[INSERT PROGRAMME NAME] CONTESTANT APPLICATION …



COUNTDOWN CONTESTANT APPLICATION FORM

PLEASE READ THIS APPLICATION FORM VERY CAREFULLY BEFORE COMPLETING AND SIGNING.

You are applying to be considered as a contestant in the programme entitled “COUNTDOWN” (the “Programme”) which ITV Studios Limited (“we”, “us”, “our”) intends but does not undertake to produce for initial transmission on Channel 4 (the “Broadcaster”). The Programme is a game show in which individuals compete to solve linguistic and mathematical puzzles.

Please fill out this application form legibly using dark-coloured ink. If you run out of space answering any question, please use the back of the form and reference the question(s) accordingly.

You must fill out the entire application form. Do not leave any question unanswered. If any question is not applicable to you, write N/A in the space provided.

Return the completed application form, together with recent photograph of yourself, either by: (i) post, to Contestant Applications, Countdown, ITV Studios Limited, The Television Centre, Kirkstall Road, Leeds, LS3 1JS; or

(ii) email, to Countdown@.

You hereby undertake that the information you give in this application form is correct and that you meet each of the Eligibility Requirements as detailed below as well accepting the appended terms and conditions of entry. If any of the information you provide in this application form becomes incorrect between the date of this application form and the date of our decision as to whether you have been chosen to go forward to the next stage of the selection process, you agree immediately to inform us of the nature of any such change. You hereby acknowledge that in the event we select you to appear in the Programme and you have given false information on this application form, or fail to abide with the Eligibility Requirements or the terms and conditions hereunder or any of our other reasonable instructions or directions, then we shall be entitled to terminate your participation in the Programme.

PROGRAMME ELIGIBILITY REQUIREMENTS

1. There is no upper or lower age limit on contestants appearing in Countdown; however, if a contestant is under the age of 16, their participation in Countdown may be subject to: (i) the consent of their parent or guardian, and their parent or guardian may be required to accompany such contestant at the studio recordings; and (ii) obtaining all necessary permissions and licences (including but not limited to permission from the local education authority).

2. Contestants must be legally resident in the United Kingdom and have a current United Kingdom address.

3. Contestants must not be employed, and have not been previously employed, by ITV Studios Limited, companies within the ITV group of companies, or Channel 4, and must not be a live-in partner or immediate relative (i.e. mother, father, son, daughter, brother or sister) of an employee of ITV Studios Limited, the ITV group of companies, or Channel 4, or any of their affiliates, subsidiaries, agencies or persons professionally associated with the programme or ITV Studios Limited or Channel 4,or the provider of any prizes, or be sufficiently connected with the programme such that their participation in the programme could create the appearance of impropriety, unless otherwise approved by ITV Studios Limited.

4. Unless otherwise permitted by ITV Studios Limited at its sole discretion, Contestants must not have appeared in the televised stages of Countdown on any previous occasion.

5. ITV Studios Limited has the right at its sole discretion to add to, delete from, modify or amend these Eligibility Requirements and to select contestants for the programme. In all circumstances concerning the interpretation and application of these Eligibility Requirements, the decision of ITV Studios Limited will be final.

(The foregoing shall be collectively referred to as the “Eligibility Requirements”)

PERSONAL INFORMATION

Please attach a single recent photograph of yourself here and print your name on the back. Please note that we are unable to return photographs. We see an enormous amount of people at interview stage and a photograph helps the production team to remember individual applicants.

| |

|Full Name | |

|Preferred name for use on | |

|the Programme | |

|Date of birth and age | |

| | |

| |We endeavour to have as diverse a range of contestants appearing on the Programme as possible, |

| |including contestants of varying ages. |

|Address | |

|Home Tel | |

|Mob | |

|Work Tel | |

|E-mail | |

|We have facilities for | |

|people with disabilities | |

|and we do everything we | |

|reasonably can to meet an | |

|individual’s needs.  To | |

|enable us to make this | |

|happen, please let us know | |

|of any adjustments that | |

|need to be considered to | |

|meet your particular | |

|requirements.  This may | |

|include wheelchair access, | |

|BSL interpreter or | |

|text-to-speech operator. | |

|All requests will be dealt | |

|with in confidence. | |

| |We require this information in order to ensure that we meet our duty of care to you as an auditionee |

| |or a contestant, including, but not restricted to, the provision of suitable access to audition and |

| |studio venues. |

|Have you ever been |Yes / No |

|convicted of a crime or are|If you have answered “yes” please specify details below. |

