SSR Annual Meeting | Speaker Consent Form
Authorization for the recording of sessions, photo release and/or use of presentation materials.
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I hereby grant permission to the Society for the Study of Reproduction (SSR) as related to the 2021 Annual Conference, the rights of my image, presentation, likeness, and sound of my voice as recorded on audio or video, without payment or any other consideration. SSR parties may rely upon this consent in including the Recordings and Materials in SSR Annual Conference related content, newsletters, and brochures, and I hereby release the SSR Parties from and against any and all claims that I may have as a result of their exercise of the rights granted hereunder, including without limitation, claims regarding invasion of privacy, defamation, copyright infringement and violation of publicity rights.  

Photographic, audio, or video recordings may be used for the following purposes:
• conference presentations
• educational presentations or courses
• informational presentations
• on-demand viewing

By signing this release, I understand this permission signifies that photographic or video recordings of
me may be electronically displayed via the Internet or in public educational settings. I will be consulted about the use of the photographs or video recording for any purpose other than those listed above. There is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed.

This release applies only to photographic, audio, or video recordings collected as part of the session(s)
listed on this document. Your presentation materials will not be used in promotional materials.

Full Name: *
Email Address: *
Speaker Type *
By signing this form, I acknowledge that I have completely read and fully understand the above release and agree to be bound thereby. I hereby release all claims against any person or organization utilizing this material for educational purposes. *
Digital Signature: *
Date: *
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