependents OVER the age of thirteen can be played as characters and are great ways to get more people involved in playing with you... But don't go overboard here. There's no need of it and really, this is just supposed to be for flavor! Don't have a bajillion people just to get a bigger house. It's lame.

Please list your marital status. Single/Married/Divorced/Widowed. If married, please list name of spouse and note if he/she intends to reside with you at this address:
Answer Here

Another self explanatory question.

Please list any large taxable material possessions below, such as motor vehicles or other property of substantial value that will be relocating to Green Ridge Island with you:
Answer Here

Gotta car? A truck? List it!

Are you a citizen or a permanent (Green Card) resident of the United States of America?:
Answer Here

Your character must be either a citizen or have their Green Card. No if, ands or buts about it. It's in the rules!



Employment Registration (Optional):

This section is for those of age sixteen or older who plan to find employment on Green Ridge Island. If you do not meet the criteria, please move to the next section.

Do you plan to find employment on Green Ridge Island? If so, which position(s) are you applying for, and where?:
Answer Here

Where is your character going to work? What are they going to do? The only adults that do not have to have an actual job are those house wives or house husbands. But please note that here if you're a stay at home mom or dad.

Do you possess necessary qualifications for the position(s) for which you are applying? If yes, please list official qualifications below:
Answer Here

Here is a good place to give us some meat on the bones of your character. Don't go nutzo with it though. Because we want realism. We highly doubt that a person that knows 120398 languages, has a Masters in Psychology and runs a horse ranch is realistic. Don't get Mary Sue or Gary Stu here.

Please list your three most recent employment positions and locations of employment below:
Answer Here

Give us dates, names and what you did there. Detail is your friend.

Do you possess any other skills that you feel may benefit your ability to perform in the position(s) for which you are applying? Examples include extra languages, history of customer service and work in the care industries, etc. If yes, please list skills below:
Answer Here

Another great place to give us some meat to gnaw on. Your character can be fleshed out here with some skills. Give us some personality. But, again, don't go crazy with it. Leave the crazy to the looney toons at the asylum!

How do you feel your previous employment will benefit your ability to perform in the position(s) for which you are applying?:
Answer Here

Give us a taste of your character's personality with this answer. Allow us to see who he or she is through his or her words. This is a great place to do that!



Education Registration (Optional):

This section is for Green Ridge Island residents under the age of eighteen. All resident under the age of eighteen who do not possess a high school diploma, GED, or reside at St. Christina's Psychiatric Rehabilitation Center are required to complete this education registration. Those who do not meet these criteria, please disregard this section and move to the next.

Please list your high school grade. Freshman/Sophomore/Junior/Senior:
Answer Here

That's right! You can play a teen character without having them be a nut job! What grade is your teen?

Please provide the name of your previous high school below:
Answer Here

You can use a fake high school name, no worries at all!

What are your academic strengths?:
Answer Here

Here is where you give your little teeny bopper a bit of character. What do they like in school? What were they good at?

What are your academic weaknesses?:
Answer Here

And here's another place to give that teen some character! What do they hate in school? What were they horrid at?

What was your previous Grade Point Average?:
Answer Here

Think about your character's history. If they were a troubled teen, there is a high likelihood that they would not be a good student. If they were a happy kid, there is a high likelihood that they were a good student. Think about this and maybe give us some flavor by explaining why!

Are you interested in extracurricular activities such as sports, art clubs, maths clubs, etc? If yes, explain below:
Answer Here

Another place to give some meat to the skeleton of your character. Give us some flavor to chew on. What did your character do for fun! What do they love to do? Were they forced to do these things? Explain and then expand. Detail is your friend!



Legal History:

Be advised that answers to this section will not affect your eligibility for relocation to Green Ridge. The information you provide will not be diverged to third parties.

