VIDEO BOOT CAMP Concho, Oklahoma

GUIDELINES

1. Enrollment will be limited to nine (9) enrolled members of the Cheyenne &

Arapaho Tribes of Oklahoma

2. This camp will be limited to students age fifteen or older who can provide their own transportation to CATV 47 studios

3. Interested students will submit an essay (1 or 2 paragraphs) on the

Importance of Native Americans in News Media and Television. 4. All applications will need to include the following to be considered

complete: Application form, Medical and Media Release form, and Student Essay

5. All completed applications will need to be turned into the CATV 47 office

by Friday June 5, 2015.

6. Participants are expected to conduct themselves in a professional manner throughout the camp.

Meals will be provided. Transportation will be

provided ONLY for the OKC field trip.

CHEYENNE AND ARAPAHO TELEVISION

VIDEO BOOT CAMP

CHEYENNE

CATV 47 Video Boot Camp Application June 15-19 2015

Last Name ________________________ First _____________________ MI _______

Tribal Affiliation ____________________________ CDIB # _____________________

Parent/Guardians Name ___________________________________________________

Mailing Address _________________________________________ ZIP ____________

Contact Number ( ) ________________ E-mail _____________________________

School ____________________Grade Next Year _____ DOB:___________ Age: _____

Emergency Contact _______________________ Number ( ) __________________

T-Shirt (Adult Sizes) S M L XL XXL

Parents Informed Consent/Release Form

This is to verify that I/we, as the parents/guardians of ____________________________ have received and read the CATV 47 VIDEO BOOT CAMP Guidelines, and further agree to encourage my son/daughter to conduct themselves accordingly while attending the Camp. I also understand that I/we will be responsible for transportation to attend the camp. I hereby release CATV 47 and its employees, Griffin Communications LLC., and the Cheyenne & Arapaho Tribes of Oklahoma, of any responsibilities for accidents or injuries that may occur while attending the CATV 47 VIDEO BOOT CAMP __________________________________________ ___________________________ Parent/Guardian Signature Date

Participants Informed Consent/Release Form

This is to verify that I, ____________________________, have read the CATV 47 BOOT CAMP Guidelines, and I agree to conduct myself accordingly while attending the camp. __________________________________________ ___________________________ Applicants Signature Date

CATV 47 VIDEO BOOT CAMP

JUNE 15-19 2015

Medical Release This is to verify that I/we, as the parents/guardians of ____________________________, hereby authorize the directors of the CATV 47 VIDEO BOOT CAMP to act for me according to their best judgment in any emergency requiring medical attention. I also hereby authorize the CATV 47 BOOT CAMP staff to seek proper medical attention for my child if they get hurt while attending the CATV 47 BOOT CAMP.

Insurance Information

Company ________________________

Group Name ______________________

Policy # _________________________

Company ________________________

Group Name ______________________

Policy # _________________________

MEDIA DEPARTMENT/ TELEVISION STATION K47MU-D CONCHO OK

TALENT RELEASE FORM

AUTHORIZATION TO USE PHOTGRAPHS AND/OR AUDIO VISUAL RECORDINGS I, ___________________________________ , hereby authorize The Cheyenne and Arapaho Tribes Television Station CATV47 K47MU-D to use, reproduce, publish or broadcast or re-broadcast or distribute over the internet, Social Media, cable television, satellite or cell phone service any and all photographs, videos or any other audio/visual recording images and audio, including my image, likeness and/or voice without compensation. I understand that this material may be used in various publications, broadcast outlets or internet websites, Social Media, public affairs release, recruitment materials, broadcast public service advertising (PSAs) , Television programming, documentary purposes, educational purposes, entertainment purposes or for other related endeavors. This material may also appear on the television station or project sponsors internet Web Page. This authorization is continuous and may only be withdrawn by my specific rescission of this authorization. Consequently, the Cheyenne and Arapaho Tribes Television Station CATV47 K47MU-D or project sponsor deems appropriate in order to promote /publicize service opportunities. Description of Material: ( Photos/ Audio-Visual or Video Recording) Printed Name Signature Printed Name and Signature of Legal Guardian if under 18 Years of age ____________________________________________________________________________Location Date Provide Copy of Date of Birth for Legal Reasons (Photo ID Card, Valid Drivers License, Birth Certificate, etc)