Application Form - Livorno Music Festival

Name (as written in your passport)

Surname

Birth date

Place of birth (place, city/town and country of birth)

Citizenship

Italian Fiscal Id. N. (if you have one)

Fiscal Residence Address (town/city, country, postal code, address)

Full Domicile (if different from fiscal residence)

Phone number

Message

IN CASE OF REGISTRATION AS AN ENSEMBLE FOR THE CHAMBER MUSIC MASTERCLASS, fill in an application form for each member, specifying in the section below the name of the belonging ensemble and Name, Surname, instrument of each member.

I will take part in the Associazione AML-Livorno Music Festival as a

Chosen Course

Curriculum vitae

Copy of an identity card or Passport, a parent document in the case of a minor

Receipt of the Registration fee

N.B. All files must be sent exclusively in pdf or jpg format. Application form without copy of the payment of the registration fee (€ 130,00) are not valid. By bank transfer or PayPal, indicate the name of the student in the purpose of the payment

How did you know about our courses?

I declare that I have read and accept the statute and the rules of the festival

The undersigned at the bottom identified as a subject involved in the processing of personal data pursuant to Article 3 of the EU Reg. 2016/679 DECLARES to have received from the Data Controller Associazione Amici della Musica di Livorno, con sede in Via Calzabigi, 74 – 57125 Livorno, the information ex artt 13-14 reg EU 2016/679, concerning the processing of personal data for the purposes indicated in the informative (available on the web site Livorno Music Festival, www.livornomusicfestival.com) note traditional methods of contact (eg of calls with operator, postage) and of automated methods (eg SMS, email, etc.).

The undersigned also authorizes:
-the publication and diffusion of his personal data, curriculum vitae and academic record;
-the diffusion of his personal image (also in case of use in posters, playbills, personal and performance press materials, photographs, audio/video recordings of the activities and performances produced by the Festival or with its participation - final concerts of the masterclass included - to be broadcasted live and/or deferred, also by Radio and/or Television and/or electronically).