R2 Guest Registration

Registration and Release

First name

Preferred first name

Last name

Honorifics or preferred form of address (Mr. Ms. Dr.)

Social media handles

{name}

Mailing address

City

State

Zip code

Country

Primary phone

Biography - Please write 3-5 sentences about your education and accomplishments.

Particularly accomplishments related to the upcoming interview.

{name}

Podcast Appearing On

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Please add me to "Good Tape" newsletter distro list

"Good Tape" is all about R2 Studios productions

Please add me to "5 Million Steps" newsletter distro list

"5 Million Steps" is all about The Green Tunnel podcast

If you would like to add an image of yourself please do so here.

Attach file

Drop files here

Consent

I hereby consent to the use of my oral and/or video presentation as described and agree with the provisions of this release form. I hereby consent to the recording and distribution of reproduction(s) of my voice and words as part of the podcasts produced by R2 Studios and the Roy Rosenzweig Center for History and New Media (RRCHNM) at George Mason University, and consent to the distribution of reproduction(s) of my voice and words in possible future, productions of R2 Studios and RRCHNM. I understand that I will receive no monetary compensation. I grant RRCHNM non-exclusive worldwide rights to reproduce, and distribute, my interview, in whole or in part, in any media, as part of this podcast or other podcasts or podcast-related media published under the auspices of George Mason University and to license these rights to others, in perpetuity. RRCHNM shall have the right to edit and/or transcribe my presentation. I also grant RRCHNM the right to use my name, biography, and likeness in connection with the podcast. I agree that images or sounds from any copyright-protected works which I provide for use in R2 Studios and RRCHNM productions are either my own property or works for which I have the permission of the copyright owner to use. If the foregoing terms are satisfactory, please select the checkbox below and submit the agreement. Execution of this agreement does not obligate RRCHNM to publish your presentation or other materials in the podcast.

Person

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Contributions to Projects & Appearances

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