Registration - Participant Entry Form Before registration, please read carefully Bylaw and GDPR information clause. All fields required PERSONAL DATA First Name Surname Date of birth CONTACT INFORMATION E-mail Phone numer including country code Street Postal code City Country Are you an implant user? YesNo QUESTIONNAIRE Implantation date Implanted ear rightleftright and left Implant type cochlearmiddle earbone conductionbrainstem Implant manufacturer Implant model COMPETITION INFORMATION Type of the performance vocalinstrumentalvocal-instrumental Original title of the composition that you will perform Name and surname of the original performing artist; if the performing artist is unknown write "unknown performer" Name and surname of the composer; if the composer is unknown write "unknown composer" Write us some sentences about yourself – what do you do in life (work, school, hobbies), how did you lose your hearing, how did you feel about it? What does the music mean to you? Describe your musical passion – when and why you became interested in music, which instrument(s) you like to play, what songs you like to sing, and your favorite music genre. What do you consider your greatest musical success? (maximum 500 words) (required field - max 1000 characters): Video attach Video must include a good quality recording of your performance, good enough to be shown during the Final Concert, and a short introduction spoken by the participant to the camera: name, surname, country, type of a hearing implant, instrument, title of the performed piece. You may send two separate files for performance and introduction. Introduction: (File names should include only alphanumeric signs; max. 25MB; accepted file formats: mp3, wma, wmv, mp4, avi.) Your performance: (the file name should comprise only alphanumeric characters; max. 25MB - file format: mp3, wma, wmv, mp4, avi, mov) Portrait photo of the participant (minimum 1MB - maximum 5MB, file types: jpg, png) agree personal data I agree on my personal data presented in the registration form to be processed by the Institute of Physiology and Pathology of Hearing based in Warsaw 02-042, ul. Mochnackiego 10, pursuant to the rules set out in the Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data, and repealing Directive 95/46/EC (General Data Protection Regulation). agree bylaw Upon registration I declare that I have read and fully accept the bylaw of the Festival. agree publication of my image Upon registration I confirm that I agree on the publication of my image and the composition performed by me for marketing purposes of the Organizers and Partners of the Organizers in compliance with the Festival Bylaw. I have read the GDPR Upon registration, I declare that I have read the GDPR information clause and fully accept it. Minors must provide signed Parental (Legal Guardian) Consent to enter Festival competition – required form is available for download here.
