Please complete the following form to submit your speaking request for Flourish.
Please note that your speaking position will not be confirmed until this form has been submitted.
Contact Kristen at firstname.lastname@example.org with any questions.
I hereby voluntarily release K&H Connection LLC d/b/a Flourish Media and their employees, subsidiaries, affiliates, agents, successors, and assigns (hereinafter “Company”) from any and all claims of any kind by me, my agents, or my estate for use by the Company of any images of me, pictures of me, audio or video recordings and/or statements of mine which the Company might use in its sole discretion for advertising or promotional purposes.
I hereby acknowledge and agree that, in my capacity as a speaker at any Company conferences, I will not use such opportunity to: (i) promote or endorse the business, products and/or services of myself and/or any other third parties, and/or (ii) make any statements that disparages the rightful dignity and social equity of any other individual and/or business.
I hereby grant to Company the right and permission to record, use, duplicate, and archive any presentation given by me at a Company conference. Such right and permission includes, but is not limited to, my name, recorded voice or video, photograph or likeness, biographical information, handouts and/or any other materials based upon or derived therefrom.
I understand that any images, pictures, audio or video recordings (and transcripts thereof), and/or statements of mine may be used freely by the Company, in whole or in part, in order to promote itself to the public at large in any number of ways including, but not limited to, any and all kinds of media, websites, presentations, publications, marketing and promotional materials, electronic communication, brochures, newscasts, and/or radio programs.
I hereby give permission to Company to release my images, pictures, audio or video recordings, and/or statements in any way and at any time the Company deems appropriate. This release is un-limited and unconditional, and is intended to survive any termination of my relationship with Company.
I hereby freely relinquish any proprietary rights that I may have in any statements, written or oral, any images or photographs of me, formal or informal, that are used by the Company for any purpose and in any manner it sees fit. I understand that I have no right of approval, no claim for compensation, and no legal claim (including, without limitation, claims based upon invasion of privacy, defamation, or right of publicity) arising out of or in connection with, any use, alteration, or use in any composite form hereunder.
I hereby warrant and represent that I have the right to enter into this agreement and to grant the rights granted to Company herein. I agree that during the course of the presentation I have not violated the rights of any third parties, including but not limited to any copyrights, rights of privacy, trade secrets, and/or non-disclosure agreements, and that in the event of any breach of any of these warranties, that I will indemnify, defend and hold Company harmless against any and all such claims. This release shall be binding upon me and my heirs, legal representatives, and assigns.