Moderator Information Form


In consideration of the opportunity to appear on an audio/videotape depicting various aspects of the presentations and activities of the 2024 USA/Canada Lions Leadership Forum, the undersigned hereby waives any and all rights and interests in said audio/videotapes, relinquishing said rights to the 2024 USA/Canada Lions Leadership Forum, including, but not limited to, the right to receive any and all proceeds derived from the sale of said tapes for educational and promotional purposes.
Clear Signature
IMPORTANT NOTICE: Typing your name in the box above will constitute your electronic signature.

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