Team Captain: The name of the original person who signed up. If you are the one who signed up the team, please put your name. *
Team Name: List potential team names that best describe your connection: (i.e., “The Brunch Bunch,” “The Talented Teachers,” “Bingo Buddies,” “Fantasy Football Friends,” etc.) *
First Name *
Last Name *
Nickname
Cell Phone Number *
Email *
City *
State *
Current Address *
Hometown (where you grew up)
How did you hear about the casting? *
What levels of education have you completed (please specify school and major): *
Who is your current employer and what is your occupation (How do you pay your bills now?) *
Please list your last three jobs: *
Do you have any military experience? Are you (active/reserve) military now? (Circle one) If so, please describe branch, rank, job, and dates of enlistment: *
What is your marital status: married, divorced, boyfriend/girlfriend, single, engaged? How long have you been in your current relationship? (if applicable) *
Do you have any children? If yes, how many and what are their ages? *
Please list any dates you are NOT available to film between October 1 – October 25, 2019: *
B) PERSONALITY AND INTERESTS: PLEASE ANSWER EACH QUESTION AS BEST AS YOU CAN. DO NOT LEAVE ANY QUESTION BLANK. YOU CAN WRITE N/A IF A QUESTION IS NOT APPLICABLE TO YOU.
Please list the full names (first and last) of your three teammates: *
Tell us three fun facts about your team members. Please be thoughtful and creative (e.g., how you know each other, relationship dynamics, funny stories, etc.). *
Describe your personality: *
What are your hobbies and interests? *
What is something we wouldn’t know by looking at you? Do you have any hidden talents? *
Have you and your teammates ever competed together as a team? If yes, please explain in detail. *
How long have you known your teammates? *
What is at least one thing everyone in your team has in common? *
Why does your group make such a good team? Please explain in detail. *
What would your team do with the money if you won the grand prize on this show? *
What role does each person play in your team? (i.e., the goofball, the competitive one, the responsible one, etc.) *
Do you know anyone else who would be good for the show? Please list their information below and include their name, phone number, email address and your relationship to them.
C) ADDITIONAL INFORMATION
Please list all game, competition or reality shows you have appeared on (in the last 10 years), the network or streaming service it appeared on, along with airdate(s) & prizes won. If none, write N/A. *
Have you ever had a restraining order issued against you or have you ever had a restraining order issued against someone else? If YES, please indicate city/state, month/year, and describe situation. If no, please write N/A. *
Are you involved in any pending litigation? If YES, please tell us about it (include dates, city, and state) explain. If no, please write N/A. *
Have you ever been convicted of a felony or a misdemeanor? If YES, please explain (include dates, city & state). (You should exclude convictions more than two years old for any marijuana offense, convictions for which the record has been judicially ordered sealed, expunged, or statutorily eradicated, and any misdemeanor conviction for which probation has been successfully completed or otherwise discharged and the case has been judicially dismissed). If no, write N/A. *
Please describe below any and all instances in your life in which you were ever detained for and/or accused of criminal wrongdoing, including, without limitation, any crime for reckless or drunk driving. If none, please write “None” in the space below. *
Please include a detailed description below of each such arrest, detention and/or accusation for which you have been involved, including, without limitation, the reason(s), the place(s), the date(s), the precise charge(s) and the resolution(s). If none, please write "None" in the space below. *
Have you ever formally or otherwise changed your name? If you have changed your name, what other names have you used? Please list all previous names, including stage names, pseudonyms, and AKAs. If this doesn’t apply, write N/A. *
Do you or any of your immediate family members or anyone living in your household know anyone who has been within the past two (2) years an officer, employee, agent or representative of: (a) Game Show Enterprises, LLC or its parent, subsidiary or affiliated companies, including, but not limited to, AT&T, Sony Pictures Television Inc., or GSN Games, Inc.; (b) Any other person or entity involved in the development, production, distribution or other exploitation of the Program or any variation thereof, including, without limitation, Silverpine Media, LLC, (c) Enteractive Solutions Group, Inc. and Sullivan Compliance Company; or (d) Caesars Entertainment, Bally’s Las Vegas Hotel & Casino, Paris Las Vegas Hotel & Casino, or Wyndham Grand Desert in Las Vegas, Nevada? If yes, please list their names, your connection to them, and the nature of their work for the applicable entity(ies). *
Are you a member of any social networking sites? (i.e., Facebook, Twitter, Instagram, MySpace, Pinterest, LinkedIn) ? If YES, please list them all, including your user name and/or URL. *
Have you ever been on any TV show or are you currently being considered for any TV shows? If YES, please name the show, the length of time you appeared on the show, the network or streaming services on which it appeared, status and when it aired. *
Have you ever posed/performed nude publicly, on TV, in a video, movie or on the Internet? If YES, include ANY instances including but not limited to: modeling, artistic endeavors, or adult entertainment paid or unpaid. *
Are you currently a member or have you ever been a member of SAG or AFTRA or any related entertainment unions? Please list all other media appearances you have made, including commercials, films, videos, webisodes, news, photographs, etc. *
In addition to any appearances listed above, please list all/any other shows you have applied for and how far you made it in the application process. *
D) APPLICANT RELEASES
I am making the following representations, warranties, indemnities, covenants, agreements and releases in this Contestant Application (“Application”) in consideration for Game Show Enterprises, LLC (“Producer”) to consider me as a potential contestant for a word-guessing television game show. I recognize that my signature on this Release is a condition of Producer permitting me to potentially appear on the Program. Accordingly, I acknowledge and agree as follows: ELIGIBILITY REQUIREMENTS AND ACKNOWLEDGMENTS: 1. On or before October 1, 2019, I will be at least 18 years of age. 2. I am not a candidate for public office and will not become one until at least one (1) year after the initial exhibition of the episodes of the Program in which I appear, if I am selected as a contestant for the Program. 3. I am a legal resident of the United States. 4. I acknowledge that any offer to become a contestant on the Program is contingent upon the completion of a background check satisfactory to Producer, in accordance with applicable laws. I voluntarily and knowingly authorize any person, firm, corporation, or government agency, its officers, employees and agents to release any and all information pertaining to me for purposes of such background check.
REPRESENTATIONS, WARRANTIES AND RELEASES: I hereby give the following representations, warranties, acknowledgements, consents and releases:
1. By signing below, I hereby represent, warrant, acknowledge, and agree that: (i) I have read and I meet and agree to be bound by the eligibility requirements set forth above; (ii) I have completed the Application honestly and accurately; (iii) if any of the information in the Application is found to be false or incomplete, this will be grounds for removal from the Program participant selection process, and/or from the Program, if selected; (iv) even if I meet the eligibility requirements, Producer has no obligation to further contact me, to interview me, and/or select me as a participant; (v) even if I am selected as a participant, Producer has no obligation to produce the Program, and the network on which the Program is intended to air (the “Network”) has no obligation to exhibit it, even if produced; (vi) I agree to keep strictly confidential all information about the Program that I may acquire during the participant selection process and/or during my participation in the Program (if applicable); (vii) all decisions by Producer concerning selection of the participants are final and not subject to challenge or appeal; and (viii) Producer has no obligation to return any materials submitted by me as part of the Application whether or not I am selected as a participant. 2. By submitting this Application, I hereby consent to the recording, use and reuse by Producer, Network and any of the “Released Parties” (as defined below) of my voice, actions, likeness, name, appearance, biographical material, and any information contained in, derived from or obtained in connection with my application to be a participant in the Program or in any materials submitted by me in connection with the Application (collectively my “Likeness”), as edited, altered, or modified by Producer or by any of the other Released Parties, in any and all media now known or hereafter devised, worldwide in perpetuity, in or in connection with the Program or any other work. I agree that the Released Parties may use all or any part of my Likeness, and may alter or modify it regardless of whether or not I am recognizable. I further agree that the Released Parties exclusively own all