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COMMON BALTIC
edition 2015

ENTRY FORM
Original title:
English title:
Film Category (Genre):
Country of orgin:
Year of production:
Language:
Subtitles (English):
Director:
name:
date of birth:
(dd/mm/yyyy)
contact address:
the nearest country capital airport:
phone number:
e-mail:
Please complete the rest of the film crew form if applicable, leave blank if not applicable.:
Producer:
name:
phone number:
e-mail:
Written by:
name:
phone number:
e-mail:
Director of photography:
name:
phone number:
e-mail:
Music by:
name:
phone number:
e-mail:
Submitter:
name:
phone number:
e-mail:
Will you need a travel visa to Poland:
Link to movie on-line (if available):
How did you hear of COMMON BALTIC:
I hereby confirm that I have read and agreed to the COMMON BALTIC terms and conditions (at http://culture.pl/en/article/common-baltic )
I hereby confirm that I am the sole owner of the copyright to the work submitted for the competition.
I hereby confirm that the work submitted for the competition does not violate privacy rights, publicity rights, copyrights, contract rights or any other rights of any person or entity.
I hereby confirm that I have the consent of people whose images were used in the work submitted for the competition and that I am entitled to use these images, publish it and present it in public.
I agree to pay for all the royalties, fees, and any other monies owed to any person or entity by reason of the use of any content embedded in the film, or violation of copyrights or any other rights.
Upon completing the registration form, an e-mail message confirming the registration will be sent to the e-mail account of the submitter. This e-mail will include a confirmation link, which needs to be clicked in order to confirm your registration. Once confirmed, the submitter will have the opportunity to upload the film for the contest.: