Raising Cain Podcast Guest Registration & Permission Form
Thank you for applying to be a guest on our podcast. We look forward your interview. Please fill in the form so we can have the information needed to conduct your interview and discuss what is important to you.
Mobile Phone for text reminder
List your Facebook, Instagram, Twitter and LinkedIn links:
Upload Headshot if applicable
Upload Logo or Book cover if applicable
Topic for Podcast
Podcast Topic: (note, we do not discuss politics, religion or sexual issues)
Family DNA Stories
Youth Empowerment Stories
Human Interest Stories
Domestic and Relationship Abuse and Awareness
About the Podcast Topic-Focus and any questions you would like us to ask or not ask:
Tell us about your book or podcast subject and list up to 10 questions you would like us to ask you.
Add any Social Media links, website and books with ISBN's or links to the book
For Promotion add your bio, up to 200 words.
Will you be willing to share your podcast with your audience?
Upload a PDF Media Kit if you have one
By signing this form, I grant Raising Cain Podcast-Crossroads Productions, its successors and assigns a universal, irrevocable, unconditional, royalty-free, right and license (with full rights to sublicense through multiple tiers) to: (1) use my picture, voice (including all written or verbal statements), appearance, name, likeness, actions, statements, performance, and biographical information (such as social media links) (collectively, my “Publicity Rights”), and (2) copy, distribute, perform, display, modify, and generally to exploit, my Publicity Rights, including without limitation to advertise, promote or market all or portions of the Podcast. If the request is from a minor and under the age of 18, a parent or guardian must sign this form. Signature:
Please verify that you are human
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