Affiliate Registration Form
Please Complete Form To Confirm Your RSVP!
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Email *
Full Name *
Market/City *
Bio *
Mobile Number *
Website URL: (if applicable)/Social Media Profiles (please provide links to your relevant social media profiles) *
Describe your primary marketing channels (e.g., blog, email marketing, social media, etc.) *
Who recommended you; How did you hear about us?; (PLEASE LIST ANY NAMES AND/OR PROMO CODES YOU MAY HAVE)   *
Age *
DOB *
Gender *
Race *
Height, Weight, Chest, Waist, Hips, Eye Color, Hair Color, Shirt Size, Pants Size, Shoe Size *
Any Tatts, Peircings or Marks? *
Interested in traveling? *
Briefly describe your experience and interest in promoting multi-media, branding, advertising, and marketing services; *
Is there a specific event /activity or campaign your registering for? If so, which one? *
What do you want your promo code to be in order to receive your commission? *
Payment Preferences: *
Do you know business owners who may need our business development, branding,  advertisement and/or marketing services? If so list below: *
By submitting this document, I hereby grant permission for the rights to my image, likeness, and sound of my voice, as recorded on audio or video tape, without payment or any other consideration, unless negotiated by all parties involved. I acknowledge that my image may be edited, copied, exhibited, published, or distributed, and I waive the right to inspect or approve the finished product in which my likeness appears. Furthermore, I waive any entitlement to royalties or other compensation arising from or related to the use of my image or recording, unless specifically negotiated with all parties.
I also acknowledge that this material may be utilized in various educational settings within an unrestricted geographic area. Photographic, audio, or video recordings may be used for the following purposes:
Company Advertisement
Presentations
Educational presentations or courses
Informational presentations
Online educational courses
Promotional videos
By agreeing to this release, I understand that this permission signifies that photographic or video recordings of me may be electronically displayed via the Internet or in public educational settings. I shall be consulted regarding the use of photographs or video recordings for any purpose other than those listed above.
There is no time limit on the validity of this release, nor are there any geographic limitations on the distribution of these materials. This release solely pertains to photographic, audio, or video recordings collected as part of the sessions listed in this document.
Furthermore, I acknowledge that a working relationship has been or may be established, in which Exclusive Modelz Magazine may disclose or deliver confidential and proprietary materials, including but not limited to documents, components, parts, information, drawings, data, sketches, plans, programs, specifications, techniques, processes, software, inventions, and any other materials, both written and oral, of a secret, confidential, or proprietary nature. This includes any information pertaining to marketing, finance, forecasts, inventions, research, design, or development of information systems and any supportive or incidental subsystems, as well as any subject matter claimed in or disclosed by any patent application prepared or filed by or on behalf of Exclusive Modelz Magazine, in any jurisdiction, along with any amendments or supplements thereto (collectively referred to as "Proprietary Information").
Given the above, Exclusive Modelz Magazine seeks to ensure the confidentiality of any Proprietary Information.
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