Youth Impact Speaker Engagement Agreement

Youth Impact Speaker Engagement Agreement

Complete the event, services, rates, payment, and acknowledgment details, then sign electronically.
Client Information
Organization Name
Client Representative Full Name

First NameLast Name
Title/Role
Contact Email
example@example.com
Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Event Information
Event Name
Event Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Event Location (Venue/Address)

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Expected Audience Size
Speaking Services Checklist
Select Speaking Services

Other
Booking Rates & Honorarium
Select Booking Rate
Final Rate Agreed Upon
Deposit and Payment
Deposit Amount (if applicable, USD)
Payment Method
Travel and Accommodations
Travel Arrangements Provided By
Accommodation Arrangements Provided By
Special Travel or Accommodation Requests
Cancellation Policy Acknowledgment
I acknowledge and accept the Clear Vision Youth Impact cancellation policy.
Media & Promotional Use Agreement
I grant permission for event photos, video, and audio recordings to be used for promotional purposes by Clear Vision Youth Impact.
Clear Vision Youth Impact Contact Information
Agreement Signatures
Client Representative Signature
Date (Client Representative)

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Donta Barrett (Clear Vision Youth Impact) Signature
Date (Donta Barrett)

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Youth Impact Speaker Engagement Agreement

Client Information

Event Information

Speaking Services Checklist

Booking Rates & Honorarium

Deposit and Payment

Travel and Accommodations

Cancellation Policy Acknowledgment

Media & Promotional Use Agreement

Clear Vision Youth Impact Contact Information

Agreement Signatures