Whole- Hearted Radio Show Guest Form

Thank you for your interest in being a guest on the Wholehearted radio show.

Once you complete the information below you will receive an email confirmation for your submission. We will be in touch to schedule our time together.

Name*

First NameLast Name

Email Address*

Phone Number

Format: (000) 000-0000.

Please provide the topic/talking points you would like to discuss.

What are five questions we may ask you during our interview time together?

Upload your Headshot and 2-4 photos or Press Package

this will be used in all content artwork

Please include your one-paragraph bio.

A little bit of background and family history, inspired experiences.

Please include your one-line bio.

Key Scriptures you will be referencing.

Are there any topics you prefer not to discuss?

What is one question about your faith that you wish you were asked more often?

Let's connect. Please share your contact information including any relevant websites and social media handles where you would like us to tag you when your episode airs.

Yes, of course!No, thanks

I hereby grant Jenny Muscatell and the Wholehearted Radio Show/Christian Mix 106 permission to share my information as provided above and that which will be recorded during programming including photo, audio, and media footage, website links or other promotional materials. I hereby forever release and discharge Jenny Muscatell and Christian Mix 106 from any and all claims, actions and demands arising out of or in connection with the use of said material, including, without limitation, any and all claims for invasion of privacy and libel. I understand that this information/material will be shared on the Christian Mix 106 platform and further syndicated through the the whole-hearted radio show affiliates and partners. This release shall inure to the benefit of the assigns, licensees and legal representatives of Jenny Muscatell or Christian Mix 106 as well as the party(ies) for whom said media are taken. Notice: This is a legally binding agreement. Read this document carefully and in entirety. By signing this agreement, you give up your right to bring a court action to recover compensation or obtain any other remedy for any harm related to the release of the show materials, now or any time in the future.Waiver, Release, Indemnification & Covenant Not to SueIn my participation in the filming of “Wholehearted,” I HEREBY DO RELEASE Jenny Muscatell and Christian Mix 106, its employees, volunteers, representatives and insurers (“Releasees”) from any causes of action, claims, or demands of any nature whatsoever including, but not limited to, claims of negligence, which I may have, now or in the future, against Jenny Muscatell or Christian Mix 106 on account of personal injury, illness, property damage, death or accident of any kind, arising out of the filming/recording of the “wholehearted” programs.I agree to INDEMNIFY AND HOLD HARMLESS Releasees from any and all causes of action, claims, demands, losses, or costs of any nature whatsoever arising out of the filming/recording of the Wholehearted programs.

Signature

Guest Information