The below named Guest does hereby consent to the recording and distribution of reproduction(s) of the Guest's likeness,  voice, and performance as part of the media program entitled “Community Manager Live” (herein referred to as the "Program"). This is to confirm that the undersigned has agreed to be interviewed or otherwise participate in the Program, a production of Collective Mindset.

As a condition of publication/broadcast and for no monetary compensation, #CmgrLive requests the non-exclusive worldwide rights to reproduce, distribute, and sell your oral and/or video presentation, in whole or in part, in any media, as part of this Program published under the auspices of #CmgrLive and to license these rights to others, in perpetuity. #CmgrLive shall have the right to edit and/or transcribe your presentation.

You also grant  Community Manager Live  the right to use your name, biography and likeness in connection with the Program.

You warrant that your presentation is original with you, that publication/broadcast will not infringe on the rights of others, and that you have full power to grant this license. Should your presentation/broadcast incorporate copyrighted materials of others, you warrant that you have obtained such permission from those parties for publication/broadcast by  Community Manager Live, consistent with this Agreement.

If the foregoing terms are satisfactory, please submit this form. Execution of this Agreement does not obligate  Community Manager Live to publish your presentation or other materials.

I hereby consent to the use of my oral and/or video presentation as described and agree with the provisions of this release form.