Keynote Speaker Contract 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 Yes Please tell us a little more about your guests (names, etc) so we may be prepared to help host them as wellLunch OptionsLunch Option (Speaker)(Required)Turkey and CheddarHam and SwissRoast Beef and Pepper JackHummus Feta Veggie WrapBring Your OwnLunch Option (Guest)(Required)Turkey and CheddarHam and SwissRoast Beef and Pepper JackHummus Feta Veggie WrapBring Your OwnSpeaker 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 MSBA event date and location as specified in the compensation addendum previously provided to the speaker. 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 that was previously sent to the speaker as a compensation addendum 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. I agree to the event date, location and compensation terms that have been previously emailed to me as a compensation addendum to this contract, no changes may be made without agreement by both parties(Required) Yes By signing below I agree to the above terms and conditions required to speak at the Missouri State Beekeepers Association event(Required)Recording 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 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 programmingUpload Bio and Photograph (multiple files allowed) Drop files here or Select files Max. file size: 20 MB. Additional InformationAdditional Requests or Comments?NameThis field is for validation purposes and should be left unchanged. Δ