AXN - ContestantApplication

8/8/2019 AXN - ContestantApplication

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101027

CONTESTANT APPLICATION

STRUCTIONS:

ut the Application legibly

IN

1. Please fill o . Print it out and handwrite it.

onestly and to the best of your ability.

to attach additional sheets if necessary.

fer to the reality-based game show program currently titled Minute

ot

2. Use dark colored ink.

3. Answer all questions h

4. Please write only on the printed side of the paper, but feel free

5. PLEASE, take your time and answer completely.

6. References to the Program in the questionnaire reTo Win It. References to Producer refer to AXN Holdings, LLC and related entities as defined in the Application.

7. o be selected as a participant in the Program, please note that you MUST (a) have a valid passport (that does nTexpire prior to June 2011) and (b) be eligible to travel outside of India and to enter any country in which the

Program may be produced (as specified in the Eligibility Requirements set forth in Section II).

The Application begins on the next page

P

c/o Multi Scre ivate Limited

Thank you for your time and effort, and GOOD LUCK!

lease send all comp ted applications to :le

AXN India

en Media Pr

Interface, Building 7, 3rd Floor

Off Malad Link Road

Malad (West)

M 4umbai - 400 06

India


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MINUTE TO WIN IT

Contestant ApplicationName:

Home Phone: Mobile:

Address:

Email: I check my email often: Y /N

Part I: About Me1) Who is your current employer and what is your occupation? (What job pays your bills now?)

2) Please list your last three jobs:

1.

2.

3.

3) What levels of education have you completed (please specify school and major/subjects - e.g., High

School, College, Bachelors Degree, Masters Degree, Professional Degree, Doctorate):

School(s)/College(s): Major(s)/Subject(s): Year Graduated:

4) Have you ever been in the military? YES NO (Circle One)

If YES, please list (1) what branch; (2) dates of service; and (3) type of discharge:

5) What are your most significant relationships (e.g., with your family, friends, employers, etc.)? How

long have you known these people?


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6) Do you have any children? If so, what are their names and ages?

7) Who is the most important person in your life?

8) Who do you live with and for how long?

9) What would your friends say are your best qualities?

10) What would your friends say are your worst qualities?

11) How are you competitive in your everyday life?

12) What is the next milestone in your life if you do not make the show?

13) Whats the most interesting thing about you that a stranger wouldnt know just by looking at you?

14) Name a few random skills that you are good at:

15) What is the most daring and dangerous thing you have ever done? Describe the circumstances:

16) If you had to practice these games at home, who would you practice them with?

17) Describe your most embarrassing moment:


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18) What is the weirdest thing about you?


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IF SELECTED AS A CONTESTANT PLEASE LIST FIVE (5) SUPPORTERS WHOM YOU WOULD

LIKE TO APPEAR WITH YOU ON THE PROGRAM TO SUPPORT YOU.Supporter #1:

Name: E-mail address:

Home #: Mobile #:

Other #:

Supporters relationship to you:

Why do you want this Supporter with you on stage?

Supporter #2:


Home #: Mobile #:

Other #:



Supporter #3:


Home #: Mobile #:

Other #:



Supporter #4:


Home #: Mobile #:

Other #:




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Supporter #5:

Name: E-mail address:Home #: Mobile #:

Other #:



NOTE: In order to appear on the Program, supporters must (a) have a valid passport (that does not

expire prior to June 2011) and (b) be eligible to travel overseas and to enter any country in which the

Program may be produced.

Have you appeared on any game/talk/reality shows that have aired in the past 2 years, or which may airwithin the next year? If yes, please fill in the following:

Show Name Air Date

(Include Tape Date if not yet aired)

Amount Won

[Use another sheet if additional space is necessary.]

List all TV game or contest shows on which you have appeared, and whether or not you won any prizes. Ifyou have NOT appeared on any such shows, please state this. Do not leave the space below blank.

Have you applied to be on any TV shows in the past year? YES NO (Circle One)

If YES, which ones?

Are you currently being considered for any other reality shows, including, without limitation, any game orcontest shows? YES NO (Circle One) If YES, which ones?

Have you ever been charged with any criminal offence?If YES, please describe in detail, tell us when and where the event occurred, and what the outcome was:

Have you ever been convicted of any criminal offence?


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If YES, please describe in detail, tell us when and where the event occurred and what the outcome was:

Have you ever had a temporary or permanent restraining order or injunction entered against you, or hasanyone tried to obtain a temporary or permanent restraining order or injunction against you?

If YES, please give details, including, without limitation, date(s), place(s) and name(s) of party(ies) seekingthe temporary restraining order or injunction and relationship of such party to you, and a description of thebasis upon which the temporary restraining order or injunction was sought, whether it was issued, and thebasis upon which it was issued:

Is there any pending litigation, arbitration, inquiry or other adverse proceeding against you?

If YES, please describe when and where the event(s) occurred, the other party(ies) to the proceeding(s),whether you were the plaintiff or defendant, the nature of the proceeding(s), and what the outcome was foreach proceeding:

Have you ever been evicted? YES NO (Circle One)If YES, please give details, places and dates:

Have you ever been the subject of disciplinary proceedings or actions in school, college, in the military, atwork or in any other context? YES NO (Circle One)

If YES, describe in detail, including, without limitation, date(s), place(s), the setting, the exact nature of thecharges and proceedings, and the actions taken in connection with the charges and/or proceedings:


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Have you ever done or been involved in anything that would reflect negatively on you or on the Program,the Producer and/or the television networks or channels that telecast the Program if you are chosen toparticipate in the Program? YES NO (Circle One)

If YES, please explain in detail, including, without limitation, date(s), place(s), person(s) involved and theirrelationship to you, context, setting, publicity (if any) and the exact nature of the incident(s):

