Annual Member Registration Form New

This signed agreement is required to be completed by all members. Permission of Acton TV staff is required for various levels of studio use and borrowing privileges.

Annual Membership Costs are: $45.00 For Acton/Boxborough Residents,  $95.00 for all Non-Residents,  $175 for Businesses (up to 5 individuals included) and $150 for Non-Profit Organizations (up to 5 individuals included). You may pay through PayPal after submitting the form below or send a personal check.

All users of the facilities of Acton Community Access Television, Inc., are required to sign the membership agreement below each year. The procedure for filling out the form is as follows:

• Read the agreement on the form below. The full Policies and Procedures are available as a PDF document.
• Enter your street address.
• Enter your town, state, and zipcode.
• Choose your Acton residential status
• Enter your telephone number.
• Enter your own email address.
• If you are under 18, enter the email address of a parent or guardian who will sign for you on the Organization line.
• A confirmation link will automatically be sent to your own email address.

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1. I understand that the following material is forbidden for presentation on the Public, Educational, and Governmental Access Channels:

2. I will be thoroughly familiar with the nature of all program material that I submit for cablecast and take full responsibility for its content

3. I understand that the material I record will be used for programming on the Public, Educational, or Governmental Access Channels.

4. I agree to obtain, in writing, all necessary clearances and permissions from any and all organizations, individuals, and groups as may be needed

5. I agree to reimburse Acton TV for any cost to repair or replace equipment which I damage or return damaged, except for normal wear and tear.

6. I understand I am responsible and agree to indemnify and hold harmless the Town of Acton, the cable provider(s), Acton TV, its directors and

First Name

Last Name

Email

Organization

Street

Town

State

Zip

Phone

Membership Resident of Acton/Boxborough - $45.00 Annual MembershipNon-Resident of Acton/Boxborough - $95.00 Annual MembershipBusinesses - $175.00 Annual MembershipNon-Profit Businesses - $150.00 Annual Membership

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