MEDIA PASS - ACCREDITATION FORM / FORMULARIO DE ACREDITACION

FIM International Six Days of Enduro
Viña del Mar (Chile). 12-17 November 2018


Please complete all mandatory fields (denoted by *) and submit before 2nd November 2018 / Favor de llenar todos los campos obligatorios y enviarlo antes el 2 de noviembre.
Contact - Sarah Kinrade, FIM ISDE Press Officer. (This email address is being protected from spambots. You need JavaScript enabled to view it.) / Alexis Vasquez, Local Press Officer | + 56 9 6661 4156 (This email address is being protected from spambots. You need JavaScript enabled to view it.).

IMPORTANT: The holder of an FIM Media Pass must be in possession of a valid general third party liability insurance covering him or her throughout the event / IMPORTANTE: El titular del FIM MEDIA PASS debe tener un seguro de responsabilidad civil valido durante el evento.
COMPANY DETAILS / DETALLES DE LA EMPRESA
Media Name / Nombre del medio (*)
Please type the company name.

Address / Dirección(*)
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Address line 2 / Dirección linea 2
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City / Cuidad(*)
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State / Provincia (*)
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Postal / Zip code(*)
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Country / País(*)
Please tell us the country the company is in.

Phone Number / Numero de teléfono (*)
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E-mail(*)
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Website / Pagina web
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Digital Platforms / Plataforme digital
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Chief Editor Name / Nombre del editor jefe (*)
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Chief Editor Email / E-mail del editor jefe(*)
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Type / Tipo de medio(*)
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Content / Contenido (*)
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Coverage / Cobertura(*)
Please specify

Frequency / Frecuencia(*)
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Circulation - Visitors / Visitantes
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PERSONAL DETAILS / INFORMACIÓN PERSONAL
Name / Nombre(*)
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First name - Given name / Nombre(s)

(*)
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Surname - Family name / Apelido(s)

Mobile phone / Numero de cellular(*)
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Email(*)
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Job title / Profesión(*)
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1. Letter from chief editor / 1. Carta de su editor jefe
2. Examples (3) of previously published work clearly showing photo - text credit / 2. Ejemplos (3) de articulos publicados monstrando foto - creditos textos
Letter from chief editor / Carta de su editor jefe(*)
Please upload attachment

Example of work 1 / Ejemplo del trabajo 1 (*)
Please upload attachment

Example of work 2 / Ejemplo del trabajo 2(*)
Please upload attachment

Example of work 3 / Ejemplo del trabajo 3(*)
Please upload attachment

FOR YOUR INFORMATION / PARA SU INFORMACIÓN

Covering rights / Derechos de coberturas:
- Media accreditation is reserved for media members – print, photo, radio, online, news agency, radio, etc. – who want to cover the 2018 FIM ISDE without TV recording & broadcasting / La acreditación de medios está reservada para los miembros de los medios de comunicación, foto, radio, online, agencia de medios, radio etc - que deseen cubrir el FIM ISDE CHILE 2018 sin grabación y transmisión de televisión.
- Media accreditation is for still images for editorial use only. Any parties wishing to use moving images must apply using the TV Pass. Commercial use of any image type is not permitted without prior authorisation / La acreditación de medios es solo para imágenes con fines editoriales. Las partes que deseen utilizar imágenes en movimiento, deben realizar la solicitud con el pase de tv. El uso comercial de cualquier tipo de imagen no está permitido sin previa autorización.
- The MEDIA PASS holder agrees to comply with FIM conditions / El titular del PASS MEDIA acepta respectar y cumplir las condiciones de FIM.
- This accreditation form is personal. It must be completed and submitted before 2nd November 2018 / Esta acreditación es personal. Debe ser llenada y enviada antes el 2 de noviembre.
- We reserve the right to refuse any accreditation request / FIM se reserva el derecho de rechazar solicitud de acreditación.
- For details, contact Sarah Kinrade, FIM ISDE Press Officer (This email address is being protected from spambots. You need JavaScript enabled to view it.) or Alexis Vasquez, Local Press Officer | + 56 9 6661 4156 (This email address is being protected from spambots. You need JavaScript enabled to view it.) / Para detalles, Contactar a Sarah Kinrade, FIM ISDE Press Officer (This email address is being protected from spambots. You need JavaScript enabled to view it.) o Alexis Vasquez, Local Press Officer | + 56 9 6661 4156 (This email address is being protected from spambots. You need JavaScript enabled to view it.).

Video & TV rights / Video & TV Derechos:
- Anyone wishing to record video for TV or Social Media broadcasting please click here / Si quieres grabar para TV o RRSS favor haga click aquí
- For details, contact Aurélie Grob, FIM TV Coordinator: +41 22 950 95 10 | This email address is being protected from spambots. You need JavaScript enabled to view it. | / Para detalles, contactar a Aurélie Grob, FIM TV coordinador : +41 22 950 95 10 | This email address is being protected from spambots. You need JavaScript enabled to view it. |