Speaker Authorization Form Question Title * 1. I understand that the Forum in which I have agreed to take part will be recorded, and that the resulting video recording(s) will be owned exclusively by the Ms President US program for purposes of program promotion and replication. I understand and agree to allow the Ms President US program to post the video and/or segments to its website (mspresidentus.org), to social media sites (such as Facebook, Instagram, etc), to partner sites, and to any other sites that help promote or fulfill the mission of the Ms President US program.I understand that the said video recording(s) may not be reproduced in whole or in part without the written permission of the Ms President US program. I agree that my staff, employees, affiliates, agents, subcontractors and/or assigns will not make any audio or video recording.Due to the non-partisan status of the Ms President US program, I agree not to use any segment(s) of the recording to promote my candidacy, positions, or political party, and I further agree to direct my employees, affiliates, agents, subcontractors and/or assigns not to use any segment(s) of the recording to promote my candidacy, positions, or political party.I hereby agree to abide by the above policy. I agree I do not agree (NOTE: we regret that those who select this option will not be able to participate in the program) Question Title * 2. Speaker Name Question Title * 3. Speaker Email Address Submit (Thank you!)