Quick Conference Navigation Main Page APFM 2021 A New Beginning: Reimagining the Art and Science of Family Mediation Panelist and Moderator Agreement 2020 Speaker Agreement & Release First Name * This will be listed on all conference materials. Last Name * This will be listed on all conference materials. Please include all designations. Text Able Phone * We need a phone number to which we can text you on the day of the session. Email * Confirm Email * I am invited to be a: * Panelist Moderator Sponsor Who is the moderator of the panel that you have been invited to join? * I am the moderator Michael Aurit Bill Eddy Susan Guthrie Jen Hawthorne Nancy Hetrick Larry Jones Hillary Linton Max Markin Marilyn McKnight Forrest "Woody" Mosten Ken Neumann Don Saposnek Amanda Singer Darcia Tudor *This information was provided in your invitation email. Participation * I will speak as a panelist or moderator on the panel 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 panels or workshops, I will need to register for the conference. (Register here.) Notification * I will notify Beth Goldfarb 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 Beth Goldfarb at [email protected] or 508-735-0961. 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. I AGREE THAT THE ACADEMY OF PROFESSIONAL FAMILY MEDIATORS MAY: Use of Name and Bio * Use my name and biographical data in any promotional material (print or online) developed in connection with the conference. Panelist/Moderator Bio Use of Content * Reproduce and republish in print, recorded media or online the presentation and remarks of my presentation. For example, video or audio files of my presentations may be provided to conferences attendees free or for a charge. Additionally, the video or audio recording may be given or sold after the conference. Use of Content for Members * Reproduce and republish in any form and in any media tables, charts or other written or visual material used by me as part of my presentation for the benefit of APFM members. In addition, any media tables, charges and other written or visual material from a presentation may include as part of a sale of the video or audio recording after the conference to the APFM membership or members of affiliate organizations. Understanding * I understand and agree to the above conditions. Questions, please contact: Beth Goldfarb [email protected] 508-735-0961 Signature and Agreement Submission Today's Date * Signature * Clear reCAPTCHA If you are human, leave this field blank. Submit
