This 3 sentence summary provides the essential information from the discharge document: The document authorizes the use of video recordings of an individual's image and speech from specified dates relating to a video production, allowing for publication, distribution and broadcast on television, the internet, cinemas and other current and future media. The individual agrees not to hold the video author liable for any moral or material damages caused by third parties or uses not outlined. The document is signed and dated by the individual in a specified city.

1. DISCHARGE DOCUMENT
Video recordingsfrom the day...... / ...... / ...... to...... / ...... / ........ relating to the Video
production titled:
…………………………….…………....................................................................
Following theagreement,
I
hereby………………………………………………….…….........................................
......
Born in ……………………………. And resident at …………………….......……...
street ……………………………………………..…………....................................
phone………………..……………....
AUTHORIZE
The author ofthe Video………………………..……................... (name and surname)
touse thevideo recording of my imageandmy speech, even ifnecessary
byreductionsoradjustments;
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 material
damage causedby third partiesor derived fromuses notprovided in the
followingDisclaimer.
city …………...…………………… day ………/………/…….…
Signature………………………………………………….