Consent Form for interviewees

Today’s Date:

I hereby grant 50 Interviews Inc. the right and permission to use, reuse, publish, and republish my name, photograph, likeness (including any video or voice recordings), statements, and comments made by me, in whole or in part, without prior review, in all formats of the Work and any derivative works, including without limitation, electronic works and including for the purposes of sale, trade, promotion, or advertising.

I warrant the accounts told, written, or furnished by me are original with me and do not violate any copyright, personal, or proprietary right.  I confirm that none of the information disclosed was acquired as a result of a confidential relationship or is treated as a trade secret.

I release you and the publisher from any and all claims, demands, or causes of action that I might assert in connection with the above use or uses by the publisher.

I am over the age of 21.  I have read the foregoing and fully understand the contents thereof.

I agree to the terms of the General Release Form:

Interviewed by
Name
Address & Phone
Email
50 Interviews may provide my contact information to others without my prior consent
I am interested in speaking engagements
Today’s Date
Image Verification
Please enter the text from the image
[ Refresh Image ] [ What’s This? ]

Thank you!