Do/did you ever abuse controlled substances, including but not limited to prescription medications, street drugs or alcohol? If yes, please explain below:
Answer Here

Be honest here. Let us know about your character's dirty little secrets. Don't worry! No one other than GR Biotech people really see this. Well, except for a select few... And you'll learn about those in the course of game play!

Have you ever been convicted of a crime? If yes, please list conviction, age of conviction and circumstances below:
Answer Here

Oooh, do you have a bad little boy or a bad little girl? Do tell, what did your character do? Give us dates, ages, list the crimes... Detail, as always, is your friend.

If you answered yes to the above, please list sentences connected to these convictions below:
Answer Here

And bad boys and girls get caught! So give us actual time frames of incarceration. Research here would be good because you need to know what you would be sentenced to if you committed this or that crime. Do we need to remind you that detail is your friend?

Have you ever knowingly committed a crime for which you were not convicted or sentenced? If yes, please explain below:
Answer Here

Self explanatory! Just detail it out... But you already knew that, didn't you?



Personal Interview:

Why have you chosen to relocate to Green Ridge Island? Please explain below:
Answer Here

Another place to give your character some meat. Green Ridge isn't a hidden island, it's more of an exclusive society. Lots of people want to live on Green Ridge because its so exclusive... So, give us a reason. But be original. Don't just say that your character wants to live here because of the exclusivity. Besides that, your character is going to have to live and work around crazies!

Green Ridge Island houses a psychiatric rehabilitation hospital, and as such, living and working amongst those with mental health issues would be typical practice. Are you comfortable with this?:
Answer Here

Your character doesn't have to be comfortable with this. It's not required but it's suggested. If they aren't comfortable, play it down. If they are, play it up! Detail is your friend... yeah, we're redundant but we love detail.

Do you agree to abide by all Green Ridge Island laws and regulations upon relocation?:
Answer Here

This is a 'must agree to' question. Green Ridge has their own specific sets of laws.

Finally, please tell us a little about yourself. Where did you grow up, and what was it like? What were your prior relationships with significant others/family or friends like? What instances have lead to your current choice in career and/or relocation? What events in your life do you feel have shaped who you are today? Include any information you feel that is pertinent about yourself and your situations:
Answer Here

Get into the character here. Tell us how your character got to this position in life. Weave together your tale and give us some personality here. Make sure that you link up everything you said prior so that your story makes sense.


Resident Signature:

By opting to relocate to Green Ridge Island and the town of Green Ridge, you hereby agree to abide by all Green Ridge Island laws and the instructions of Green Ridge Security, Green Ridge Town Officials, and St. Christina Facility administrators. You hereby waive rights granted to you by the state of Oregon or any other state belonging to the United States of America or to any other country or county. You acknowledge that Green Ridge Island, the town of Green Ridge and the St. Christina facilities are not subject to any state laws. You acknowledge that any personal property transported to Green Ridge Island becomes the responsibility of GR Biotech and its subsidiaries. You hereby waive your right to register to vote in any states within the continental United States, within the states of Alaska and Hawaii, and within any US territories. You waive your right to representation by any political parties or persons within the aforementioned US locations or other countries. You acknowledge that you are legally bound not to disclose information regarding Green Ridge laws, protocols or procedures of any kind with persons not residing on Green Ridge Island. You acknowledge that visitors to Green Ridge Island become the sole responsibility of the undersigned, and are subject to the same laws, protocols and procedures as Green Ridge island residents during their stay. You acknowledge that visitors to Green Ridge Island are subject to surveillance by Green Ridge officials and employees, and may be removed from the island without notice. You acknowledge that any minors under the age of thirteen (13) that are claimed as dependents remain the sole responsibility of the undersigned, and are subject to the same laws, protocols and procedures as all Green Ridge Island residents. GR Biotech and its Subsidiaries reserve the right to add to or amend these terms of service at any time.

Please sign and date below:

Firstname Lastname mm/dd/yyyy

All applications must be signed by the filler outer. Yes, it's a technical term. Don't question it.