Training Membership Enrollment & Agreement
This membership is for video production training only.  All classes are $100 each.  For Hillsborough County residents, classes are free.

Asking you for all this info probably looks like we’re nosey.  That’s not the goal.  We’re trying to find out as much as we can about our members so that we don’t miss any opportunity to apply for funding, speak at an organization’s meeting, increase viewership and expand our member, supporter and vendor bases. Thanks for filling out the form completely.  Your Training Membership expires a year after date of this signed agreement. 
Email *
Tampa Bay Community Network
Last Name *
First Name *
Middle Name or Initial
Residence Address (street address, city, state, zip) *
Mailing Address (If different from above)
Main Telephone Number *
Secondary Telephone Number
Instagram/Facebook/Twitter and Other Social Networking Websites
Emergency Contact
Are you employed: *
Would you like to be referred to Career Source Tampa Bay for career opportunities? *
Employer Name & Address
Your Occupation or Title
Does Your Employer Provide Matching Grants or Other Contributions to Non-Profit Agencies?
Organizan/Association Memberships [List groups that you are a member of]
Your Date of Birth
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Your Gender
Name and Location of High School Attended
Name and Location of College(s) Attended
Highest Education Level
Ethnicity
Skills/Talents [let us know if you have any special talents that could be helpful to TBCN]
Languages You Are Fluent In
Current Military Status
Branch of Service
Clear selection
Have You Been Involved With Other Public Access Television Stations Before?
Volunteering [check all the ways you’d like to help TBCN]
How Did You Hear About TBCN?
Are You a Cable Subscriber?
If So, Who is Your Cable Provider?
How Often Do You Watch TBCN Programming?
I hereby agree to indemnify and hold harmless The City of Tampa, Hillsborough County, all cable operators that transmit my programming, Speak Up Tampa Bay Public Access Television, Inc. (d/b/a TBCN) and its officers, directors, employees and other agents from liability, damages, and/or expenses, including legal fees, arising out of this Agreement and/or any other aspect of my relationship with TBCN.   I agree that I will not commence arbitration or bring suit against TBCN and/or its officers, directors, employees and other agents, until I have submitted the claim, dispute or complaint for resolution pursuant to the Complaint/Grievance Procedures and Appeal processes set forth in the TBCN P&P and such procedures and processes have been finally and completely concluded.  In the event a grievance, complaint, dispute or controversy between you and TBCN is not finally resolved through the Complaint/Grievance Procedures and Appeal processes set forth in the TBCN P&P, any remaining controversy arising out of, or in connection with any aspect of your relationship with TBCN shall be resolved by binding arbitration in accordance with the then prevailing Commercial Arbitration Rules of the American Arbitration Association.  It is understood and agreed that the arbitrator(s) have no power to vary or modify any of the terms of this agreement and their jurisdiction is limited accordingly.  Judgment on the award may be entered in any court having jurisdiction.  In any dispute, mediation, arbitration, litigation and/or appeal, including without limitation interpretation or enforcement of this agreement and any claim of intentional tort, breach of duty or contract or violation of my rights by TBCN, that arises from any aspect of my relationship with TBCN, the prevailing party or parties shall recover its/their costs, including reasonable attorneys’ fees, from the other party or parties.   *
Required
P&P RECEIPT/ACKNOWLEDGEMENT - TBCN’s Policies & Procedures Manual is provided to you for your information and immediate reference. It is your responsibility to read it carefully and completely. Policies included are subject to change from time to time and it is your responsibility to assure that you are following the most up-to-date P&P revisions.  I have received a copy of TBCN’s current Policies & procedures Manual.  I have read or had it read to me.  I recognize that it is my responsibility to review, be familiar with and abide by all the policies, procedures, practices, standards and rules contained in this P&P Manual.  I agree to obtain releases and other permissions including, but not limited to full copyright authorization.  I also understand that all required model/talent releases and copyright authorizations must be obtained by me and provided to the TBCN Programming Department prior to production of any and all programming. As a Producer or sponsor of taped or live programming, I accept full responsibility for program content submitted for transmission on Tampa Bay Community Network (TBCN) or other retransmission methods. I agree to release TBCN and its employees from responsibility if any program is damaged, lost or stolen while in its/their custody. I will abide by the policies and procedures contained in the TBCN Public Access Policy and Procedure Guide (“P&P”), which are subject to change upon reasonable notice during the term of this agreement. I am responsible to obtain releases, licenses and other permissions including but not limited to full copyright authorization, with respect to the program[s].  From time to time, amendments to this manual may be implemented following appropriate notice. I understand that I am solely responsible for complying with future changes in all policies, practices, standards, and rules. *
Required
Electronic Signature Agreement.  By selecting the "I Accept" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. *
Required
E-Signature (Simply Type Your Legal Name Below - no special signature is required) *
Today's Date *
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A copy of your responses will be emailed to .
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