Pivot NOW! TV Show

Name*

First NameLast Name

Email*

example@example.com

Phone Number

Please enter a valid phone number.

Where did we meet? (be specific please)*

Watching/Listening to Pivot NOW! TV ShowNetworking/ConferenceReferred by (provide name)

For the interview, please provide the service you provide, 3 topics you would like to discuss, and your freebie (PDF, checklist, etc).*

What was the biggest problem or struggle you have or have overcome in your business?*

Provide your Affiliate link so that we can revenue share anything you pitch, sell or enroll someone into from the show (Sign up link or special link for you to track leads) *

Please provide ALL social media, website, book URLs, and hashtags so that we can tag you in all social media posting. *

Please provide a link to your headshot and bio (or email to suzanne@sibillacoaching.com)*

Reviews and Followers help the show stay in the top of the charts. I would greatly appreciate a 5* Review and comment of the show. More reviews help ensure YOUR episode will be seen by more people. Thank you!*

Yes, I have listened, reviewed, and followedNo, doing it right now!

Do you have a podcast, Facebook Group, Coaching group, or YouTube Channel that you would be open to inviting me to be a guest?*

Yes, that would work!No, I don't have a showNo, not a good fit

Media Release Agreement

This release is made to allow Sibilla & Associates and Pivot NOW! successors and/or assigns to record my voice, video, photograph, and conversation during my podcast interview with Suzanne Sibilla that will be released on the internet through e360 TV, Amazon Fire, Android, FB, LinkedIn, YouTube, and other streaming platforms.

In consideration of my appearance on Suzanne Sibilla's Pivot NOW! TV Show and without any further consideration, I hereby grant permission to Sibilla & Associates & Pivot NOW! to utilize my appearance and I agree that Sibilla & Associates and Pivot NOW! will have the clients permission and all copyright and other rights in and to such taping, photography, and recording and shall be able to use the same in any and all media throughout the world in perpetuity and in any and all advertising, publicizing, promotion for Sibilla & Associates Marketing, and Advertisement.

I agree that Sibilla & Associates and Pivot NOW! have the right to use, and allow others to use, my name, voice, likeness, and any biographical information I've provided in connection with the Pivot NOW! TV show. This includes any related or future versions of the TV show, as well as its advertising, marketing, and promotion, across all media platforms. I confirm that, to the best of my knowledge, any statements I make during the show are truthful and do not violate any third-party rights. I give Sibilla & Associates, along with its successors, licensees, and assigns, permission to use these recordings indefinitely.

I agree not to make any claims against Sibilla & Associates or Pivot NOW! or its affiliated entities regarding the use of the materials as described above. I also waive and release all claims against Sibilla & Associates Or Pivot NOW!, its affiliates, licensees, individuals, and anyone involved with the TV show, including any claims related to copyright, libel, moral rights, privacy, publicity, or confidentiality.

This release covers all versions and uses of the Pivot NOW! TV show as well as any related content or media. In the event of a dispute, I agree that California law will govern, and any legal matters will be resolved in California.

I understand that there will be no compensation, royalties, or stipends paid as a part of my participation as a contributor.

I am over eighteen years of age and have full legal rights and authority to consent to the terms of this Media Release Agreement.

Do you agree to the terms of the Media Release Agreement as outlined above?

Yes, I agree to the terms of the release.No, I do not agree to the terms of the release.

E-Signature (Type your full name)*