Sports Media Interview Consent Form
Please complete this form to provide your consent for participation in a sports media interview.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Media Outlet/Organization Conducting Interview
*
Interview Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Consent Statement
*
By signing below, I confirm that I have read and understood the consent statement above and agree to participate in the sports media interview.
*
Submit Consent
Submit Consent
Should be Empty: