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Discharge document 7Questions

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Discharge document 7Questions

  1. 1. DISCHARGE DOCUMENTVideo recordingsfrom the day...... / ...... / ...... to...... / ...... / ........ relating to the Videoproduction titled:…………………………….…………....................................................................Following theagreement,Ihereby………………………………………………….……...............................................Born in ……………………………. And resident at …………………….......……...street ……………………………………………..…………....................................phone………………..……………....AUTHORIZEThe author ofthe Video………………………..……................... (name and surname)touse thevideo recording of my imageandmy speech, even ifnecessarybyreductionsoradjustments;I authorizethe publication, distribution andbroadcastonpublic and private television,internetand in cinemasandin every otherpossible andnew media with film, tape,anddigital mediaand not, present andfuture.IN NOEVENTI cantake it out on the author to claim damagesfor moraland materialdamage causedby third partiesor derived fromuses notprovided in thefollowingDisclaimer. city …………...…………………… day ………/………/…….…Signature………………………………………………….

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