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    ROX VEGAS CLOUD — LOCATION PERMISSION FORM

    Videotaping / Photography Authorization

    This form grants permission to a Rox Vegas Cloud production team or client to videotape and/or photograph at the location listed below for the purposes of a video production project.

    Location Name / Business:
    Address:
    City, State, ZIP:
    Contact Person at Location:
    Contact Phone:
    I / We, the undersigned, authorize:
    Producer / Videographer Name:
    Company / Project Name:
    To conduct video and/or photography at the above location on:
    Date(s) of Shoot:
    Time(s):
    For the following purpose:
    Description of Project:
    Special Conditions or Restrictions:
    Authorized Representative Signature:
    Printed Name:
    Title / Role:
    Date:
    Producer / Videographer Signature:
    Date:

    If there are any questions regarding this production, please contact:

    Rox Vegas Cloud · (830) 402-4168 · roxvegascloud.com

    Rox Vegas Cloud · roxvegascloud.com · Adapted from Art Institute of Houston Production Forms, 1998