Practicing Life Podcast Intake Form
Do you have something you want to share on a podcast platform? My podcast may be an option for you. Practicing Life is about heartfelt leaders learning from their lessons and sharing it with the world. It is called practicing because life isn't perfect. We are here to discover more about ourselves and gain new perspectives. Then we put what we have learned into practice. 
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Hello!

Thank you for your interest in appearing as a guest on Practicing Life Podcast. This form contains all the information I need to get started and plan an episode.

If you are a good fit, I will reach out to you to set up a zoom recording date and time for the podcast. The podcast will be on video and uploaded to YouTube. Plan accordingly.

I'm looking forward to our conversation!
What is your name? 
(Please write the phonetic pronunciation of your full name)
*
Business Name or Organization?
What is your email address? *
What is a good number I can reach you at if needed? *
What time zone are you in?  *
What do you want to share on the podcast and why is it important to share it?  *
Is there a specific timeframe you need the podcast released by? 
Bio:
(Brief - 4 Sentences)
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Social Media Links/Website:  *
If you are willing, you can offer the guest an opportunity to share some sort of freebie or promotional item. If yes, please describe: 
Is there a specific product/service/event you'd like to promote during the show?
*
Are there specific questions you would like me to ask? 

I acknowledge that by being on Practicing Life Podcast (the “Podcast”), I am consenting to the recording of my statements (the “Interview”) and grant permission for the Podcast and Host, Ashley Pitzer (the "Host), the right to copy, reproduce and use all or a portion of the Interview.  I hereby give permission to the Podcast and Host to use, reproduce, and distribute the Interview, including my name and submitted photo(s). 

I permit the use of all or a portion of the Interview in the Podcast in all forms and media including advertising and related promotion throughout the world and in perpetuity. I grant the right to use my image and name in connection with all uses of the Interview and waive the right to inspect or approve the use of my Interview as incorporated in the Podcast. I release the Host and the Podcast from any claims that may arise regarding the use of the Interview including any claims of defamation, invasion of privacy, or infringement of moral rights, rights of publicity, or copyright. I hereby agree to release the Podcast and Host from any claims, damages or liability arising out of such use or distribution. I understand that the use of my name, likeness, and voice recordings will be primarily for the purposes of commercial use, education and/or promotion by this organization. I have read and understand the foregoing and I consent to the use of my picture and/or voice as specified for the above-described purpose(s). 

I acknowledge that I have no ownership rights in the Podcast. The Host is not obligated to utilize the rights granted in this Agreement. I acknowledge I am a guest on the Podcast as such, it is voluntary and without compensation. I further understand that no royalty, fee, or other compensation of any character shall become payable to me.

I have read and understood this agreement and I am over the age of 18. This Agreement expresses the complete understanding of the parties.


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