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.
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Topic for Podcast
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Podcast Topic: (note, we do not discuss politics, religion or sexual issues)
Author
Women Empowerment
Relationships
Kids
Travel
Family DNA Stories
Immigrant stories
Youth Empowerment Stories
Human Interest Stories
Nonprofit Agencies
Domestic and Relationship Abuse and Awareness
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About the Podcast Topic-Focus and any questions you would like us to ask or not ask:
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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:
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