Grad School Femtoring Podcast Interest and Consent Form
Thank you for expressing interest in participating as a guest speaker for the Grad School Femtoring podcast. All recordings will be done via Zoom (audio and video). Please fill out this form to express your interest and provide your consent.

Please note that due to scheduling limitations you may not hear back to book a date or time for a few weeks after filling out this form.

As a guest of the above-named Grad School Femtoring podcast (“Podcast”), I consent to the audio and video recording of my voice, name, and image as part of my appearance on the Podcast. I further consent to the distribution and broadcast of my appearance, including any information and content I provide in audio, video, or text form without restriction.

I further acknowledge and agree:

(a) I will receive no monetary compensation for my appearance. The consideration I receive for executing this release shall be the exposure I receive to the audience of the Podcast.

(b) I am granting the Podcaster a non-exclusive, royalty-free, perpetual, worldwide license to publish any copyrighted work I supply as part of my appearance on the Podcast.

(c) I am waiving any intellectual property claims including, but not limited to, trademark and copyright infringement claims, associated with personal or business interests discussed during my appearance on the Podcast.

(d) I am waiving any right to publicity and privacy claims, and agree my name, likeness, and business information may be used by Podcaster in the episode in which I appear and future reproductions as well as the marketing materials supporting the Podcast in general.

(e) That Podcaster is the sole owner of any all rights to the Podcast, including the episode in which I appear. I further acknowledge and agree that the Podcaster has the right to edit the content of my appearance and publish the same in any media now and in the future without first obtaining my approval.

(f) I am releasing and discharging the Podcaster together along with all of the Podcaster’s principals, shareholders, officers, employees, agents, successors, and assigns from any and all liability arising out of or in connection with my appearance on the Podcast or the subsequent reproduction and distribution of the episode in which I appear in any medium.
Email *
Full Name *
Topic you'd like to speak on *
Short Bio (50-100 word bio to be used to introduce you during the podcast recording) *
Today's Date *
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A copy of your responses will be emailed to the address you provided.
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