Hasbro Conference Speaker Agreement Name(Required) First Last Conference or Event(Required) Presentation Title(Required) Presentation Date MM slash DD slash YYYY On behalf of Boston Children’s Hospital (BCH) and its Continuing Medical Education (CME) Department, we are pleased to engage you to provide and perform the Curriculum identified above as a Presenter as further described below. The terms of your engagement hereunder are as follows and by signing below you agree to the following: 1. I acknowledge that I have read the “Guidelines-Boston Children’s Hospital Online Continuing Medical Education (CME) Program” and the “Online Continuing Education (CE) Program Compensation Schedule for Online Courses used as Enduring Materials.” 2. I agree to present the Continuing Medical Education Curriculum on the date and time indicated herein. 3. 3. I approve that this presentation of the Curriculum will be recorded and available for external viewing by the public and hereby release the use of my name, image, likeness, still or motion picture and/or audio recording made therefrom for the purposes set forth herein. 4. The Curriculum is my own original material or material which complies with the “Guidelines-Boston Children’s Hospital Online Continuing Education (CE) Program”. 5. I agree that BCH shall own the recording of the Curriculum and shall have exclusive right to offer and/or provide the recording of the Curriculum for CE purposes. I agree not to provide or perform an unmodified version of the Curriculum, in-person and/or for a recording, for CE purposes. I agree that my only compensation for participating hereunder will be under one of the two options outlined in the Online Continuing Education (CE) Program Compensation Schedule for Online Courses used as Enduring Materials, and that I will not be entitled to, and hereby waive my right to, any other compensation or accounting of revenue received by Boston Children’s Hospital for the Curriculum, including my rights under the Intellectual Property Policy of Boston Children’s Hospital. 6. I agree to remove any unauthorized patient Protected Health Information and/or I will provide patient permission approval, as necessary. If you have questions about these provisions, please contact CMEdepartment@childrens.harvard.eduLearning ObjectivesRSS presenters are required to provide at least one objective for their presentations. Please enter your learning objective(s) in the spaces provided below.Learning Objective 1: This presentation will prepare learners to(Required)Click the plus sign to add more objectives. Add RemoveIs it okay to use your presentation as an enduring material in online CME course offerings? I grant permission to use my presentation in the online CME program. NameAdding your name here will act as a signature. First Last Date(Required) MM slash DD slash YYYY EmailThis field is for validation purposes and should be left unchanged.
