Speaker Release Form

Stanford Sports Medicine requests your permission to distribute the presentation, which you deliver at the upcoming session to the participants. We further request the nonexclusive rights to highlight the presentation on the Stanford Sports Medicine website as well as Stanford Sports Medicine social media (i.e, photo, video, audio).

As an invited speaker, please complete the agreement below and send to Stanford Sports Medicine.

Speaker Contact Information

Speaker Name

Title

Institution

Address

Email

Telephone (xxx-xxx-xxxx)

Presentation Information

Presentation Title

Program Title

Date(s) (xx/xx/xxxx)

Location

Release Agreement

I agree to participate as a speaker for Stanford Sports Medicine in reference to the above listed program

I grant Stanford Sports Medicine the right to use my name, voice and presentation content, if Stanford Sports Medicine so chooses

I warrant that my presentation and any material(s) I submit do not infringe on the rights of others

I agree to obtain such permission(s) from the copyright owner(s) should my presentation or the material(s) I use during or in connection with my presentation require permission for use

I understand that execution of this Agreement does not obligate Stanford Sports Medicine to publish my presentation or the materials used therein

I verify that I am the author of this presentation, I have authority to enter into this agreement and that I will be bound by its terms

Contact Details

Email
contact@stanfordsportsmedicine.com
Telephone
650.723.1214
Address
Stanford Sports Medicine
Phillip & Penelope Knight
Athletic Training Center
641 E. Campus Drive
Stanford Sports Medicine