Public Speakers Conference Attendee Form
We are so excited to see you at the next conference. We have a blast getting to meet everyone in person, learning from so many experts and making a real and permanent connection to those to collaborate with! Yippee... can't wait!
Company Name (can just be your name)
Address Line 2
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Bosnia and Herzegovina
British Indian Ocean Territory
Central African Republic
Democratic Republic of the Congo
Republic of the Congo
Papua New Guinea
Saint Kitts and Nevis
Saint Vincent and the Grenadines
Sao Tome and Principe
Trinidad and Tobago
United Arab Emirates
United States Minor Outlying Islands
Virgin Islands, British
Virgin Islands, U.S.
Email (this is the email address we will be sending ALL information to)
I will be attending the following event dates:
(Check dates attending)
Friday, June 30th VIP Pre-Conference Evening Event 7pm
Saturday, July 1st 8am-6pm
Sunday, July 2nd 8am-6pm
Monday, July 3rd 8am- 6pm
Would you be interested in doing something fun on Tuesday, 4th of July?
YES... Sign me up! I wouldn't miss it for the world!
$399 Early Jump in Price... Paid in Full (reg $797)
I accept the charges above and will have my credit/debit/check card charged by Public Speakers Association for the amount selected above. I have 3 days in order to receive a full refund but I may use my ticket next year if circumstances change and I can’t attend. Change information must be received no later than 2 weeks before the event. Golden Nugget in Palm Springs, CA has discounted hotel room rates and parking rates available and sold separately. Travel costs are not included. All details are on www.publicspeakersconference.com!
I also agree to the Public Speakers Conference June 30th- July 4th 2016 Standard Audio and Visual Release Agreement, Standard Terms and Other Conditions
The event, Public Speakers Conference will be recorded in parts, segments and through photography. The signing party (those who have signed the agreement to attend) for all participants in the Public Speakers Conference are hereby known as Participant/Customer, the Public Speakers Conference is known as Product/Program and Tonya Hofmann/Your Local City, Inc. is known as Company/Principals in this document.
I hereby grant you, Tonya Hofmann and Public Speakers Conference, ALL RIGHTS with my irrevocable explicit approval to use my likeness, voice, etc. as captured or edited, recorded and rendered in various audio, visual, and written medium associated with or recorded or captured at the Public Speakers Conference, to be used in commercial, instructional, and promotional activities as Tonya Hofmann, Public Speakers Association and Public Speakers Conference sees fit.
Tonya Hofmann, Public Speakers Association and Public Speakers Conference shall own 100% rights, title and interest in resulting product and shall have the rights to sell rights and transfer rights of the resulting product at their discretion (i.e. sales of Video and Audio of Public Speakers Conference).
Disclaimer and Standard Terms
To accept participation in the Public Speakers Conference , which is offered by Tonya Hofmann and Public Speakers Association , Participant expressly acknowledges and agrees that nothing in this document or any other written or oral communication relating to the Project, or any materials promulgated or distributed with respect thereto constitute a representation or guarantee. The project is performed by Company as an educational event for the Participant, and no representation or warranty of any kind regarding specific or general benefits, monetary or otherwise, was or has been made by the Program and/or its board, agents, and employees including, without limitation, Tonya Hofmann, Public Speakers Association and Public Speakers Conference and any of the other vendors who participant in realizing the project. Participant acknowledges that neither the Program nor the Company, in whole or in part, are responsible for Participant’s business success or failure, for Participant’s acts or omissions, or the appropriateness or Participant’s business decisions heretofore or hereafter.
Under every circumstance Participant’s only representation, guarantee, and recourse is a refund or purchase price under the conditions stated in the special report describing the event. All Participants may receive a full refund within 3 days of purchase or whatever “cooling off” period is in their state/province or country.
If Participant does not agree with terms and conditions of the Standard Audio and Visual Release and Standard Terms Participant does not have to participate in this offer and event.
Participant hereby releases the Program and the Principals from, and agrees and covenants that participant will not contact any governmental agency nor sue the Principals on account of any and all claims or causes of action in connection with the Program, and, in no event shall any Course, the Program or the Principals be liable for any punitive damages, incidental or consequential damages whatsoever.
Participant hereby agrees to and does indemnify the Program and its Principals and holds them, and each of them, harmless from and will defend them against any and all claims, judgments, liabilities, expenses and damages (including attorney’s fees and costs) arising out of or in connection with any breach by Participant of its obligations, agreements of covenants hereunder, and, any acts or omissions by the Participant, its agents, representatives and employees whatsoever. Any and all claims and actions arising out of the Program, this document, or otherwise, shall be exclusively arbitrated in United States of America, in the State of Texas, in accordance with the then prevailing Rules and Regulations of the American Arbitration Association, which proceedings shall be final and binding, and strictly confidential. Neither the existence of such proceedings or the results thereof shall be disclosed to any third party, unless expressly required by law.
PARTICIPANT REPRESENTS AND WARRANTS THAT PARTICIPANT IS FULLY COMPETENT TO CONTRACT IN HIS/HER OWN NAME, HAS CAREFULLY READ THIS STANDARD AUDIO AND VISUAL RELEASE AND STANDARD TERMS, FULLY UNDERSTANDS ITS CONTENTS AND HAS HAD AMPLE OPPORTUNITY TO CONSULT WITH PARTICIPANT’S OWN INDEPENDENT ATTORNEY OR OTHER ADVISOR BEFORE EXECUTING SAME.
Who referred you?
Do Not Fill This Out