2012 SPEAKERS’ AGREEMENT
EVENT INFORMATION:
Event Name:
Topic:
Session Title:
Session Day/Date:
Room Set-Up:
Session Format:
Session Time:
Crescent Rounds
Single Speaker
Classroom Style
Theatre Style
Multiple Presenters
Panel Discussion for
Event Location/Address:
Hotel Location/Address (If different than the Event Location):
NA
KEYNOTE/PRIMARY SPEAKER INFORMATION:
Name:
Title:
Company:
Email:
Mobile Phone (Required for Event Day):
Work Phone Number (if applicable):
Mailing Address:
SECOND SPEAKER/PANELIST INFORMATION (if applicable):
Name:
Title:
Company:
Email:
Mobile Phone (Required for Event Day):
Work Phone Number (if applicable):
Mailing Address:
NSHMBA National Office, 450 E. John Carpenter Freeway, Ste. 200, Irving, TX 75062
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THIRD SPEAKER/PANELIST INFORMATION (if applicable):
Name:
Title:
Company:
Email:
Mobile Phone (Required for Event Day):
Other Phone Number (if applicable):
Mailing Address:
SERVICES:
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Speaker agrees to make a presentation on the topic set forth above for the Event. Speaker acknowledges that the
presentation is educational in nature, rather than promotional. The Sessions are not intended to sell products
and services. Speaker agrees to limit presentation to educational/informational content and use brand examples
only for non-promotional “best practice” illustration and to highlight case studies specific to the program’s
content area.
MATERIALS:
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Speaker agrees to provide NSHMBA the following in accordance with the timeline given for all speakers on your
team:
Item
Specifications
Date Due
Session Description and Key Learning Objectives
100-150 words max.
Completed
Short Presenter Bio
100-150 words max.
Completed
High Resolution Portrait
300 dpi.
Completed
Materials to be used as Hand-Outs
MARKETING RELEASE WAIVER:
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Speaker grants NSHMBA the right to: (i) use the Speaker’s name, likeness, portrait, picture, voice, biographical
material and appearance during the Event and to advertise and publicize the Event; and (ii) use and distribute any
written materials prepared by Speaker for use in or with the Sessions.
Speaker gives NSHMBA permission to photograph, videotape, and capture image and likeness in the Speaker’s
Session, and to publish such photographs, videotapes, and/or video streaming for marketing and/or informational
purposes. Speaker waives the right to inspect and/or approve the photographs, and/or videotape.
NSHMBA National Office, 450 E. John Carpenter Freeway, Ste. 200, Irving, TX 75062
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AUDIO/VISUAL REQUESTS:
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
The Speaker is responsible for bringing his/her own laptop computer for the presentation.

The Speaker is encouraged to save his/her presentation as well as any DVDs/videos on his/her laptop
computer as well as have a back-up option. There will be no internet access unless The Speaker specifically
requests and pays for it.

The Speaker is responsible for providing an adaptor for connection to the LCD Projector when using a Mac
computer.

Microphones:

NSHMBA will provide at least 1 standing microphone in the audience for Q&A opportunities.

NSHMBA will provide 1 tabletop microphone for every 2 people for panel discussions.

NSHMBA will provide a podium with wired microphone.

Please inform NSHBMA representatives of any special ADA or other needs for speakers or panelists where
appropriate.

Specific needs for room set-up and A/V equipment must be requested in writing to NSHMBA at least 45
days before the Event by completing the checklist below. NSHMBA agrees to use commercially reasonable
efforts to accommodate requests submitted after this Agreement is completed.

Should the Speaker request audio-visual or room set-up changes after the execution of this Agreement, the
Speaker will be billed for any additional costs.
Will You Require:
Yes
Item:
No
LCD Projector and Screen
Wireless Remote/Slide Advancer
Audio Feed for DVDs/Videos Played via Speaker’s Laptop Computer
Flip Chart with Paper and Markers for You and/or for Participants/Small Group
Discussions. Please denote how many flip charts you require: _______
Podium with Microphone
Lavaliere Wireless Microphone. If yes, how many: _______
Internet Connectivity (Cost to be incurred by the Speaker)
Water on Head Table(s)
Should you require additional A/V or room set needs not listed above, please list
here. Costs will be determined and incurred by the Speaker.
NSHMBA National Office, 450 E. John Carpenter Freeway, Ste. 200, Irving, TX 75062
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NSHMBA National Office, 450 E. John Carpenter Freeway, Ste. 200, Irving, TX 75062
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PAYMENT & TRAVEL POLICIES:
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
Payment: NSHMBA will reimburse the Speaker for travel expenses per the policies listed below.

Airfare: Speakers are asked to make their own flight arrangements. NSHMBA will reimburse the Speaker for
coach class airfare to and from the Event. Flights costing over $450 must first be approved by the Content
Development Senior Manager before booking. Please arrive at least one day prior to speaking engagement.
Speakers must submit an email with their flight arrangements and payment address to the Content
Development Senior Manager to receive reimbursement. Flight reimbursements may occur prior to the
event.

Lodging: NSHMBA will reserve a single room for 1 night (May 17) at the Event's host hotel for the Speaker.
The room rate and tax will be billed directly to NSHMBA while all other incidentals will be charged directly to
Speaker.


