


Produced by JCI Productions - Craig and Mauri Gandy
I hereby give my permission to the above listed program producer to use part or all of the above program(s) for cable casting on Channel Austin, Inc.'s public access channels, as well as other news and information agencies, world wide webcasting and exhibition media.
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PRINTED NAME OF INDIVIDUAL PARTICIPATING
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PRODUCTION DATE
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PRODUCTION LOCATION
I hereby release all organizations and individulas involved in the production of the program(s) as listed above from any privacy, defamation or other claims I may have arising out of the cablecast or promotions of the above listed program(s)
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Signature Date ________________________________________________________________________________________________
Address City State Zip
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Phone (Day) Phone (Evening)
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