Guest Application For The Exercise Is Health Podcast
Sign in to Google to save your progress. Learn more
Email *
Your Name *
Your Professional Title (What Do You Call Yourself?) *
Your Email Address *
Your Phone Number *
Your Website *
Your Social Handles (Instagram, Facebook, YouTube, TikTok) *
Your Professional Bio (Under 100 Words) *
What are potential topics you would like to discuss on the Exercise Is Health podcast? List up to three below. *
What are potential episode titles you would use for an interview you do on the Exercise Is Health podcast? List up to three below. *
Why do you believe that your expertise, story, and message are something that the listeners of the Exercise Is Health podcast need to hear to be healthier or live a healthy life? (Under 100 Words) *
Please include a link below to one other interview you have done (podcast, YouTube, Facebook Live, etc) *
Do you have an offer you would like to promote to our listeners? If so, what does it entail?
If we record and publish an episode together for the Exercise Is Health podcast, would you be willing to promote the episode on your social platforms and to your email list? *
By recording an interview together, we are not committing to publishing the interview. We hand-pick the best interviews to get released and figure out the best time of year to release them. Do you understand that by recording an interview together, it may not get released as an episode on the Exercise Is Health podcast? *
Exercise Is Health Podcast Release Form: By checking the box below, entering my FULL NAME and dating this document - I authorize and hereby grant to Self Made Fitness, Inc., their subsidiaries, affiliates, agents, successors, and assigns the right and permission to record, use, publish, stream live, offer for sale, or otherwise distribute any audio or video interview with me. Such right and permission includes, but is not limited to, my name, recorded voice or video, photograph or likeness, biographical information, handouts or any material based upon or derived therefrom. I understand that the Exercise Is Health podcast may, at its sole discretion, produce presentations or publications based in whole or in part upon audio interview (or any portions thereof) and/or video or audio recordings or photographs of said interview, and that such media or transcripts may appear in print, online, or in any manner or media, including but not limited to promoting the podcast or streaming audio program. I have no right of approval, no claim for compensation, and no claim (including, without limitation, claims based upon invasion of privacy, defamation, or right of publicity) arising out of or in connection with, any use, alteration, or use in any composite form hereunder. I hereby warrant and represent that I have the right to enter into this agreement and to grant the rights granted to the Exercise Is Health podcast herein. I agree that during the course of the interview I have not violated the rights of any third parties, including but not limited to copyrights, rights of privacy, trade secrets, and non-disclosure agreements, and that in the event of any breach of any of these warranties, that I will defend and hold the Exercise Is Health podcast harmless against any such claims. This release shall be binding upon me and my heirs, legal representatives, and assigns. *
Required
YOUR FULL NAME *
RELEASE AUTHORIZATION DATE *
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Muscle Activation Schaumburg. Report Abuse