M Baker APFM 2025 M Baker Speaker Agreement Are you a Solo Presenter, Panel Moderator or Panelist? * Solo Presenter Panel Moderator Panelist Speaker Info First Name * This will be listed on all conference materials. Last Name * This will be listed on all conference materials. Please include all designations. Textable Phone Number * We need a phone number to which we can text you on the day of the session. Email * Confirm Email * Speaker Bio * 0 of 250 max words Please include your short professional bio – no more than 250 words Speaker Profile Picture * Drop a file here or click to upload Choose File Maximum file size: 2MB Please upload your most current professional headshot (in JPEG or PNG format). If you are unable to upload through this form for any reason, please email your headshot ASAP to: [email protected] Speaker Agreement Please confirm your agreement with the statements below. Participation * I will speak as a presenter, moderator or panelist on the session that I have been invited to join. Technology * I will join the panel via Zoom, using a device with a camera, microphone, and stable internet connection. I will use the Zoom link provided to me and I will not share that link with any person. Expenses * I understand that any expenses incurred to participate in this conference are my responsibility, and I will not be reimbursed by APFM. Registration * I understand that if I wish to attend other conference workshops, I will need to register for the conference with the 20% discount code provided to me. Notification * I will notify APFM immediately in the event that I am unable to meet my commitment as a speaker and understand that APFM is counting on me to present at the conference.For questions, please contact APFM at [email protected] or 802-823-2566. For questions, please contact APFM at [email protected] or 802-823-2566. For questions, please contact APFM at [email protected] or 802-823-2566. Content * I warrant and represent that, to the best of my knowledge, nothing in my presentation violates any proprietary or personal rights of others (including, without limitation, any copyright or privacy rights), is factually accurate, and contains nothing libelous or otherwise unlawful. Release I AGREE THAT THE ACADEMY OF PROFESSIONAL FAMILY MEDIATORS MAY: Use of Name and Bio * APFM may use my name, headshot and biographical data in any promotional material (print or online) developed in connection with the conference. Ownership and Use of Work Product: * The Speaker retains full ownership of all Work Product, including but not limited to presentations, training materials, written content, and intellectual property created for or used in connection with this Agreement. APFM is not granted any license, right, or permission to use, modify, distribute, or reproduce the Work Product in any form, except during live training sessions delivered exclusively by the Speaker. Recording * Recording of the event is permitted. The Speaker will receive a free copy of the recording following the event. This recording shall not be sold, shared externally, or made available to anyone other than conference registrants by either party. The Speaker and APFM may use photographs taken during the session and clips of the recording, lasting no more than 3 minutes, in public promotional materials. Understanding * I understand and agree to the above conditions. Questions, please contact: Kacy Wiant, APFM Administrator [email protected] Signature and Agreement Submission Today’s Date * Signature * signature keyboard Clear Captcha Submit If you are human, leave this field blank.