Speaker will Check-In on:
Provide Date (MM-DD-YEAR)

Speaker will Check-Out on:
Provide Date (MM-DD-YEAR)
Post-Event Reimbursable Expenses: Speakers may submit an invoice to the Content Development Senior
Manager with their name, payment address, and an itemized list of expenses and receipts for the following
after the event:
 Airport Parking: NSHMBA will reimburse $10 per day for airport parking. Speakers must submit a receipt
showing the day and time that they entered and exited the parking area for reimbursement.
 Meals: NSHMBA will only reimburse for meals that are not included in the event. The reimbursement
maximum per day is $50. Meals are only reimbursed if the following information is submitted:

Itemized receipt showing what was purchased and the cost (not the credit card receipt that shows
the total paid).

Payment receipt showing proof of payment.

The first and last names of all who attended the meal that is being reimbursed (if applicable).

Reason for the expense.

Please be aware that NSHMBA will not reimburse for alcoholic beverages.

Tips: NSHMBA will reimburse for gratuity of up to 20% of the total charges (excluding alcohol). Tips
will also be reimbursed for taxi drivers or hotel staff when you denote how much was paid, to whom,
and for what purpose.

Taxi/Ground Transportation: Ground transportation is reimbursable to/from the airport and hotel.
You must provide a receipt that shows the starting and ending location and the cost (including the
tip).

Mileage: Mileage is reimbursable when using private automobiles for necessary business travel in
excess of 10 miles round-trip. Mileage will be reimbursed at the current IRS rate for business travel.
To receive mileage reimbursement, you must submit the mileage from the starting location to the end
destination via a mapping program such as mapquest, google maps, etc.
NSHMBA National Office, 450 E. John Carpenter Freeway, Ste. 200, Irving, TX 75062
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NO CONFLICT OF INTEREST:
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By his/her execution hereof, the Speaker represents that: (i) he/she is not a party to any existing agreement nor
will Speaker enter into any agreement while this Agreement is in effect which would conflict with this Agreement
or prevent the Speaker from providing the services described herein in accordance with the terms hereof; and (ii)
the Speaker’s execution of this Agreement and the consummation of the transactions contemplated herein does
not conflict with any applicable law, guidance, or Code of Ethics or policy of any public, private or governmental
institution with which Speaker is affiliated.
CANCELLATION/TERMINATION:
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In the event that the Speaker will no longer be able to participant in the Event, written notice of cancellation must
be provided at least 60 days in advance. If the Speaker fails to provide at least 60 days prior written notice of
cancellation, the Speaker shall reimburse NSHMBA for all expenses incurred and fees paid by NSHMBA hereunder.
NSHMBA may terminate this Agreement at any time either with or without cause, in which case, NSHMBA shall
reimburse the Speaker for reasonable travel expenses incurred by the Speaker and for which the Speaker provides
supporting documentation.
INDEPENDENT CONTRACTOR:
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In the performance of this Agreement, the Speaker shall at all times be acting as an independent contractor, and
not as an employee or agent of NSHMBA. The Speaker shall not have any claim under this Agreement or
otherwise against NSHMBA for workers' compensation, unemployment compensation, any insurance coverage or
employee benefits, or payment of any federal, state or local taxes, all of which shall be the sole responsibility of
the Speaker.
CONFIDENTIALITY:
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The Speaker shall treat as confidential all business and proprietary information of NSHMBA acquired or developed
in connection with the services provided by the Speaker hereunder, or becoming known to the Speaker as a result
of entering into this Agreement, including without limitation, information relating to NSHMBA’s marketing, sales,
research and development activities and the terms of this Agreement (“Confidential Information”). The Speaker
shall not use or duplicate any material containing Confidential Information, except as approved by NSHMBA. The
Speaker shall return all materials that NSHMBA provides under this Agreement upon request or upon termination
or expiration of this Agreement. The term “Confidential Information” shall not include (i) any information the
Speaker has or knows prior to entering into this Agreement; (ii) any information the Speaker lawfully obtains or
derives from a third party not subject to an obligation of confidentiality; or (iii) information that has been
disclosed to or is available to the public other than through the act of the Speaker.
SEVERABILITY:
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If any portion of this Agreement is found to be invalid for any reason by a court of competent jurisdiction, that
finding shall not invalidate any other terms of this Agreement, and those terms shall remain in full force and effect
as set forth according to the surviving terms of this Agreement.
NSHMBA National Office, 450 E. John Carpenter Freeway, Ste. 200, Irving, TX 75062
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WAIVER:
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Waiver by either party or the failure by either party to claim a breach of any provision of this Agreement shall not
be deemed to constitute a waiver or estoppel with respect to any subsequent breach of any provision hereof.
ASSIGNMENT:
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The Speaker may not assign this Agreement. NSHMBA may assign this Agreement to its affiliates or successors.
Any purported assignment made in violation of this paragraph shall be null, void, and without legal effect.
GOVERNING LAW:
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This Agreement shall be governed by the laws of the State of Texas, without reference to its choice of law
principles.
NOTICES:
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All notices required hereunder shall be deemed given when sent by scan via email, registered or certified mail,
postage prepaid, return receipt requested, nationally recognized overnight delivery service or facsimile, to the
address and fax numbers set forth on the first page of this Agreement.
COUNTERPARTS:
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This Agreement may be executed in counterparts, each of which shall be deemed to be an original, and all of such
counterparts shall together constitute one and the same Agreement.
ENTIRE AGREEMENT/AMMENDMENTS:
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This Agreement supersedes any previous understandings or agreements, whether written or oral, between the
parties regarding the subject matter hereof. This Agreement may be amended only by a written document signed
by both parties. No terms of any subsequent purchase order or invoice will add to, modify, or supersede the
terms of this Agreement.
Speaker or Sponsor’s Signature
Date
Kimberly A. Rovansek, Sr. Manager, Content Development
Date
NSHMBA National Office, 450 E. John Carpenter Freeway, Ste. 200, Irving, TX 75062
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