6to.FESTIVAL INTERNACIONAL DE VIDEOARTE DE CAMAGEY. DEL 31 DE MARZO AL 4 DE ABRIL, 2015

FORMULARIO DE REGISTRO REGISTRATION FORM / 2015

DATOS DEL AUTOR(A) / Authors personal information:

1. Nombre completo / Full name: ______________________________________________________ 2. Nmero de Pasaporte o carn de identidad / Passport: ______________________________ 3. Pas / Country: _________________ Nacionalidad / Nationality: __________________________ 4. Ciudad / City: _________________________Cdigo Postal / Zip Code: ____________________ 5. Direccin / Home Address: __________________________________________________________ 6. E-mail: _____________________________________ Telfono/ Phone Number:_______________

DATOS DE LA OBRA / Artwork Details:

1. Titulo Original / Original Title _________________________________________________________ 2. Direccin de descarga / Link: _______________________________________________________ 3. Ao de realizacin / Creation Year: _________________ 4. Color / Color: Blanco y negro / Black and white: 5. Sonido / Sound: Mono: Stereo: Silence: 6. Duracin (min.) / Film Length (minutes): ______________________ 7. Formato de proyeccin / Screening Format: Quicktime H264: MPG2 (DVD): 8. Texto sobre la obra / Statement: _______________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 9. Proyecciones previas de la obra, festivales, premios / Previous screenings of the work, festivals, awards: _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

ACUERDO / AGREEMENT: El Festival de Vdeo Arte de Camaguey (el Festival) es un evento no lucrativo, la subscripcin de su trabajo (la obra) para su posible inclusin en el Festival implica la conformidad con las bases del mismo, as como la cesin de los derechos de reproduccin y exhibicin de las obras en relacin a su proyeccin, o en cualquier actividad del Festival como: exposiciones, catlogos, vdeos, folletos y otras acciones promocionales slo y exclusivamente en relacin con el festival. El artista asume toda la responsabilidad ante terceros por cualquier reclamo sobre la autora u originalidad de la obra presentada. The Camaguey Video Art Festival (the Festival) is a non-profit event. By submitting your work (the Film) for possible inclusion in the Festival you agree with the conditions of entry. You also grant performance and reproduction rights to the Festival for all non-commercial activities related to the promotion of the Festival and screening of the Film in the Festival. Also, for use in exhibitions, videos, catalogs, educational programs, brochures, and outreach material related to the Festival. You are responsible for obtaining any legal advice related to this release and to issues related to the originality and legal use of the Film. Fecha / Date: _________ Firma legal / Legally binding signature: __________________________

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6to.FESTIVAL INTERNACIONAL DE VIDEO ARTE DE CAMAGEY. DEL 31 DE MARZO AL 4 DE ABRIL DE 2015

6TH INTERNATIONAL VIDEOART FESTIVAL OF CAMAGEY FROM MARCH 31ST TO APRIL 4TH, 2015

FORMULARIO DE INSCRIPCIN PARA EVENTO TERICO, FIVAC 2015 ENTRY FORM FOR THE THEORETICAL EVENT / FIVAC 2015 DATOS DEL AUTOR(A) / Authors personal information:

1. Nombre completo / Full name: ____________________________________________________________________

2. Nmero de Pasaporte o carn de identidad / Passport or ID: ____________________________________________

3. Pas / Country: ___________________ Nacionalidad / Nationality: ______________________________________

4. Ciudad / City: __________________________ Cdigo Postal / Zip Code: _________________________________

5. Direccin / Address: _______________________________________________________________________

6. E-mail: ______________________________________ Telfono/ Phone Number: ________________________

DATOS DE LA INTERVENCIN / ABOUT THE PRESENTATION:

1. Titulo / Title

2. Temtica en la que se inscribe/ Selected topic

3. Resumen de la intervencin (entre 400 y 500 palabras). (Adjunto) / Abstract (between 400 and 500 words).

(Attached to the Entry Form)

4. Necesidades tecnolgicas para la presentacin. (Adjunto) / Technological requirements for the presentation

(Attached to the Entry Form)

5. Sntesis curricular del autor.(Adjunto) / Authors CV (Attached to the Entry Form)

ACUERDO / AGREEMENT: El Festival Internacional de Vdeoarte de Camagey (FIVAC) es un evento no lucrativo. La inscripcin de su ponencia para su posible inclusin en el Festival implica la conformidad con las bases del mismo, as como la cesin de los derechos de reproduccin para acciones promocionales slo y exclusivamente relacionadas con FIVAC. El autor asume toda la responsabilidad ante terceros por cualquier reclamo sobre la autora u originalidad del texto presentado. The International Videoart Festival of Camaguey (FIVAC) is a non-profit event. By submitting your work (your presentation) for possible inclusion in the Festival you agree with the conditions of entry. You also grant reproduction rights to the Festival for all non-commercial activities related to the promotion of the Festival. You are responsible for obtaining any legal advice related to this release and to issues related to the originality and legal use of the work.

Fecha / Date: __________________ Firma legal / Legally binding signature: _________________________

PERSONAL PHOTO