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EMERGENCY ALERT
SERVER SHUTDOWN Sunday, September 24th from 8:00 a.m. to 2:00 p.m.
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Request for Taping and Broadcast
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This form has been modified since it was saved. Please review all fields before submitting.
Requests must be submitted four weeks prior to the event for consideration. Please be detailed in describing your event and the benefits to the community.
Contact Name
Phone Number
Email
Name of Event
Date and Time of Event
Date and Time of Event
Date and Time of Event
Location of Event
Length of Event
Start Time
Start Time
End Time
End Time
Number of Individuals Speaking or Performing
i.e. Number of microphones required for speakers at podium.
Name and number of contact person at event location if different from Contact Name above
Name
Phone Number
Describe your event purpose, number of people participating, etc.
Please be detailed in the answers you provide. Incomplete forms are not considered.
Describe any benefits to the community if your event is aired on Riverside TV.
If the public address system is supplied by organization - Please let us know whether the PA system you will be using has the capacity for audio output jacks to be accessed by Riverside TV for audio feeds to our cameras.
If you have any questions regarding this form, please direct them to the Village of Riverside at 708-447-2700.
Electronic Signature Agreement
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
I agree.
Electronic Signature
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