Podcast Release Form

Sign/Submit the Guest Release Form Below

In today’s fallen world, we regret having to ask you to sign a Guest Release Form. We have made it as easy as possible. Please read in full, make sure you understand it, and know that your story could have an eternal impact on someone else.

We will/may use your story in the following ways:

The initial video or audio podcast. This is most likely a recorded interview with CTJ.
Repeated or Best of episodes.
Promotions
Social media
Print media such as ads, booklets, or books.

CTJ Consent v2

Crossing the Jordan Podcast (CTJ) Guest Release Form

Crossing the Jordan Podcast is part of
Finger Lakes Publishing
1854 Eastwood Dr
Lima, NY 14485
writeus@fingerlakespublishing.net

Please read and agree to each paragraph below.

Please check the box by each paragraph to signify that you have read and understood what it says and that you agree with it. Then sign in the signature box using your finger, stylus, or mouse, type your full name below, and add the date. Thank you for completing this document.

The below named Guest does hereby consent to the recording and distribution of reproduction(s) of the Guest's voice and performance as part of the media program entitled “Crossing the Jordan Podcast” (herein referred to as the "Program"). This is to confirm that the undersigned has agreed to be interviewed or otherwise participate in the Program, a production of the Finger Lakes Publishing.

As a condition of publication/broadcast and for no monetary compensation, [Name of Organization] requests the non-exclusive worldwide rights to reproduce, distribute, and sell your oral and/or video presentation, in whole or in part, in any media, as part of this Program published under the auspices of [Name of Organization] and to license these rights to others, in perpetuity. [Name of Organization] shall have the right to edit and/or transcribe your presentation.

You also grant [Name of Organization] the right to use your name, biography and likeness in connection with the Program.

You warrant that your presentation is original with you, that publication/broadcast will not infringe on the rights of others, and that you have full power to grant this license. Should your presentation/broadcast incorporate copyrighted materials of others, you warrant that you have obtained such permission from those parties for publication/broadcast by [Name of Organization], consistent with this Agreement.

If the foregoing terms are satisfactory, please sign and date this agreement below and return it to the Program coordinator. Execution of this Agreement does not obligate [Name of Organization] to publish your presentation or other materials.

I hereby consent to the use of my oral and/or video presentation as described and agree with the provisions of this release form:

Guest Signature (referred to as “Guest” above)

Sign Here

Guest First and Last Name

Date

Guest Email

Guest Phone/Mobile

FLP Signature

Sign Here

FLP Typed Name

Date

Submission Completed

If you have:

Sent your Story
Signed the Guest Release Form

CTJ will review your story and will respond via email. If your story is accepted, then we will arrange for a time to be interviewed. Your interview will be by your phone or computer via remote meeting software.

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