Conference – General Speakers Contract Δ URLThis field is for validation purposes and should be left unchanged.Contact DetailsOfficial Name (for Advertising) Prefix Mr.Mrs.MissMs.Dr.Prof.Rev. First Middle Last Suffix Official Title (Director of XYZ, etc)Organizational Name (Company, University, Etc)Website Preferred Way to Be Introduced/Addressed (Dr. Smith, John, etc)Email(Required) Enter Email Confirm Email Phone(Required)Address(Required) Street Address City State / Province / Region ZIP / Postal Code I will be bringing an additional guest with me (approved guests are immediate family members or partners only, please have any other guests attending register through our event attendee registration) Yes Please tell us a little more about your guests (names, etc) so we may be prepared to help host them as wellLunch OptionsOur lunch will be served as a deli buffet consisting of House Made Chicken Salad, Sliced Deli Meats & Assorted Cheeses, Ciabatta Rolls, Wraps, Wheat Berry, & Croissants, House Fried Kettle Chips, Freshly Baked Cookies and Brownies with Coffee and Iced TeaLunch Option (Speaker)(Required)I will participate in the Deli Lunch BuffetBring Your Own (no lunch provided)Lunch Option (Guest)(Required)I will participate in the Deli Lunch BuffetBring Your Own (no lunch provided)Speaker Agreement & CompensationSpeaker AgreementThis Speaker Agreement ("Agreement") is made between Missouri State Beekeepers Association (the "Conference") and the above registered speaker (the "Speaker") for the Speaker's participation at the 2025 Missouri Bee Day June 21, 2025 in Springfield, Missouri. 1. Presentation 1.1 The Speaker agrees to present at the Conference on the agreed-upon topic and time as per the Conference schedule. 1.2 The Speaker's compensation shall be limited to the compensation listed below this agreement 2. Promotion and Materials. The Speaker grants permission for the Conference to use their name, image, biography, and presentation materials for promotional purposes. The Speaker shall provide presentation materials as needed. 3. Cancellation. In case of cancellation, the Speaker shall notify the Conference Organizer promptly. This Agreement represents the entire understanding between the parties. Any amendments must be made in writing and signed by both parties. Compensation (General)Speaker Honorarium: $75 Conference Registration for Speaker and 1 guest (immediate family member or partner only) I would like to donate my speaking honorarium ($75) back to MSBA (MSBA thank you for your generosity and willingness to help promote events like this in the future) Yes By signing below I agree to the above terms and conditions required to speak at the Missouri State Beekeepers Association event(Required)Your NameYour NameYour NameYour NameRecording ConsentRecording Consent (not required)I give MSBA the non-exclusive, royalty-free right to record, reproduce, and distribute my presentation in all forms of media now known or hereafter devised. This content may be used for promotional, educational, or any other purposes without further compensation to me.I agree to allow MSBA to record and store my presentation as outlined above(Required) Yes No Speaker Bio and PhotographPlease upload your bio/introduction and class description that you would like us to use for advertising and welcoming at the event. Also please upload a photo of yourself we may use for advertising and programming. If you have spoken for us in the past and want us to use your past photo and bio please mention in the comments below.Upload Bio and Photograph (multiple files allowed) Drop files here or Select files Max. file size: 20 MB. Additional InformationAdditional Requests or Comments?This field is hidden when viewing the formHotel ConfirmationMSBA Internal Use Only *** Hidden Backend Entries*** This field is hidden when viewing the formHotel Reserved Yes This field is hidden when viewing the formConfirmation NumberThis field is hidden when viewing the formArrival Date Month Day Year This field is hidden when viewing the formDeparture Date Month Day Year This field is hidden when viewing the formConfirmation of Presentation Topics and TimesMSBA Internal Use Only *** Hidden Backend Entries*** This field is hidden when viewing the formTopics Assigned Yes This field is hidden when viewing the formPresentation 1 TitleThis field is hidden when viewing the formPresentation 1 Start Time Hours : Minutes AM PM AM/PM This field is hidden when viewing the formPresentation 1 DurationThis field is hidden when viewing the formPresentation 2 TitleThis field is hidden when viewing the formPresentation 2 Start Time Hours : Minutes AM PM AM/PM This field is hidden when viewing the formPresentation 2 DurationThis field is hidden when viewing the formPresentation 3 TitleThis field is hidden when viewing the formPresentation 3 Start Time Hours : Minutes AM PM AM/PM This field is hidden when viewing the formPresentation 3 Duration
