I, the undersigned, of legal age, hereby grant, irrevocably and perpetually to Alexia Vernon Empowerment, LLC and its subsidiaries, affiliates, successors and assigns:

My consent and absolute, unrestricted right and permission to publish, exhibit, and distribute my image, visual likeness, photograph, workshop, and biographical information, in whole or in part, in conjunction with Moxie Camp via mass and/or electronic media, including but not limited to podcast, video, newsletter, or replay of the virtual event. Any use of my material beyond Moxie Camp requires my written consent.

I hereby release and agree to indemnify and hold harmless Alexia Vernon Empowerment, LLC and its subsidiaries, affiliates, successors, assigns, officers, directors, agents, owners, employees, thereof, from any and all claims, actions, causes of action, damages, expenses, court costs, attorney fees, liability damage or judgment brought forth as a result of my participation in the Moxie Camp event.

I hereby acknowledge that I have not been paid or otherwise compensated, nor will I be compensated, for my participation in Moxie Camp and that I shall retain all copyright rights to my intellectual property.

I further certify that all material provided in my Speaker Application is true and correct to the best of my knowledge. And, if selected to speak, all material I will share, whether verbal, written, or exhibited, will belong to me, represent my individual opinions and beliefs, and be true and correct to the best of my knowledge.

Finally, if selected to speak at Moxie Camp, I willingly agree that I will send a minimum of one dedicated email to my full newsletter list and that I will post about the event a minimum of two times on the social networks as I’ve outlined in my Speaker Application.