|you the subject of ongoing | |

|criminal proceedings? | |

|Do you have any County |Yes / No |

|Court Judgments against |If you have answered “yes” please specify details below. |

|you? | |

| | |

| | |

| |PLEASE NOTE: That if you progress further in the application process, we reserve the right to carry |

| |out background checks on you to verify the above information. Furthermore, disclosure of criminal |

| |convictions, current criminal proceedings and/or county court judgments may not automatically exclude|

| |you from participating and we shall be entitled to exercise our discretion on this point but in all |

| |cases our decision shall be final. |

ABOUT YOURSELF

|Children (names and ages) | |

|What is your present | |

|occupation? (Please give | |

|details) | |

| | |

|What jobs have you | |

|previously had? | |

| | |

| | |

|What qualifications do you | |

|have? (Include, O Levels, | |

|GCSEs, CSEs, A-Levels, | |

|Degrees, Masters, PHDs as | |

|well as any other academic | |

|and non-academic | |

|qualifications) | |

|Have you applied for or |Yes / No |

|appeared on any other |(If yes, please list all television appearances (completed and pending as is applicable) and give |

|television shows? |details, i.e. name of show, broadcast date, channel and any prizes won – all as is applicable) |

| | |

| | |

| | |

| | |

| |PLEASE NOTE: Unless otherwise permitted by us at our sole discretion, you will not be eligible to |

| |participate if you have appeared in the televised stages of the Programme on any previous occasion. |

|Please give details of any | |

|hobbies/associations/ | |

|clubs | |

| | |

|Please give details of any | |

|special interests or other | |

|information which you feel | |

|is entertaining or unusual | |

|Where did you see the |Please specify: e.g. newspaper advertisement , TV (i.e. on the Programme itself), Twitter, Facebook, |

|advert for Countdown |etc |

|contestants? | |

AUDITIONS

|Please state any dates on | |

|which you will be | |

|unavailable between now and | |

|the end of 2011 | |

|Please state the two major | |

|cities or towns that are | |

|nearest to you and to which | |

|you would be able to travel | |

|to in order to attend |PLEASE NOTE: Neither we, nor the Broadcaster, are liable to refund any costs or expenses incurred in|

|Programme auditions |applying to participate in the Programme and/or attending any auditions, including, but not limited |

| |to: travelling expenses; transportation; accommodation; meals; drinks and other costs, unless |

| |otherwise agreed in writing and arranged by us. |

DATA RETENTION

|We would like to keep the |YES, I WOULD LIKE THE DATA SUPPLIED ON THIS APPLICATION FORM TO BE RETAINED SO AS TO BE CONSIDERED |

|information you provide in |FOR ANY POSSIBLE FUTURE SERIES OF THE PROGRAMME OR OTHER SIMILAR PROGRAMMES |

|this application form for |[ ] |

|future related use when, for| |

|example, producing a further|NO, I DO NOT WANT THE DATA SUPPLIED ON THIS APPLICATION FORM TO BE CONSIDERED FOR ANY POSSIBLE |

|series of the Programme or |FUTURE SERIES OF THE PROGRAMME OR OTHER SIMILAR PROGRAMMES [ ] |

|other similar programmes. If| |

|you do not consent to this | |

|it will not influence our | |

|decision in the selection | |

|process for this Programme. | |

|Please tick the appropriate | |

|box to indicate your | |

|preference | |

FOR OFFICE USE ONLY

| |

| |

| |

| |

| |

TERMS AND CONDITIONS

The following terms set out the agreement between you and us for your application as a contestant on the Programme (this “Agreement”).

1. GENERAL

1. These terms and conditions relate to your application to take part in the Programme which we propose but do not undertake to produce for the Broadcaster.

2. Only one application per person will be considered for the Programme. Multiple applications shall result in all your applications being withdrawn from the Programme application process.

3. Neither we nor the Broadcaster are liable to refund any costs or expenses incurred in applying to participate in the Programme, and/or in attending any auditions, including but not limited to the costs of calls made, postage, ISP charges, telephony fees, travelling expenses, transportation, accommodation, meals, drinks, insurance, taxes and other costs unless otherwise agreed in writing and arranged by us.

4. We and our subcontractors do not accept any responsibility whatsoever for any technical failure or malfunction or any other problem with any computer network, system, server, provider, telephony system or otherwise or any postal service failures which may result in any application not being properly received.

