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* 1. Name

I hereby give my consent to Leonardo Lightbourne to use my image and/or video for the "Pushing Your P's" show. I understand that the show is a 30-minute podcast where I will be interviewed and discussing various topics.

I acknowledge that my image and/or video may be used on Leonardo Lightbourne's platforms, including but not limited to his website, social media accounts, and other promotional materials. I also understand that a link for the interview will be sent to me prior to the filming, and I have the option to review and approve the final version before it is published.

By signing this consent form, I agree to the terms and conditions outlined above and grant Leonardo Lightbourne the right to use my image and/or video for the "Pushing Your P's" show.

Please click DONE at the end of this consent form.

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* 3. I consent to the use of my image and video on the platforms of Leonardo Lightbourne for the show "Pushing Your P's," which is a 30-minute podcast.

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* 4. Enter date

Date

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