Podcast Guest Form – Red Hat Society

PLEASE FILL IN ALL FIELDS BELOW

Name(Required)

First Last

Email(Required)

Phone(Required)

RHS Member ID(Required)

If you are not a member, please tell us what organization you are with and why we should consider you for the Podcast.

TELL US ABOUT YOURSELF

What type of segment would you like to be on?(Required)

Interview

Cooking

Other

What are you an expert in?(Required)(Required)

What main topics are you excited to talk about?(Required)

If you want to do a cooking segment, do you have a recipe you would like to cook?(Required)

Please tell us the name of the recipe you would like to cook.

Is there anything off-limit subjects you want to avoid?

Filming Location(Required)

In person in West Jordan, Utah

By Zoom

On location at an event the host is attending

Segment Length(Required)

Short 15 min segment

Long 45 to 60 min segment

SHORT BIO OF YOU

(PLEASE INCLUDE A PHOTO)

Bio(Required)

Please provide a short outline of what you'd like to discuss and cover on the show, including any highlights, specific programs, etc., that you want to make sure the host is aware of.

What would you like the RHS community to gain from hearing from you?(Required)

Photo(Required)

Accepted file types: (iejpg, gif, png, pdf), Max. file size: 512 MB.

Please provide a photo of yourself

TERMS: The undersigned Guest hereby consents to the video recording and use of their voice, image, and performance as part of the media program entitled “Friday Broadcast” (herein referred to as the “Program”). This confirms that the Guest has agreed to be interviewed or otherwise participate in the Program, a production of Friday Broadcast or Friday Podcast. This is a video Podcast.

As a condition of publication or broadcast, and for no monetary compensation, the Guest grants Friday Broadcast the non-exclusive, worldwide, perpetual rights to record, reproduce, distribute, publish, sell, and/ or license their oral and/or video presentation, in whole or in part, in any media, as part of the Program. Friday Broadcast retains the right to edit, excerpt, and/or transcribe the Guest’s presentation.

The Guest also grants Friday Broadcast the right to use their name, biography, and likeness in connection with the Program.

The Guest warrants that their presentation is original to them, does not infringe on the rights of others, and that they have full authority to grant this license. Should their presentation include copyrighted materials owned by others, the Guest warrants that they have obtained all necessary permissions for use consistent with this Agreement.

If the foregoing terms are satisfactory, please sign and date this Agreement below and return it to the Program Coordinator. Execution of this Agreement does not obligate Friday Broadcast to publish or broadcast the Guest’s presentation or materials.

All travel expenses related to in person recording (in West Jordan, Utah) are the responsibility of the guest. Lodging may be available at the Host’s location, depending on availably, at no cost.