I hereby apply for membership in CAI Keystone Chapter’s Speaker’s Bureau. By my signature below I acknowledge that membership in the speaker’s bureau is contingent upon my membership remaining current with the chapter. I further acknowledge that if my membership should lapse, any scheduled speaking engagement will be revoked by the chapter.

I warrant and represent that, to the best of my knowledge, nothing in my presentation(s) violates any proprietary rights of others (including, without limitation, any copyrights or privacy rights); and that my presentation(s) is factually accurate, and contains nothing libelous or otherwise unlawful. I further warrant and represent that my presentation(s) is (are) an original work, that I have the right and authority to make this Release and that I am the sole owner of copyright or that I have obtained all necessary permissions or licenses from any persons or organizations whose materials are included or used in my presentation(s). Iunderstand that I will not receive any royalty or other compensation from CAI for my speaking services. I understand that this Release does not prohibit me from using my presentation(s) in the future in my professional or personal work. I authorize CAI to use my name, likeness, photograph, and biographical data in connection with the use and promotion of the educational program(s) or event(s) and my presentation(s).