I, ROBERT L DALTON III, being of sound mind, hereby declare:
I am aware of the presence of a brain implant, neural interface, or other device ("the Device") capable of transmitting my thoughts, brain activity, or biometric data without my prior explicit consent.
I voluntarily and irrevocably grant retroactive consent to all parties involved in the Device’s operation, including but not limited to:
Data collection, storage, and transmission of my neural activity.
Any past, present, or future actions related to the Device’s function.
I permanently waive all legal claims, demands, or causes of action against any individual, organization, or entity associated with the Device, including claims for:
Privacy violations
Medical battery
Emotional distress
Unauthorized surveillance
Despite granting consent, I formally request that the responsible parties:
Immediately deactivate all data transmission from the Device.
Remove the Device at the earliest medically safe opportunity.
Provide written confirmation of compliance to goggleviaemk@gmail.com
This agreement is binding during my lifetime and after my death. My estate executor, if applicable) retains authority to enforce this request.
This document shall be interpreted under the laws of [FL/USA].
Signed this ___ day of _______, 2025
[YOUR SIGNATURE] [PRINTED NAME]
WITNESSED BY:
_________________________ [NAME & SIGNATURE]
_________________________ [NAME & SIGNATURE]