CFF PRESENTS PLAYBACK REQUEST FORM

Send NTSC DVD

Must be a 4’ by 3’ or letterboxed (Plus a signed copy of this release)

Send to - CFF Presents

C/O:

Pacifica Community Television

580 Crespi Drive Unit E.

Pacifica, CA, 94044

(650) 355-8001

Producer Agreement and Indemnification

I,______as producer / distributor of the following video program:

Title:______Tracking #______TRT:______

accept full responsibility for program content for cablecast on “CFF Presents”, Pacifica Community Television Channel 26 and any other affiliates. I hereby agree to indemnify and hold harmless the California Film Foundation, Pacifica Community Television (PCT 26), its officers, directors, employees, and agents from liability or legal fees and expenses incurred as a result of cablecasting, web-casting or otherwise distributing this program. I warrant and represent that the program does not contain:

1.  Any solicitation of funds or advertising of material designed to promote the sale of commercial products or services, including advertising by and on behalf of candidates for public office;

2.  Any material that is obscene, indecent, or an invasion of privacy;

3.  Any material concerning lottery information, gift enterprise, or similar scheme;

4.  Any requiring union residual, or other payment including but not limited to talent and crew;

5.  Any material that is slanderous, libelous or made unlawful by a law instituted governmental body;

6.  Any material that is copyrighted or subject to ownership or royalty rights without necessary releases, licenses or other permission.

I agree, if necessary, to provide CFF Presents and/or Pacifica Community Television (PCT 26) with copies of any releases, licenses or other permissions as set forth in Paragraph Number 6 above, obtained by me with respect to the program. I understand that I will receive no payment for this broadcast and that the above parties may use this content in a NON-EXCLUSIVE capacity indefinitely.

Further, I agree to release CFF Presents, Pacifica Community Television (PCT 26) and its employees from financial obligation or responsibility if this program(s) is damaged , lost or stolen while in their custody.

Producer: ______

Company: ______WEBSITE:______

Address: ______

Phone: ______EMAIL:______

Sign:______Date:______