Storyteller Details
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
example@example.com
Have you told a story at a storytelling event before?
*
Please Select
Yes! I'm a seasoned storyteller!
I've told one before.
I've not told one before but I know the format.
I'm a total newbie!
Other
*
Please tell us about your story in 25 words or less:
Anything else you'd like to share:
'This Is Totally Fucked' is a Live Podcast. Do you Give Permission for your story to be included in the 'This Is Totally Fucked' podcast?
Yes
No
By clicking 'Yes', You grant This Is Totally Fucked’ the right to photograph you and to record your voice, and story, and use my picture, photograph, silhouette and other reproductions of my physical likeness in connection with the event tentatively entitled ‘This Is Totally Fucked’ for event archives and possible inclusion onto the ‘This Is Totally Fucked’ Podcast.
By clicking 'Yes', you grant to ‘This Is Totally Fucked’, its successors, assigns and licensees the perpetual right to use this recording.
By clicking 'Yes', you hereby certify and represent that you are over 18 years of age and have read the foregoing and fully understand the meaning and effect thereof.
The storytelling events for 'This Is Totally Fucked' are primarily designed for its Podcast. By clicking 'No', your story will most likely not be included in the 'This Is Totally Fucked' live events.
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