Media Release Consent Form
'Life Outside the Box' 

I hereby agree and give my permission to participate as a guest on the 'Life Outside the Box'  multicast (hereinafter referred to as LOTB), and consent to the digital publication of the subsequent recording on the KBI Inspire Magazine website.  Additionally, I understand that the episode of LOTB in which I participate will be distributed and promoted on other digital media platforms, including but not limited to: YouTube, Spotify, Apple Podcasts; and on social media: Instagram, Facebook and Twitter. 

I am 18 years old or above.
I am under 18 years old but have the consent of a parent or guardian to participate as a guest on the 'Life Outside the Box' podcast.

I have read this Media Release Consent Form and fully understand the contents and meaning of this release.

Signature of Participant: ____________________________________
 

Parent/Guardian: __________________________________________

 

Date: ____________________________                                                                                          

Thanks for submitting!