Podcast Mastery Blueprint™

Cohort Registration & Media Release Form

Complete this form to finalize your enrollment and receive immediate access to the EmpowerCast™ community

First Name *

Last Name *

Professional Title / Brand Name

Email Address *

Phone *

Optional

Short Bio (2-3 sentences) *

Podcast Name

If chosen

Social Media Handles *

Upload Headshot (image) *

Click to upload your headshot

Professional headshot for your Welcome Flyer and community introduction

Upload Logo (optional)

Click to upload your logo

Your brand/company logo for promotional materials (JPG, PNG OR SVG). Max 5 MB

✅ Permission for Dr. Alisa Whyte & Team to create a Welcome Flyer and graphic for cohort announcements.

✅ Permission for use of name and image in Podcast Mastery Blueprint™ and ElevateCast™ Media promotions.

✅ Understanding that all public features require final approval from Dr. Alisa for brand alignment.

✅ Consent to share testimonial (written or video) post-launch.

Optional: “I’d like to be considered for feature on the ElevateCast channel on Apple Podcasts for additional visibility and pod-roll placement.

Signature *

Date *

30-DAY SPRINT | FROM ZERO TO LAUNCH

Questions? Email [email protected]