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                                WCET  - TV
                     AIR TIME REQUEST FORM

( PERSON, GROUP, OR ORGANIZATION )
NAME________________________________________________________
ADDRESS_____________________________________________________ 
CITY________________________________STATE_______ZIP__________                                                                                                                                                                           HOME PHONE_(_____)________________
BUSINESS PHONE_(_____)______________________________________

PERSON TO CONTACT  OTHER THAN ABOVE MUST BE A RESIDENT

OF GRANDVILLE, JENISON, HUDSONVILLE  

PHONE_(____)________________________                                      
NAME___________________________________________________
ADDRESS_________________________________________________
CITY______________________________STATE______ZIP_________

PROGRAM TITLE:________________________________________________
LENGTH OR TIME:_______________________________________________
FORMAT: VHS_____S-VHS______DVD_______

STATEMENT OF COMPLIANCE
Applicant has read and is thoroughly familiar with the operating rules and procedures of WCET - TV Public
Access Television. Applicant is thoroughly familiar with the contents of the program material to be shown and
states that they will be consistent with the rules, listed below, governing the access channel.

1. Neither a lottery nor lottery information will be cablecast.

2. No advertising material designed to promote the sale of commercial products or services will be
cablecast.

3. All appropriate arrangements, clearances, and copyrights have been obtained as may be necessary
to transmit the program materials.

4. The program materials do not contain obscene material as determined in a court of competent
jurisdiction.

5. The program materials do not contain slanderous or libelous materials.

6. I assume full responsibility for the content of all my program material cablecast and will ensure that
such program material will not violate any right or any third party.

7. Any person who should knowingly make any open or indecent exposure of his or her person or of
the person of another shall be guilty of a misdemeanor, punishable by imprisonment in the county jail
or a fine as determined by the Cities of Grandville and Hudsonville and the Township of Georgetown.

INDEMNIFICATION
The Applicant agrees to defend, indemnify, and hold harmless the City of Grandville, City of Hudsonvillle,
Georgetown Township, the Public Cable T.V. Supervisory Board, the Adult
Community Education Consortium of Grandville, Hudsonville, and Jenison Public School, Comcast Cable
and Charter Communications, their officials, officers, employees, and agents from and against any and all
claims, demands, causes of action, liabilities, judgements, costs and expenses ( including attorney fees ) arising
out of the user's use of, and transmission of program materials on the access channel.

APPLICANT' SIGNATURE:_________________________________________
( IF SIGNING ON BEHALF OF AN ORGANIZATION, INDICATE CAPACITY )
DATE:______/______/_______

WCET -TV Hudsonville High School - 5035 32 Ave. Hudsonville, MI