Guest Intake & Release Form

1

We will record for about an hour via Streamyard but recording slots are 2 hours in case of technical, connectivity, audio, or any of a million other possible difficulties.

McCrazy's Place started with game night in my home and attempts to keep that same vibe. #JustConversation is all it is. I do not edit or censor my content. Let's have #ActuallyAuthentic conversation.

After submitting your form, you will receive (a) confirmation email(s) from Jotform and then an email from McCrazy's Place regarding scheduling a time to record. Once a timeslot is confirmed, a calendar invitation and Streamyard link will be sent to you.

2

What name would you like the host to call you?* This field is required.

3

Email* This field is required.

4

Phone Number* This field is required.

Country Code

Area Code

Phone Number

5

Do you have an area of expertise and/or a specific topic you’d like to discuss?* This field is required.

6

Are there any topics that are off limits?* This field is required.

7

What's your Instagram handle?* This field is required.

(e.g. @jonbstrong or leave blank if not applicable)

8

Please link to a headshot of yourself* This field is required.

(use imgur if you need to host your image somewhere)

9

GUEST RELEASE:

Guest hereby grants to the program, its affiliates, agents, successors, and assigns the right and permission to record, use, publish, stream live, offer for sale, or otherwise distribute any audio or video of our recording session. Such right and permission includes, but it is not limited to the name of the guest, recorded audio or video, photograph or likeness, biographical information, handouts or any material based upon or derived. This grant of permission does NOT include the release of any of guest’s confidential information. For purposes of this paragraph, ''confidential information'' is defined as email address and phone number of the guest.

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10

Signature* This field is required.

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