RANGEWAY VIDEO CONTEST
84 Chester Street,
Chester, NH 03036
603-887-2288 /
pegtalk@chesterpublicaccess .org
Registration
form:
Producer:_______________________________________________________________________
School Grade as of September 1,
2011: _____________________________________________
Address:_________________________________
City:__________________________________
State:________________ Zip
Code:___________________ Phone:________________________
Email:__________________________________________________________________________
Rules of the contest:
1. Video must be no longer than 15
minutes in length.
2. Video must be submitted as a finalized
DVD, able to be played on any DVD player or DVD Rom drive.
3. Video must be original content, and
within the rules of compliance attached to this registration form.
4. Deadline for video submission is
August 31, 2011. All videos must be
received by that date, and by mail to:
Rangeway Video Award
Public Access Community Television
84 Chester Street
Chester, NH 03036
5.
All entrants must be a resident of Chester.
6. Registration form and Statement of
Compliance must be signed by entrant and a parent or guardian if entrant is
under the age of 18 years.
Signature of
Entrant:_____________________________________________________________
Parent or Guardian: Print
Name____________________________________________________
Parent or Guardian: Signature______________________________________________________
Public Access
Community Television
Chester, NH
84 Chester Street
Chester, NH 03036
603-887-2288
Email
pegtalk@chesterpublicaccess .org
STATEMENT OF
COMPLIANCE
Producer:_______________________________________________________________________
Program:________________________________________________________________________
Address:_________________________________
City:__________________________________
State:________________ Zip
Code:___________________ Phone:________________________
Email:__________________________________________________________________________
1. I am familiar with the nature of this
program, and accept full responsibility for its content.
2. I understand that the following
material is prohibited:
a. advertising
of commercial products and/or services
b. obscene
and/or indecent material
c. material
which constitutes libel, slander, or invasion of privacy
d. use of
publicity rights, trademark or copyright which violates local, state, or
federal law
e. political
advertising
3. I have obtained all of the clearances
and releases (permissions) from any and all organizations,
individuals and groups that are needed to
legally record and cablecast this program on Public Access Community Television
(hereto know as PACT) in Chester, NH, which includes Channels 20, and 21.
4. In recognition of the fact that
neither PACT staff nor any employee of the Town of Chester, NH, the Chester
School District, or Comcast Communications are censoring the content of this
program, I agree to indemnify and hold harmless PACT, the Town of Chester, NH,
the Chester School District, and Comcast Communications from any and all
liability or other injury (including reasonable costs of the defending claims or
litigations) arising from or in connection with claims for failure to comply
with any applicable laws, rules, regulations, or other requirements of local,
state or federal authorities, for claims of libel, slander, invasion of
privacy, or infringement of common or statutory copyright; for unauthorized use
of trademark, trade name, or service mark; for breach of equity which claims
result from the producer’s use of PACT facilities.
3. I am aware that the PACT, equipment,
or facilities cannot be used for financial gain or other commercial purposes.
4. I understand that programming produced
with PACT equipment or facilities must be cablecast or used educationally in
the classroom.
5. The following information is agreed to at the
discretion of the producer. (Please
initial
response):
1. PACT may
cablecast this program as often as the staff deems appropriate.
Yes______ No______
2. Clips of raw footage may be kept for file footage.
Yes______ No______
3. This program may be share with other public access
television stations.
Yes______ No______
4. Please note any specific instructions or
restrictions:
I have read and agree to abide by the aforementioned
policies of PACT.
Signature:_________________________________________________
Date:_______________
If producer/sponsor is a minor, parent or guardian
must also sign:
Parent/guardian (print
name):_____________________________________________________
Parent/guardian
signature:_______________________________________________________
PACT Representative:_________________________________________________________