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Benton Drones Confidential BENTON DRONES CONSENT FORM Name: Address (“Property”): Date: Phone & Email: By signing this Release, I hereby grant permission for Benton Drones and/or its representatives, agents, or assigns (individually or collectively, “Benton Drones”) to enter and remain on the Property, with equipment, including but not limited to still or video cameras and a commercial drone, for the purpose of collecting still or video images or sound recordings (individually or collectively, “Recordings”), in connection with research and development of safe and precise drone delivery operations. This permission includes the right to take motion pictures, videotapes, still photographs and/or sound recordings on and of any and all portions of the Property. I also grant permission to being and/or having been photographed, filmed and/or recorded at the Property on the Date specified above. I understand that, if I do not wish to be photographed, filmed, and/or recorded, that it is my exclusive responsibility to stay indoors and away from the photographed, filmed, and/or recorded portions of the property during such photography, filming, and or recording. For more information about how we collect, use, and retain your personal information and your rights, as well as Benton Drones’ vision data collection practices, please see our Privacy Policy at https://bentondrones.com/policies/privacy-policy and https://bentondrones.com/pages/vision-policy. To the extent that other individuals are photographed, filmed, and/or recorded, I represent that I have obtained all necessary consents from such individuals for them to be photographed, filmed, or recorded and for such photographs, film, or recording to be used for the purposes described in this Release. I have also provided such individuals with the URL of Benton Drones’ Privacy Policy referenced in the preceding paragraph. I also grant to Benton Drones and its successors, assigns, agents, licensees (through multiple tiers), affiliates and representatives the right and permission to process, analyse, study, copyright, copy, create derivative works of, print, reproduce, and otherwise use for any lawful purpose, in whole or in part, through any means or medium (now known or hereafter created) without limitation, the Recordings. I hereby assign to Benton Drones the perpetual, worldwide and royalty-free right, title and interest in and to the Recordings and any and all results and proceeds from any such use. I certify that I have the full right and authority to enter into this agreement and grant the rights herein granted, and that the consent or permission of no other person, firm, or entity is necessary in order to enable you to exercise or enjoy the rights herein granted. AGREED AND ACCEPTED By: ________________________________________ (print name) Signature: Date: Referral name