Conversation Spotlight

Name *

First Name

Last Name

Video Release *

By checking below, you are authorizing Supportive Guide LLC to use any video recording for future video content use. You are also confirming you have the ability to authorize your release of any recording. You must be 18 years or older to participate.

I authorize Supportive Guide to use recordings of myself in Conversation Spotlight for future content use.

Compensation *

By checking below, you understand that at this time there will be no compensation offered for Conversation Spotlight guest.

I understand there will be no compensation for my participation.