2019 BFS Speaker Registration
Speaker Name
*
First Name
Last Name
Speaker Email
*
example@example.com
Speaker Cell Phone Number
*
-
Area Code
Phone Number
Primary Contact (if different)
First Name
Last Name
Primary Contact Phone Number (if different)
-
Area Code
Phone Number
Primary Contact Email (if different)
example@example.com
Guest's Name
First Name
Last Name
Presenters' Resume
*
Browse Files
(required by the American Council on Exercise which provides CECs to our Attendees)
Cancel
of
Headshot (Minimum 600x600 px)
*
Browse Files
Cancel
of
Bio (approx. 250 words)
*
Presentation Title
*
Description of Presentation
*
(50 words minimum; 100 words max)
Learning Objective #1
*
Learning Objective #2
*
Learning Objective #3
*
MEDIA WAIVER We record every session, conduct video interviews with speakers, and have an onsite photographer. All of the media gathered may be pushed out to the public through various media/social channels. All conference participants must sign our media waiver below. I hereby authorize WLC Conferences, hereafter referred to as “Company,” to publish photographs and video taken of me, my name, and my likeness for use in print, online and video-based marketing materials, as well as other Company publications. I hereby release and hold harmless WLC Conferences from any reasonable expectations of privacy or confidentiality associated with the images specified above. I further acknowledge that my participation is voluntary and that I will not receive financial compensation of any type associated with the taking or publication of these photographs or participation in company marketing materials or other company publications. I hereby release WLC Conferences, its contractors, its employees, and any third parties involved in the creation or publication of marketing materials from liability for any claims made by me or any third party in connection with my participation.
*
AGREE
DISAGREE
Social Media Handle(s): (Facebook, Instagram, LinkedIn, Twitter)
*
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