Initial Registration Form

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Note to Resellers:

Resellers must not submit this form on behalf of their customers!

Note to Customers:

By submitting this form you will enter into the legal agreement in between you (the "Licensee") and Captcha, Inc (the "Vendor") and accept to be bound by the latest version of the BotDetect CAPTCHA Subscription-License Agreement (the "Agreement")!

Note to Spammers, Spam-tool Vendors, Other Miscreants, and Their Fronts:

The Agreement contains clauses specifically designed to ensure that you neither ever receive executables / source-code, nor to ever be issued a refund; and to waste you the maximum amount of time and financial resources in an intentionally never-ending process; all while the Vendor collects the data that will be passed to the relevant law enforcement agencies!

Executables Delivery Request
Executables & Source Code Delivery Request

Please note that, as a part of our customer identification process, all of the submitted data will be verified before the delivery takes place!

1. ORDER INFO

Order Reference Number

Order Reference Number: *

2. REQUESTED RELEASE

The latest release

The latest release candidate

Release candidate with the specfic commit hash

Commit hash:

3. BOTDETECT USE INFO

URLs that allow us to understand where BotDetect will be used

URLs on which BotDetect will be used

OR
Homepages of the OnPrem products in which BotDetect will be used

OR
Homepages of the SaaS products in which BotDetect will be used

4. LICENSEE INFO

Licensee Organization's Name, Website, and Address

Organization's Full Legal Name: *

Organization's Full Legal Name (Latin chars only): *

Website URL: *

Country: *

State / Province:

City: *

District:

ZIP / Postal Code:

Street, and Street Number: *

Street, and Street Number (Latin chars only): *

5. CONTACT INFO

Licensee's Technical Contact

Name: *

Name (Latin chars only): *

Email: *

Phone: *

Instant Messaging:

Licensee's Billing Contact

Name: *

Name (Latin chars only): *

Email: *

Phone: *

Instant Messaging:

Licensee's Legal/Administrative Contact

Name: *

Name (Latin chars only): *

Email: *

Phone: *

Instant Messaging:

6. ADDITIONAL COMMENTS

Whatever Additional Info or Comments You Might Wish to Share:

7. LICENSE AGREEMENT

BotDetect License:

I have read and fully understood the license.

Your Organization: *

Your Organization: (Latin chars only): *

Your Name: *

Your Name: (Latin chars only): *

Your Role in Your Organization: *

Your Email: *

IP Address:

Country:

GMT Datetime:

Local Time:

Local Timezone:

Browser / Version:

Operating System:

Please note that, as a part of our customer identification process, all of the submitted data will be verified before the delivery takes place!