5. You agree that any application forms which are incomplete, incomprehensible, incorrectly addressed, lost in transit, or with insufficient postage, or not received by us at the relevant postal, email address or fax number (all as is applicable) may not be considered.

6. You accept that due to the large number of applications we receive that we will not acknowledge or respond to each application but only to those of successful applicants. We will review your application and shall decide which application is suitable to be put forward to the next stage of the selection process. And you further accept that applicants will be selected at our sole discretion and such decision shall be final. You agree that there will be no right of appeal against any decisions taken by us on this matter.

7. You accept that receiving an application form and/or a phone call from a staff member of the Programme production team and/or attending an audition DOES NOT automatically mean that you will be appearing on the Programme and we reserve the right at our sole discretion at any time to stand you down, even if you have been given a date to attend auditions or take part in a recording.

8. We do not represent, undertake or warrant that we will produce or broadcast any episode of the Programme which may or may not include an applicant’s participation.

2. YOUR OBLIGATIONS

1. You agree to abide by the rules and regulations of the Programme as shall be notified to you in writing or verbally which you accept may be varied from time to time by us and you further accept that our decision is final.

2. You agree to attend any auditioning processes, heats and any promotional activities relating to the Programme if required by us on any dates as notified to you.

3. If required to do so by us, you agree to undertake a medical assessment, conducted by a certified practitioner. This would assist us in assessing your fitness to take part in the Programme and enables us to comply with our duty of care to you under health and safety legislation.

4. You warrant that you comply with each of the Eligibility Requirements and if required by us, you agree to provide us with documentary evidence as well as providing all consents and assistance in carrying out any police background searches if so required by us to substantiate the information provided in this application form.

5. You warrant that nothing in this application will infringe the copyright or any other right of any third party or breach any contract or duty of confidence, constitute a contempt of court or expose us to any civil or criminal proceedings or be defamatory or blasphemous and/or otherwise intended to bring us or any other party into disrepute.

6. You hereby warrant that you have truthfully and accurately completed this application form and acknowledge and agree that we may in our sole discretion disqualify you from any stage of the Programme auditioning and selection process or the Programme itself at any stage if you supply or have supplied any untruthful, inaccurate or misleading details and/or information and/or have failed to abide by the rules of the Programme and/or otherwise have deceived us about your identity or fail to abide with any of our other reasonable instructions or directions or are otherwise in breach of any of the terms of this Agreement.

7. You warrant that you have notified us if you have ever been convicted of a crime / have any county court judgments against you / if you are the subject of any ongoing criminal proceedings.

8. Should you be selected to go through to the next stages of the Programme contestant selection process, you agree that you shall notify us immediately if there are any criminal charges and/or convictions brought against you from the date of this application up until the first transmission of the final episode of the series of the Programme in which you participate.

9. You warrant that you have never been part of or contributed to a media story that may bring us, the Broadcaster or the Programme into disrepute and further warrant that you will not withhold information from us of any material fact that may in our reasonable opinion jeopardise or otherwise impact on the Programme or which might result in publicity adverse to our good name, the Broadcaster or the Programme. You agree that should you have anything in your history that would make for negative press or publicity you agree to make us aware of it in order to protect your public interest and our reputation and that of the Broadcaster.

10. Should you be selected to take part in the Programme you agree and undertake to enter into further contracts with us including without limitation: a Contestant Agreement, a Health Statement and any rules of the Programme and you agree to abide by the terms therein.

11. You agree to notify us of any changes to the circumstances and/or information and/or data provided in this application form during your continued participation in the Programme selection process.

12. You agree to indemnify us and our successors in title, assigns and licensees against any and all claims, costs, actions, losses and/or damages suffered directly or indirectly by us as a result of the breach, non-performance or non-observance by you of any of your obligations, warranties, undertakings and representations under this Agreement.

13. You shall keep confidential and shall not disclose to any third party any confidential information, photographs or other material relating to us or the Programme or anyone taking part in it which comes to your knowledge as result of your participation in the Programme. The foregoing will not include matters already in the public domain (other than by way of your breach of this Clause).

3. INTELLECTUAL PROPERTY RIGHTS

1. In the event that you are invited to attend an audition and any other subsequent stages of the Programme selection process you agree and consent to the filming and recording of your voice, conversation and sounds, including any performance of any musical composition(s), during and in connection with your application for the Programme at our discretion (the “Contribution”) and the use of your Contribution in the Programme in whole or in part or not at all. You irrevocably grant and assign us any and all copyright and other rights, title and interest in your Contribution so as to permit the fullest use throughout the world of the Contribution or any part(s) thereof by all means and in all media in connection with the Programme or otherwise in perpetuity. For purposes of clarity, you accept that we have the right to edit, copy, adapt or translate the Contribution as we see fit and you irrevocably waive the benefits of and agree not to assert any provision of law known as "moral rights" or any similar laws of any jurisdiction.

2. You further agree to the photographic and video material(s) and any other materials you have submitted (collectively referred to as the “Submission”) as part of your application to the Programme and/or your Contribution to be featured in the Programme and you warrant that you have the necessary licences, rights, consents and permissions to authorise us to use your Submission in full or in part. You hereby grant us a worldwide, perpetual, royalty free and transferable licence (with the right to sub-license) to use, edit, reproduce, record, modify, translate, distribute, play, perform, make available to others, prepare derivative works of and to display your Submission by any medium or method whether now known or later developed to be exercised in our sole discretion throughout the world for the full term of copyright and other rights and all renewable and extension thereof and you irrevocably waive the benefits of and agree not to assert any provision of law known as "moral rights" or any similar laws of any jurisdiction.. You agree to provide us with details of all such licences, rights, consents and permissions if we so request.

3. For the avoidance of doubt, you agree that we have no obligation whatsoever to return any materials (including without limitation, the Submission) which you have submitted as part of this application whether or not you are selected as a participant and that we are in no way obligated to use any such materials in connection with the Programme.

4. You hereby grant us the right to use your name, voice, likeness, photographs and any biographical material concerning you in connection with the promotion and exploitation of the Programme and/or ancillary products/services and/or in connection with us and/or the broadcaster of the Programme, throughout the world in all media in perpetuity.

4. DATA PROTECTION

1. We shall comply with our obligations under the Data Protection Act 1998 to the extent that we are required to collect and process the information supplied on this form. The information you provide about yourself to us will be used to assess whether or not to select you for the Programme. We may share your information with the Broadcaster of the Programme as part of the selection process and if you are selected as a contestant you agree that this information and data may be used in connection with the production and promotion of the Programme. You further accept that that we may pass on your personal information to a regulator or governmental authority including without limitation the Information Commissioner and/or OFCOM should it be requested of us.

2. You agree and accept that we may use the information you have provided in this application form to verify your identity and to carry out background checks with law enforcement and government agencies.

3. Appropriate technical and organisational measures will be taken to ensure that the personal data you provide to us will be processed and stored securely. Save as otherwise stated no data you provide to us will be passed to any third parties, with the exception of freelance and contract staff working as part of the Programme production team where necessary.

5. MISCELLANEOUS

You agree that we may freely assign or licence this Agreement and this Agreement shall be governed by and construed in accordance with the laws of England and Wales and the English courts shall have exclusive jurisdiction.

1.

By returning this completed application form you confirm that:

i) you have read, meet and agree to be bound by each of the Eligibility Requirements;

ii) you have answered all the questions in this application form honestly and truthfully; and

iii) you have read, understood and agree to the terms and conditions.

IF YOU ARE RETURNING THIS FORM BY E-MAIL, THEN BY PRINTING YOUR NAME YOU ARE AGREEING TO THE ABOVE TERMS AND IF YOU ARE ASKED TO ATTEND AN AUDITION WE WILL ASK YOU TO SIGN AND RE-DATE THIS FORM IN PERSON.

|Signature (if emailing form, type in name): | |

|Print Name: | |

|Date: | |

please complete this form and send it back to us with a recent photograph of yourself via ONE OF THE FOLLOWING METHODS:

EMAIL TO: Countdown@

OR POST TO:

Contestant Applications,

Countdown,

ITV Studios limited,

The Television Centre,

Kirkstall Road,

Leeds, LS3 1JS.

Dear Viewer,

Thank you for your request to appear on Countdown.

Please find below a list of locations where our auditions are held. Please select at least one audition location which it is convenient for you to travel to.

LOCATIONS

ABERDEEN

BELFAST

BIRMINGHAM

BRISTOL

CAMBRIDGE

DUBLIN

EDINBURGH

EXETER

GLASGOW

KENT (Canterbury)

LEEDS

LIVERPOOL

LONDON

MANCHESTER

NEWCASTLE

NOTTINGHAM

OXFORD

SOUTHAMPTON

We look forward to hearing from you.

Best wishes,

The Countdown Team

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download