CBN Testimony Consent Form

To ensure that our producers have adequate details, please fill out the following information using the checkboxes and open text fields.

Please document your testimony below.*

(Include as much detail as possible. If the testimony is health-related, please include details such as diagnosis, prescription, and treatment.)

The testimony, as stated above, may be included in the following media formats, and subject to the conditions stated below:

On-Air: On The 700 Club program, and any other television program produced by CBN or any of its affiliates

Print: In any correspondence, brochures or other materials published by CBN or any of its affiliates for purposes of partner relations, fundraising, or any other reason

Digital Media: On the websites of CBN and any of its affiliates, and/or on Facebook, Instagram, and any other social media outlet with which CBN or any of its affiliates has an account.

I consent to have a CBN producer contact me to arrange a session to take a video of my testimony for possible use on-air to encourage others who connect with the ministry. (Please Note: This selection is optional.)

Conditions:
(1) I hereby give THE CHRISTIAN BROADCASTING NETWORK, INC. (“CBN”) and any of its affiliates the right to share my above-stated testimony via print, broadcast, and digitally. (All of these are now called the “material.”)

I give CBN:
· The right to use the material in the above media formats without restrictions
· The right to own the material and use it around the world forever
· The right to edit and distribute the material through television or other forms of video distribution or by any other method
· The right to make copies of the material
· The right to copyright the material or grant that right to anyone else

(2) I confirm that the above-mentioned material is accurate, and will not violate the rights of another person or organization, and I release CBN from all liability related to the material.

Please Note: There is no guarantee that the testimony will be used for a story or read on air.

If you agree with the above statements and conditions, kindly select the checkboxes below and press send.