DISCLAIMER FOR
AUDIO/VIDEO REGISTRATIONS AND AUDIO/VIDEO PUBBLICATIONS
The undersigned _____________________________________________________________
Home address: _______________________________________________________________
City: ________________________ Nationality: _______________________ Age: ________
(Requires the consent of both parents for minors)
Father (name) ________________________ (surname) _____________________________
Mother (name) ________________________ (surname) _____________________________
AUTHORIZE
l’ACCADEMIA DELLA MUSICA “F. GEMINIANI” to make photos and audio-video registrations for
informative public use, without commercial exploitation of the images, but only for informative
purposes about the activity of ACCADEMIA MUSICA “F. GEMINIANI”
The visual reproduction, will be exclusive property of ACCADEMIA DELLA MUSICA “F.
GEMINIANI”, which will prohibit a misuse and a use in contexts that undermine the dignity of
the individual.
It also authorized the publication pursuant to Article 675 Privacy Policy.
(Place and date)______________________, _ _ / _ _ / _ _ _ _
Signature (legible)
______________________
(in case of minor need the signatures of both parents)
Father
________________________________ (legible signature)
Mother ________________________________ (legible signature)
Attach copy of identification
Scuola: P.za Ricasoli, 29 – Altopascio (LU) - Sede legale: via romana, 215 - Montecarlo (LU)
tel. 0583 269173 - cell. (+39) 348 77.38.666 - e-mail: [email protected]
www.accademiadellamusicafg.it - Cod. fis. e P.iva 01884950468