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Nominating A Participant

Participant Information

Name

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Last

Email

Phone

Tell us why you would like to be featured in a Participant Spotlight.

What would you like people to know about you?

(Optional) Is there anything specific you would like us to highlight?

Nominating a Participant

Name

First

Last

Email

Phone

Your relationship to the Participant.

Participant Name

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Last

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Please note: We may need additional permission before moving forward with a spotlight.

Why do you think this Participant should be featured?

(Optional) What makes their story special?

(Optional) Is there anything specific we should know before reaching out?

How would you prefer to be contacted?

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Generally, what time of day works best for you?

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Testimonial Agreement

I understand my testimonial as outlined above (the "Testimonial") and made on behalf of Lori Knapp Choice™ (the "Company") may be used in connection with publicizing and promoting the Company. I authorize the Company to use my name, brief biographical information, and the Testimonial as defined on this form.

I hereby irrevocably authorize the Company to copy, exhibit, publish or distribute the Testimonial for purposes of publicizing the Company’s services or for any other lawful purpose. These statements may be used in printed publications, multimedia presentations, on websites or in any other distribution media. I agree that I will make no monetary or other claim against the Company for the use of the statement.

In addition, I waive any right to inspect or approve the finished product, including written copy, wherein my testimonial appears.

I hereby hold harmless and release the Company from all claims, demands and causes of action which I, my heirs, representatives, executors, administrators or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.

Testimonial Consent

I HAVE READ AND UNDERSTAND THE ABOVE TESTIMONIAL AGREEMENT. I AFFIRM THAT I AM AT LEAST 18 YEARS OF AGE.

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Who is completing this form?

Participant Information

Nominating a Participant