Speaker Form

Speaker Information

Thank you for agreeing to speak at our event! We are excited to have you join us and for God to work through you to impact our members. Please complete and submit both forms below. Once you have done so, please email a high resolution photo of your self to communication@paconference.org.

Please note there are two forms to complete and submit.

Media Release

The undersigned enters into this agreement with the Pennsylvania Conference of Seventh-day Adventists, 720 Museum Road, Reading, PA.

The messages shared at Pennsylvania Conference events can be a blessing to many more people than those who attend. To accomplish wider distribution of the messages presented, the Pennsylvania Conference wishes to produce audio and/or video recordings of the presentations given at its events, to place them on the internet for downloading, and/or to offer these events live through our Facebook and YouTube channels. To make such recording and distribution possible, the Pennsylvania Conference requests your permission to make audio and/or video recordings of your presentation(s) and to distribute those recordings and/or transcripts of the recordings.
By completing this form, you (the individual named below) acknowledge your understanding and acceptance of the following terms granting to Pennsylvania Conference a license to make recordings of your presentation(s), to edit those recordings to be suitable for distribution, and to distribute the recordings and/or transcripts of the recordings in any format or formats in accordance with the following provisions:

In consideration of the opportunity to make one or more presentations, I grant to Pennsylvania Conference an irrevocable, worldwide, royalty-free license with right to sublicense to make, edit, reproduce, and distribute recordings and/or transcripts of any presentation or presentations I make at this event, and to reproduce and distribute together with those recordings and/or transcripts any printed materials which were used as a part of or distributed in conjunction with my presentation or presentations. The recordings of presentations, transcripts, and reproductions of printed materials may be in any format and distributed through any distribution channel or distribution mode selected by Pennsylvania Conference. Where appropriate and reasonably practical as determined by Pennsylvania Conference, I will be credited as the Speaker or Presenter of the recorded presentation(s) or transcript thereof, but Pennsylvania Conference shall not be subject to any liability for omission or unintentional error of identification of Speaker or Presenter.
This license to Pennsylvania Conference shall not limit or detract from my right to present the same or similar material at other events in the future and/or to distribute recordings of my presentation(s).
As used in this license, the term “distribution” and similar terms referring to distributing recordings and/or associated materials means any and all forms of communicating the contents of said recording(s) and/or associated materials, whether currently existing or not. This includes, without limitation, file sharing, media streaming, CDs, DVDs, and/or other forms.

I hereby consent and authorize the Pennsylvania Conference or its assigns, to use my name, likeness, image, voice, appearance, video and audio recordings, and performance for the purpose of news releases, advertising, publicity, publication or distribution in any manner whatsoever, in composite or edited forms.

I warrant and represent that all material furnished by me is my own or that I have full authority to use it for such purposes. I expressly release and indemnify the Pennsylvania Conference and its assigns from all liability in connection with such uses.
I have read this release and am fully familiar with its contents.

Speaker Information

I have read the media release form.