Speaker Agreement DATC Tour Speaker Agreement Form Name(Required) First Last Email(Required) Enter Email Confirm Email Organization/Ministry/Church(Required)Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Mobile Phone(Required)I am available to speak at DATC Ohio Tour Stop a live, in-person conference, to be held at Cuyahoga Valley Church in Cleveland, OH, September 11-12, 2025.(Required) Yes No I understand that I am responsible for my travel and lodging expenses. I will receive ONE complimentary conference registration which will include lunch on Friday. I will also receive an invitation to be Key Ministry's guest at the Speaker Dinner on Thursday evening, September 11.(Required) Yes No Key Ministry and Cuyahoga Valley Church have the right to record, stream, film and photograph my presentation at DATC Ohio Tour Stop (the “Presentation”) and to distribute, broadcast, edit, translate or otherwise disseminate it, without any further approval from me, in whole or in part, throughout the world, in perpetuity, in any and all media now known or hereafter developed. This includes, but is not limited to, the right to use the Presentation either alone or together with supporting information, such as my name, voice, photograph, likeness and biographical data (collectively, “Supporting Information”).(Required) Yes No Your WebsiteSocial Media AccountsSpeaker Bio(Required)My HeadshotMax. file size: 256 MB. I give permission for Key Ministry to use the photo, bio and program description above for communications and marketing materials promoting DATC Ohio Tour Stop.(Required) Yes No I agree to utilize the speaker graphics package that will be emailed to me to promote the conference on my social media platforms.(Required) Yes No I will attend the Speaker Dinner (Thursday, September 11).(Required) Yes No I will be bringing one complimentary guest with me to the Speakers Dinner.(Required) Yes No Do you have any dietary restrictions?(Required) Yes No Please describe your dietary restrictions.(Required) Key Ministry Statement of Faith Click here to view: http://keyministry.org/statement-of-faith After reviewing Key Ministry’s Statement of Faith, I affirm my agreement and support of its doctrinal positions.(Required) Yes No
