Music Video Outdoor Venue Authorization
Date:
To (Venue Owner/Representative):
Venue Address:
Production Company/Band Name:
Contact Person:
Contact Email/Phone:
Music Video Title:
Requested Filming Date(s) & Time(s):
Expected Number of Cast/Crew:
I, the undersigned, authorize the above applicant to use the outdoor area of the venue specified for the purpose of filming a music video, subject to the following terms and conditions:
Conditions/Restrictions (if any):
Authorized Signature:
Name:
Date: