NYRP Community Garden Filming Request Form

Community Garden Media Permit Request
This is the form to request permission to use a New York Restoration Project community garden for commercial or non-commercial filming, photography, or recording. Completion of this form does not guarantee approval.
Requester Information
Individual/Group/Company Name:
Primary Contact Name:
Email:
example@example.com
Phone Number:
Format: (000) 000-0000.
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Type of Request (Check all that apply)

Other

Project Details
Footage Usage
How will the final footage be used/distributed? Select all that apply and describe.
Do you intend to use New York Restoration Project or the garden's logo, name, or mention the organization in the final product? If yes, prior written approval of all text and/or visuals is required.

Clean-up & Environmental Impact
The garden must be left in its original state. All trash must be removed from the site. Describe your plan for clean-up:
Will your project involve any elements that could potentially damage the soil, plants, or infrastructure?
Please describe these elements:

Community Garden Media Permit Request