Interview &
media release.
Please read the terms below and complete the secure signature form. Your submission will be recorded securely on RoxieBeckles.com, and a notification will be sent to Roxie Beckles.
Questions? You may ask questions before signing. Recording will begin only after you have signed and also confirmed consent aloud at the session.
Who is agreeing: This agreement is between you, the undersigned participant, and Roxie Beckles, professionally known as That Black Catholic Chick (“Producer”). It applies to your participation in the online interview described here.
Recording the interview
The interview is a one-on-one online video conversation expected to last about 60 minutes. By signing, you consent to the intentional recording of the interview in audio and video, including your name, image, voice, likeness, statements, and any biographical details you choose to share. The recording may begin only after you sign this release and affirm your consent aloud at the session. If you do not consent, the interview will not be recorded.
Please do not share private or confidential information you do not want included in the recording.
Permission to use the interview
You grant Roxie Beckles and That Black Catholic Chick a non-exclusive, worldwide, ongoing, royalty-free permission to record, reproduce, edit, excerpt, publish, publicly display, distribute, and promote your interview and your name, image, voice, likeness, and statements as part of the editorial project and related interview promotion. This includes:
- the complete interview on the members’ platform;
- selected interview moments in public documentary-style video essays and related editorial releases;
- short clips, trailers, and excerpts shared publicly; and
- reasonable promotional materials for these interview-related releases.
You retain ownership of your pre-existing work and may discuss or publish your own views and work. No ownership of your independent projects is transferred by this release.
Editing & editorial control
Roxie Beckles retains creative and editorial control over the interview, essay, clips, and related promotional materials, including the themes, framing, selection and arrangement of excerpts, narration, title, thumbnail, and final conclusions.
You will not receive a right to approve, review, or veto the finished interview, essay, clips, titles, thumbnails, or promotional materials before or after release. The finished work may include commentary, research, Church teaching, historical context, original footage, and perspectives beyond the interview. Excerpts may be shortened or rearranged for clarity and narrative flow. Producer will not knowingly edit your words to create a meaning you did not express. Participation does not mean you endorse the essay’s thesis or conclusion.
Compensation, scope & limits
Unless separately agreed in writing, you will receive no fee, royalty, or other compensation for participating or for the permissions granted here. You are not asked to endorse or guarantee the essay’s conclusions.
The material will not be used to create a synthetic voice, digital replica, or AI-generated depiction of you. This release covers only the interview, related excerpts, editorial releases, and reasonable promotion described above. A materially different use requires separate written permission. Once released, copies, embeds, or excerpts may be shared by third parties on platforms Producer does not control; Producer cannot guarantee removal of those third-party copies.
Electronic records & signature
You agree to conduct this transaction electronically and consent to receive and retain this agreement as an electronic record. By typing your name and submitting this form, you intend your typed name to be your electronic signature and to signify your agreement to these terms. Your typed initials acknowledge the specific provisions indicated. The completed record will include the text of this agreement, your signature and initials, and the submission date and time. You may download and retain a PDF copy after submission. Each party should retain a copy of the signed agreement.
This agreement is governed by California law, without regard to conflict-of-law rules. If any provision is held unenforceable, the remaining provisions continue to apply to the extent permitted by law.
Review and sign the release
Complete the secure form below. It asks for your contact details, initials, consent, typed electronic signature, and signature mark. When submitted, your release is saved by Ninja Forms on RoxieBeckles.com and a notification is sent to Roxie.
If the form does not appear here, open the Roxie Beckles release form directly.