right, title, and interest (including, without limitation, all copyrights) in and to any and all recordings made by them and in and to any and all video that I have provided in connection with the Application (if any) and any other materials that I have provided or may provide in connection with the Application or the Program (collectively, the “Materials”), including, without limitation, the right to edit, alter or modify the Materials and to use all or part of the Materials and my Likeness in any and all media now known or hereafter devised worldwide, in perpetuity and to assign them, and to license others to use them, in any manner Producer may wish and in any and all media now known or hereafter discovered or developed. I further agree that Released Parties may use my Likeness and the Materials in connection with any promotion, publicity, marketing or advertisement. I grant the rights hereunder whether or not I am selected to participate in the Program in any manner whatsoever. I understand that I will not be paid any money for giving Released Parties these rights or for submitting this Application. 3. I further grant Producer and any person or entity designated by Producer the right to use and license my Likeness in and in connection with the Materials, whether as part of the Program or otherwise, or in connection with advertising, programming respective parent, subsidiary, related entities or affiliates, sponsors of the Program, and for the institutional purposes of Producer and Network and/or their respective affiliated entities, throughout the world, in any and all media, now known or hereafter devised, in perpetuity. 4. I hereby authorize Producer and any person or entity designated by Producer to investigate, access and collect information about me, about any of the statements made by you in the Application, any supporting documents and any other documents that I have signed or provided or do sign or provide in connection with my application to be selected as a participant in the Program, or any other written or oral statements I make in connection therewith to the maximum extent permitted by law. I irrevocably authorize Producer and any person or entity designated by Producer to secure information about me and my experiences from my current and former employers, associates, friends, family members, educational institutions, government agencies any branch of the military, and any references I may have provided, and I irrevocably authorize such parties to provide information concerning me. I hereby unconditionally and irrevocably release and forever discharge each of the Released Parties, the persons or entities designated by Producer, and all such parties and persons from any and all liabilities arising out of or in connection with any such investigation. To the maximum extent permitted by law, you specifically authorize investigation of my employment records and government records, including but not limited to my motor vehicle records, criminal records, civil records, military records, and/or consumer report(s). I acknowledge and agree that any such information obtained by Producer or by any person or entity designated by Producer pursuant to this paragraph or otherwise may be used for purposes of selecting participants in the Program or in the course of producing the Program (including without limitation, providing information to and consulting with Network), and may be described or otherwise related in and in connection with the Program, in and in connection with another program, and in and in connection with any advertising, promotion or publicity for the Program or other program. 5. I recognize that proof of damages suffered by Producer and Network in the event that I breach any provision of this Paragraph 5 will be costly, difficult or inconvenient. Accordingly, I agree to pay Producer and Network the sum of One Million Dollars ($1,000,000) per breach plus disgorgement of any money or the value of any thing that I have received or that I may receive in connection with my breach as liquidated damages in the event I breach any provision of this Paragraph 5. Furthermore, I will defend, indemnify and hold harmless the Released Parties from and against any and all claims, actions, damages, liabilities, losses, costs and expenses (including, without limitation, attorneys’ fees) that in any way arise out of or result from my breach of any provision of this Paragraph 5. *
PLEASE READ AND ACCEPT THE TERMS BELOW. (By checking this box) *
I have read, understand, and agree with the foregoing. I UNDERSTAND THAT I AM GIVING UP CERTAIN LEGAL RIGHTS UNDER THIS APPLICATION AND RELEASE, INCLUDING, WITHOUT LIMITATION, MY RIGHT TO FILE A LAWSUIT IN COURT WITH RESPECT TO ANY CLAIM ARISING IN CONNECTION WITH THIS APPLICATION AND RELEASE. *
Date: *
Date of Birth (for identification verification purposes) *