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Thank you for agreeing to participate in the Penn State PILOT lab Computing History Initiative! 

The purpose of this project is to document computing history through the eyes of early participants.  PILOT lab hopes that your stories will help stimulate student interest in careers in computing, conveying important historical context for today's technology policy and legal challenges. 

We also hope that this initiative will lead to the eventual launch of a Smithsonian Museum of Technology History - a dedicated national museum that introduces future generations of students to computing and its social implications.

Please acknowledge your consent to be recorded by filling out the form below, confirming your participation in our multimedia computing history documentation project.  (This is a Penn State form, not one drafted by PILOT lab.)


Consent, License, and Release Agreement


I, the undersigned, hereby grant my permission and consent to the Penn State Policy Innovation Lab of Tomorrow (“PILOT Lab”) and its affiliates, faculty, students, agents, successors, assigns, and employees (together, “PILOT Lab Representatives”) to photograph, video record, and/or audio record me.

I hereby grant an irrevocable, world-wide, royalty-free right and license to PILOT Lab and PILOT Lab Representatives to utilize, adapt, modify, reproduce, distribute, publicly perform and display the photographs, video, and/or audio (collectively “Media”) taken of me for use in promotional, educational, informational, advertising or commercial materials and communications in any form now known or later developed, including but not limited to publications, websites, articles, brochures, books, magazines, newsletters, exhibits, videos, films, social media, advertisements, and training programs (collectively “Materials”). Furthermore, I hereby authorize and consent to the use of my name, image, likeness, and voice (collectively, “Likeness”) in the Media for all Materials or any other purposes deemed appropriate by PILOT Lab.

I hereby waive any right to be notified or to inspect or approve the Media or any Materials that are created using my Likeness, now or in the future, whether that use is known or unknown to me. I hereby waive any right to royalties or other compensation arising from or related to the use of the Media or Materials. I hereby release and hereby agree to hold harmless PILOT Lab, PILOT Lab Representatives, and their licensees and assigns for any and all claims that I or any third party may have now or in the future for invasion of privacy, right of publicity, copyright infringement, defamation, or any other cause of action arising of the use, utilization, adaptation, modification, reproduction, distribution, public performance or display of my Likeness in the Media or Materials. In accordance with this complete release of all rights in my Likeness used in the Media and Materials, I hereby waive any and all claims, damages, or liability arising from or related to the use of the Media, including but not limited to any misuse, distortion, blurring, alteration, optical illusion, or use in composite form, either intentionally or otherwise, of my Likeness that may occur or be produced in taking, processing, reducing, adapting, modifying, producing, reproducing of the Media and Materials and their publication, distribution, display or performance.

I understand and agree that PILOT Lab is and shall be the exclusive owner of all right title and interest, including any copyright, in the Media and Materials.

I hereby represent that I am eighteen (18) years of age or older and am competent to contract  in my own name. 


I have read the above Consent, License, and Release before signing, and I fully understand the contents, meaning, and impact of this Consent, License, and Release.


This Consent, License, and Release shall be binding upon and inure to the benefit of my successors and assigns, and contains the entire understanding of the parties with regards to the Media and Materials.



Thanks for submitting!

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