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PROBLEM BUSTERS PODCAST GUEST RELEASE FORM
The above named Guest does hereby consent to the recording and distribution of reproduction(s) of the Guest's voice and performance as part of the media program entitled “Problem Busters” (herein referred to as the "Program").
This is to confirm that the undersigned has agreed to be interviewed or otherwise participate in the Program.
The undersigned hereby grants Problem Busters and its affiliates, licensees, successors and assigns (collectively, “Problem Busters”) permission to use his/her name, likeness, voice and biographical material in connection with the Program and for any other purpose related to Problem Busters' business.
The undersigned acknowledges that he/she has no right to approve or inspect any finished product or advertising copy that may be used in connection with the Program.
The undersigned hereby releases Problem Busters from any and all claims arising out of or in connection with the use of his/her name, likeness, voice and biographical material in connection with the Program.
The undersigned represents that he/she is at least eighteen (18) years of age and has read this release prior to signing it.
Dated:
Guest Full Name:
Consent
