MUSEUMS IN SHORT 2017 – IV Edition
RELEASE NOTE FOR THE USE OF VIDEO
(Please, fill in the document digitally)
Me, undersigned…………………………………………………………………………………………………………………………………………….
Born in……………………………………………………………………………………..……….on.………………………………………………………
Telephone number…………………………………………………………………………………………………………………………………………
Email………………………………………………………………………………………………………………………………………………………………
On behalf of the museum……………………………………………………………………………………………………………………………….
Grant, without demanding anything, the release note to the organization of Museums in Short for the use, in accordance with law and in accordance with the purposes of the Regulation, of the video entitled:
……………………………………………………………………………………………………………………………………………………………………..
……………………………………………………………………………………………………………………………………………………………………..
and for the use of materials submitted, in particular for the following activities: storage, public showing, broadcast in tv programs linked to the initiative, publication on the website and social networks, re production without commercial purposes, use in various events for cultural purposes and promotion of Museums in Short.
Aware of the penalties stated in art. 46 of D.P.R 445/2000, in case of false statements, in accordance with art. 47 of the aforementioned D.P.R, under my responsibility:
- I declare that the museum owns the video rights;
- I declare to know every part of the Contest Regulations and accepts them unconditionally;
- I authorize the organizers of Museums in Short contest about the processing and storage of personal data, including sensitive data, in accordance with and by effect of Legislative Decree no. 196/2003, for the purposes set out in this application form.
Date Signature
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MUSEUMS IN SHORT 2017 – IV Edition
RELEASE NOTE FOR THE USE OF THE MUSIC IN THE VIDEO
(Please, fill in the document digitally)
Me, undersigned…………………………………………………………………………………………………………………………………………….
Born in……………………………………………………………………………………..……….on.………………………………………………………
Telephone number…………………………………………………………………………………………………………………………………………
Email………………………………………………………………………………………………………………………………………………………………
On behalf of the museum…………………………………………………………………………………………………………………………..
Grant, without demanding anything, the release note to the organization of Museums in Short for the use, in accordance with law and in accordance with the purposes of the Regulation, of the piece of music entitled:………………………………………………………………………………………………………………………………………………………… composed for the video entitled…………………………………………………………………………………………………………………….
in particular for the following activities: storage, public showing, broadcast in tv programs linked to the initiative, publication on the website and social networks, re production without commercial purposes, use in various events for cultural purposes and promotion of Museums in Short.
Aware of the penalties stated in art. 46 of D.P.R 445/2000, in case of false statements, in accordance with art. 47 of the aforementioned D.P.R, under my responsibility:
- I declare that the museum owns the music rights;
- I declare to know every part of the Contest Regulations and accepts them unconditionally;
- I authorize the organizers of Museums in Short contest about the processing and storage of personal data, including sensitive data, in accordance with and by effect of Legislative Decree no. 196/2003, for the purposes set out in this application form.
Date Signature
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MUSEUMS IN SHORT 2017 – IV Edition
TREATMENT OF PERSONAL DETAILS
(Please, fill in the document digitally)
In compliance with the Italian Legislative Decree no. 196 dated 30/06/2003, on behalf of the museum…………………………………………………………………………………………………………………………………………………………I hereby authorize the recipient of this document to use and process our personal details. Giving the email address I authorize the organization of Museums in Short to send us information related to Museums In Short contest and its initiatives.
I authorize, furthermore, the use of our images, eventually contained in photo shoots/audio/video made by staff in charge of Museums in Short. The images will be for realization, development, promotion and testimony of initiatives organized by Museums in Short in line with the institutional purposes specified in the Regulations and can be included and spread in newspapers, brochures, posters, TV broadcast, DVD, web or other media suitable for storing, in contexts related to the scope of activities in which Museums in Short operates. The use in contexts that affect personal dignity and decorum is forbidden.
Date Signature
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