Speaker Release Form

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

Speaker Contact Information

    Speaker Name





    Telephone (xxx-xxx-xxxx)

    Presentation Information

    Presentation Title

    Program Title

    Date(s) (xx/xx/xxxx)


    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 nonexclusive rights to highlight the presentation on Stanford Sports Medicine social media with a photo, brief highlight article and tag

    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

    Stanford Sports Medicine
    Phillip & Penelope Knight
    Athletic Training Center
    641 E. Campus Drive

    Stanford Sports Medicine