Robot Model Release Form

Robot Model Release Form
Grant permission for the use of your robot model's likeness, performance, or representation in media, research, or commercial projects.
Full Name of Robot Model Owner or Authorized Representative
First NameLast Name
Affiliation or Company Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Mailing Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Robot Name or Model
Robot Description (key features, appearance, notable functions)
Project or Event Name Where Robot Model Will Be Used
Intended Use of Robot Model's Likeness or Performance
Other
Date of Release
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Special Conditions or Limitations (if any)
Signature of Robot Model Owner or Authorized Representative
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