Access Humboldt Online Playback Request Form
Humboldt County residents can submit programs to be played on Access Humboldt TV channels and on our online Community Media Archive. It is your responsibility to make sure that your program does not violate our policy on commercial content. By completing and signing this form, you assume full responsibility for the program content pursuant to all applicable laws and statutes, and affirm that your program complies with AH programming policies.

No Commercial Content
Commercial content is prohibited on AH’s community access TV channels. AH defines commercial content as information that is designed for the purpose of personal financial gain. Businesses or individuals may donate a specific product, service, or funding to assist an access program in return for non-commercial acknowledgment on that program.

Provide Notice of Adult Content
Programs that contain sexually explicit content, nudity, offensive language, or excessively violent material are considered adult programming. If your program contains adult content it can only be played during "safe harbor" hours from 11 p.m. to 5 a.m. Failure to answer the relevant questions on this form honestly and/or failure to have the required warning on your program may jeopardize your program and your status at our facility.

Priority for New Content
Please be aware that our policies give playback priority to new programming. Programs that played previously on the station are replayed only at management discretion.

Email address *
Name *
Your answer
Address *
Your answer
Group or Organization (if any)
Your answer
Phone Number *
Your answer
Program Information *
Program Title *
Your answer
Episode Number (If Series)
Your answer
Episode Title (If Series)
Your answer
Total Running Time *
List running time in Hours:Minutes:Seconds -- 00:00:00
Your answer
Have you previously submitted this program? (If so, when?) *
Your answer
Content Category *
One Sentence Description of Program *
Your answer
Does Program Contain Adult Content? *
Please check all that apply. Programs that contain adult content will be aired during "safe harbor" hours between 11 p.m. and 5 a.m.
Required
Desired Date/Time to Air Program
Your answer
Expiration Date
If this program is time sensitive, please specify the last date that it should be shown.
Your answer
Post Program to Archive.org? *
Please note that only locally produced programs will be posted.
Is Program Licensed at CreativeCommons.org? *
If you have not licensed your program, please see below for informational video and link to simple Creative Commons licensing tool
Captionless Image
What Is Creative Commons?
Choose Your Creative Commons License: https://creativecommons.org/share-your-work/
Paste your selected license URL below
Your answer
Is Duplication Allowed? *
Can we burn a DVD of your program if someone requests a copy?
Acknowledging Responsibility *
By digitally signing this form, you acknowledge the following terms of use: The information submitted on this form is accurate. No obscene, libelous, defamatory or otherwise illegal material is to be transmitted.The program does not include a lottery, game of chance or other wagering information. The program is not commercial in content and doesn't sell services or solicit business for a for-profit entity. You have all appropriate clearances from copyright holders, music licensing organizations, sponsors, and/or representatives, and have authority to transmit this program on cable television and online over the internet (we may request proof of such clearance or authority if a complaint is made). You indemnify Access Humboldt, its agents and employees, from any liability arising out of your use of our channels or online webcasting services. Such liability may include, but is not limited to, copyright infringement, presentation of libelous, defamatory or obscene material, violation of any local, state, county or federal laws and regulations. The submitter saves and holds harmless Access Humboldt and all their agents and employees for any and all damages or claims arising as a result of the use of these channels or online transmission services. Access Humboldt channel programming schedules are subject to change without notice at the discretion of the station. Access Humboldt has the authority to replay your program at its discretion, unless and until we receive written notice to the contrary, and is authorized to make copies of your program for promotional or other purposes. Access Humboldt is not responsible for original tapes, DVDs, or other storage media left in our possession. Programs that violate our policies will be pulled from playback.
Digital Signature *
Type your full legal name as a digital signature to complete this form. Submissions without a valid signature WILL NOT be aired.
Your answer
Program Submission *
For online submissions, paste a link to your video in the space below. (Videos can be shared from YouTube, Dropbox or other file sharing services.) If you plan to submit a program by mail, send a DVD or USB drive via postal service to Access Humboldt, P.O. Box 157, Eureka, CA 95502, and type "Submitted by Mail" in the box below.
Your answer
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
Submit
Never submit passwords through Google Forms.
This form was created inside of Accesshumboldt.net. Report Abuse - Terms of Service - Additional Terms