Invited Speaker/Faculty Participation Agreement Terms and Conditions of Engagement
Last name:
Credentials (MD, PhD, MPH, PA, RN, etc.):
Email:
Mobile Phone
Date of the activity:
I AGREE TO THE FOLLOWING STATEMENTS:
I am the presenting author completing this information:
I am the presenting author completing this information:
I hereby consent to participate as a faculty/invited speaker and/or moderator in the SOCS Scientific Symposium ("Program"). I agree to give the Presentation(s) I am submitting (“Presentation”).
I will prepare the Presentation in PowerPoint or a digital format as instructed.
I understand the SOCS intends to record the Presentation and upload to the Dermatology E-Learning and Equity Platform (DEEP). I hereby grant SOCS a non-exclusive, royalty-free license to record the Presentation, to prepare a transcript of the Presentation, and to reprint, excerpt, display, sell, prepare translations and/or derivative works of, or otherwise make use of the Presentation, in whole or in part, in any media, whether print, audio, video, or other forms now known or hereinafter developed. I understand and agree that SOCS will acknowledge my participation in the Program and my authorship of the Presentation, but I will receive no compensation and no other benefit with respect to the Presentation.
I hereby represent that, to the best of my knowledge: (a) The content of my Presentation is accurate; (b) The Presentation does not violate any copyright, proprietary rights, or personal rights of others; (c) The materials, including photographs and video, used in this Presentation do not identify, by name or otherwise, suggest the identity of, or present a recognizable likeness of any patient or others; or, if they do, I have obtained all necessary consents from patients and others for the further use, distribution, and publication of such materials; (d) The Presentation will be educational, will not promote any specific product or service, and will not contain any false or misleading statements regarding any products or services or include materials that are anticompetitive, slanderous, libelous, or otherwise illegal, offensive, or inappropriate; and (e) I am authorized to make these representations.
I hereby indemnify and hold harmless the SOCS, its officers, directors, members, employees, and agents from and against any and all claims, expenses (including reasonable attorneys’ fees), and liabilities whatsoever arising, directly or indirectly, from any breach of my representations herein, or my actions or inaction at, or participation in, the Program. I further waive any and all rights I may have against SOCS, its directors, officers, members, employees, and agents and release and discharge them from any claim relating to the Program or the manner in which it is conducted.
I HAVE READ THIS FACULTY PARTICIPATION AGREEMENT AND AGREE TO BE BOUND BY ITS TERMS.
Name:
Name:
Today's Date:
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