4.3.3 Presenter Authorization Form

Click to print a pdf of the Presenter Authorization Form. (Sample provided below.)

ACAP Presenter Authorization

(Please print) _________________________________    ______________________________

                       Name                                             Employer organization

Please initial:

________  I commit to being a presenter for an ACAP program and acknowledge receipt of:

1. Program Presenter Information
2. ACAP Guiding Principles
3. Program Outline
4. Sales and Promotion of Products and Services Policy

Please initial one:

________  I commit to being a presenter for an in-person ACAP program and understand my presentation may be livestreamed as well as recorded and permanently saved on ACAPcommunity digital media platforms. I understand:  (1) I will be given appropriate acknowledgement for my intellectual property, (2) that the video and/or audio may remain online permanently, and (3) the video and/or audio may be used for other official ACAP purposes.  I further agree to the additional stipulations below.  (Please initial if in agreement)

________  I commit to being a presenter for an in-person and/or livestreamed/recorded ACAP program but decline authorizing my presentation to be saved on ACAPcommunity digital media platforms.  I request that the recording be deleted immediately after my presentation. (Please initial if in agreement)

I hereby release any and all claims against any person or organization utilizing my voice, likeness participation and performance in video, photographs, written materials and audio-visual recordings prepared by or on behalf of ACAPcommunity, or for the benefit of ACAPcommunity for any lawful marketing, educational, promotional, commercial and/or non-commercial reason whatsoever.

Presenter

Signature: __________________________________________________________________ 

Date:  _____________________________________________________________________