APPLICATION FORM

CREATION

- M2 -

No...... Date: ...... / ...... / ......

The undersigned,

Composer:

Name e surname (nickname): ...... Sex: (M/F) ......

Phone: ...... e-mail: ......

Lyricist:

Name e surname (nickname): ...... Sex: (M/F) ......

Phone: ...... e-mail: ...... Interpreter:

Name and surname (nickname) ...... Sex: (M/F) ......

Country: ...... Nationality ...... City: ...... Region / Province: ...... Street: ...... SSN ...... Identity card / passport ...... Series...... No...... Date of birth: ...... Sign ...... Profession: ...... Phone: ...... e-mail: ...... fax ......

The legal representative: Name surname ...... as ...... SSN ...... Identity card / passport ...... Seria ...... No...... Phone: ...... e-mail: ...... fax ......

ask to be enrolled in the age category of ...... with the song ...... at the International Festival - Competition for Children and Youth "Euro Pop Music Vision - Romania 2017" which will be held between November 24th – 25th, 2017, in Bucharest, Romania.

We agree that for a period of a year, from November 26, 2017, the song, will be transmitted by the television station that the "Festival - Contest of Pop Music for Children and Youth, Euro Pop Music Vision – Romania 2017” has signed a contract for the transmission of the event, and the artistic performance, sound and video recordings, are retransmitted or used for the festival promo, for promotional purposes in newspapers, radio, TV, Internet (online transmission event), printing, duplication, distribution and marketing of CDs and DVDs with the participants and winners of this event.

We agree with the assignment in favor of the Romanian - Italian Cultural Association "Veronica Arts" of rights derived from the artistic performances and audio video recordings from all events of the festival.

I composer, pledge myself, to solve the problem of the relationship with the author of the text covering all the rights arising from the competition and will inform him of the contents of this agreement that I sign.

I read "Rules of Organization and Development" and "Regulation Policy" of the International Festival – Contest of Pop Music for Children and Youth "Euro Pop Music Vision - Romania 2017" and fully agree with the conditions indicated and I undertake to respect them.

Also, I declare on my own responsibility that the information provided in this form is true and accurate.

Date ...... / ...... / ...... Signature composer ......

Signature interpreter ......

Signature legal representative ......

The Romanian - Italian Cultural Association Veronica Arts

Romania, Bucharest, sector 2, Lanternei Street, Number 138 A, Room C2 Phone +4.0214.119.320 / +4 0736.494.578

www.veronica-arts.webgarden.com e-mail: www.euromusicvision.ro e-mail: