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PHOTO, VIDEO AND SOUND RECORDING RELEASE FORM ____________________________________________________

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P H O T O , V I D E O A N D S O U N D R E C O R D I N G R E L E A S E F O R M

____________________________________________________

By signing this document,

I allow EASIT partners

• Dyslexiförbundet,

• Radiotelevizija Slovenija Javni Zavod Ljubljana,

• SDI München,

• Stiftung Universität Hildesheim,

• Universidade de Vigo,

• Università degli Studi di Trieste,

• Universitat Autònoma de Barcelona,

• Zavod RISA

to record photo, video and sound recordings of me. This is completely voluntary and up to me.

I am aware that my photo, video and sound recordings may be used as part of the EASIT educational materials.

I am aware that these materials will be made available with a Creative Commons licence CC-BY-SA on Universitat Autònoma de Barcelona’s open access repository DDD (ddd.uab.cat).

They may also be made available and used:

• on EASIT Youtube playlist,

• on EASIT’s website,

• on other educational activities organised by project partners.

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I transfer the exploitation, reproduction, public communication and distribution rights that I may hold over these recordings, in whole or in part, to the EASIT partners, on a non-exclusive basis, with

disseminating, training, educational, institutional or scientific

purposes, for all countries, during all the period intellectual property rights apply.

I allow EASIT partners to use my name, affiliation, and any other personal data, events or other material in or in connection with any such uses of the photographs, video and sound recordings, under the Spanish personal data protection legislation.

I am aware of the EASIT data policy as expressed on the EASIT website: http://pagines.uab.cat/easit/en/content/contact

Signature:

Printed name:

Date:

If relevant:

Mr/Ms ___________________,

with ID/passport number _____________,

acting on behalf of _____________________________, with ID/passport number _____________,

by virtue of his/her status of legal guardian by judgement of the Court ________________ of (include date) ___________________.

Signature:

Date:

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