Competitions

Name *

First

Last

Email *

Cell Phone Number *

Alternative Contact Number *

Physical Address *

Gender

• Male
• Female

I authorize 1AFRICARADIOTV, and those acting pursuant to its authority, to (1) Record my participation and appearance on videotape, audiotape, film, photograph or any other medium; (2) Use my name, likeness, voice and/or biographical material in connection thereto; and (3) Exhibit or distribute such material in whole or in part without restrictions or limitation for any publicity or promotional purpose which 1AFRICARADIOTV, and those acting pursuant to its authority, deem appropriate. *

• Yes

Submit