Form Center

2. Producer Name
3. Membership ID #
4. Email Address
6. Program Title
7. Program Subtitle
9. Type of Program
   -- Select One --StudioField RecordingPodcastLive Broadcast/StreamOther
10. Location
    -- Select One --MCTV / Midland CountyNon-Local / Outside Midland
11. Duration of Program

    Hours:Minutes:Seconds

12. Pre Paid Services

    1. YouTube
    2. Podcast

    Receipt of payment required.

14. Category
    -- Select One --ChildrenLifestyleMusicNewsSportsOther
15. Sub-Category
    -- Select One --Education/InformationalEntertainmentReligionAdviceArts/LiteratureFood/HobbiesHealth/FitnessAwardsPerformanceMagazinePoliticsPublic RelationsTalk ShowScience/TechnologyOther
17. Program Description

    Tell us about the program you created. This will be used to help others search for your program as well as inform the viewer of what to expect.

19. Content Disclosure (Check all that apply) MCTV RESERVES THE RIGHT TO REFUSE TO CABLECAST ANY PROGRAM IF FAILURE TO DISCLOSE THAT THE PROGRAM CONTAINS ANY OF THE FOLLOWING

    1. Adult Language

    1. Sexual Content

    1. Violence

    1. Nudity

    
    

    Adult Language: A program including: profanity, vulgarity, cursing, or Inappropriate for minor children will cablecast no earlier than 9pm and finish by 5:30am.

    Sexual Content: A program that includes actual, depicted or descriptions of sexual conduct or activity will cablecast no earlier than 11pm and finish by 5:30am.

    Violence: A program that includes actual or depicted acts of violence or physical abuse will cablecast no earlier than 9pm and finish by 5:30am.

    Nudity: A program that includes the showing of the human male or female genitals, pubic area or buttocks with less than a fully opaque covering, or the showing of the female breast with less than a fully opaque covering of any portion thereof below the top of the nipple, or the depiction of covered male genitals in the discernibly turgid state will be cablecast no earlier than 11pm and finish by 5:30am.

21. Acknowledgment

    I HEREBY ACKNOWLEDGE MY RESPONSIBILITY FOR THE TOTAL PROGRAM CONTENT OF THIS VIDEO SUBMITTED FOR CABLECAST, AND DO AGREE TO REIMBURSE MCTV FOR ANY COPYRIGHT LIABILITY WHICH MAY INCUR AS A RESULT OF THE CABLECASTING OF THE PROGRAM. I ACKNOWLEDGE THAT PROGRAM MATERIAL WHICH CONTAINS THE FOLLOWING CONTENT IS PROHIBITED AND MCTV RESERVES THE RIGHT TO NOT CABLECAST THE PROGRAM IF IT CONTAINS ANY OF THE FOLLOWING:

    * ANY MATERIAL THAT IS OBSCENE, INDECENT, OR AN INVASION OF PRIVACY 

    * ANY MATERIAL REQUIRING UNION RESIDUAL OR OTHER PAYMENT INCLUDING BUT NOT LIMITED TO: TALENT AND CREW UNLESS PAYMENTS HAVE BEEN EXECUTED OR WAIVED 

    * ANY MATERIAL CONCERNING LOTTERY INFORMATION, GIFT ENTERPRISE, OR SIMILAR SCHEME 

    * ADVERTISING 

    * ANY MATERIAL THAT IS SLANDEROUS OR LIBELOUS

23. Producer(s) Signature

    By typing your name, you agree to the terms and conditions put forth by the rules and regulations of the MCTV Network and the City of Midland.

24. Today's Date
    Today's Date
25. Phone Number
Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit Submit and Print

* indicates a required field