Have you ever created a website or posted any materials on any website? YES NO (Circle One)If YES, describe the website(s) you created and/or the materials you posted:

Have you appeared in any magazines, publicly disseminated photographs, advertisements or the Internet?YES NO (Circle One)If YES, please describe:

Do you know anyone else who is applying to be on the Program (other than your supporters)?YES NO (Circle One)If YES, please list their name(s) and number(s):

Is there anyone among your family, friends, or work colleagues that would object to you appearing ontelevision? YES NO (Circle One)If YES, please identify all such persons, including your relationship with them and the reason they wouldobject:

PLEASE CONTINUE TO PART II OF THE APPLICATION


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PART II: ELIGIBILITY REQUIREMENTS, REPRESENTATIONS AND RELEASES

Eligibility Requirements

1) You must be at least 18 years of age, and you must be of sound mind and not disqualified or prohibitedunder any law or contract from entering into any agreement in respect of the Program (as definedbelow).

2) You must be a legal Indian resident and/or living and/or working in India.

3) You must be proficient in reading, writing and speaking the English language.

4) You must not be a candidate for public office and must agree not to become one until after the initialtelecast of the episodes of the Program in which you appear, if selected as a participant.

5) You may not participate in the Program if your participation would create impropriety or the

appearance of impropriety. In making this determination, Producer will consider whether you, anymember of your immediate family or anyone living in your household is or has been within the last two(2) years an employee, officer, director, agent or representative of any of the following:

(a) Producer or any television production company, network, channel or distributor owned oroperated by Sony Pictures Television or NBC Universal;

(b) Producer, or any other person or entity any person or entity involved in the development,production, distribution or other exploitation of the reality-based game show programcurrently titled Minute To Win It (the Program) or any variation thereof;

(c) Any sponsor of the Program or its advertising agency; or

(d) Any person or entity supplying prizes or other services to the Program.

Please list any such relationships here; if none, write None. __________________________________________________________________________________________________________________________

In addition, Producer reserves the right to render ineligible any person whom it determines, in its solediscretion, is sufficiently connected with the production, administration, judging or distribution of the Program,such that his or her participation in the Program could create the appearance of impropriety.

6) If selected as a participant you must execute waivers and release agreements required by Producer or

any of its licensees, successors or assigns.

7) You must be willing to submit to a background check.

8) You will need to be willing to travel to the production location, to be determined. The productionlocation is expected to be in Malaysia, but could be in any other country. To be selected as aparticipant, please note that you MUST (a) have a valid passport (that does not expire prior to

June 2011) and (b) be eligible to travel outside of India and to enter any country in which the

Program may be produced.


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Representations, Warranties, Acknowledgements, Consents and Releases

You hereby give the following representations, warranties, acknowledgements, consents and releases:

(a) I desire to voluntarily participate in interviews and auditions (the Activity) for the Program.In connection with my participation in the Activity and/or the Program, and by signing below, Ihereby represent, warrant, acknowledge, and agree that:

(i) I have read, and confirm that I satisfy, the eligibility requirements;(ii) I have completed this Application honestly and accurately;(iii) If any of the information in this Application is found to be false or incomplete, this will

be grounds for dismissal from the Program participant selection process and/or fromthe Program contest (if any), if selected;

(iv) Even if I meet the eligibility requirements, Producer has no obligation to interview me,and/or select me as a participant;

(v) Even if I am selected as a participant, Producer has no obligation to conduct the

Program contest (if any), produce the Program or telecast the Program even ifproduced;

(vi) All decisions by Producer concerning selection of the participants are final and notsubject to challenge or appeal;

(vii) Producer has no obligation to return any materials submitted by me as part of thisApplication whether or not I am selected as a participant;

(viii) I am in good health and I have no mental, physical or emotional condition that mightinterfere with my engaging in the Activity or participating in the Program;

(ix) I am not under the influence of any medication, drugs or other substance that mightimpair my physical or mental ability to engage in the Activity or that might impair my

judgment while engaging in the Activity or participating in the Program;(x) I will follow all rules made and directions given by Producer and its representatives in

connection with the Activity and/or the Program; and(xi) I agree to keep strictly confidential all information about the Activity and the Program

that I acquire during the participant selection process and/or my participation in theProgram.

(b) By submitting this Application, I hereby consent to the recording, use and reuse by Producerand any of its licensees, successors, assignees, parents, subsidiaries or affiliated entities, and each oftheir respective employees, agents, representatives, officers and directors (collectively, Releasees) ofmy 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 anymaterials submitted by me in connection with my Application (collectively, Likeness), as edited,

altered, or modified by Producer or by any of the other Releasees, in any and all media now known orhereafter devised, worldwide in perpetuity, in or in connection with the Program or any related work. Iagree that the Releasees or any of them may use all or any part of my Likeness and may alter or modifyit regardless of whether or not I am recognizable. I further agree that the Releasees exclusively own allright, title and interest (including, without limitation, all copyrights) in and to any and all recordingsmade by them and in and to any and all audiovisual materials that I have provided in connection withmy Application and any other materials that I have provided or may provide in connection with myApplication or the Program (collectively, the Materials) including, without limitation, the right toedit, alter or modify the Materials and to use all or part of the Materials and my Likeness in any and allmedia now known or hereafter devised worldwide, in perpetuity. Without in any way limiting theforegoing, if I perform or include any music (other than music supplied to me by Producer) inconnection with my Application or the Program, I represent and warrant that I own all rights to such

music, and I grant Producer the right to record, reproduce and publicly perform any such music in andin connection with the Program or any related work, worldwide, in perpetuity. Without in any waylimiting the waivers and releases set forth herein, I waive any claims to royalties of any kind, whetheraccruing now or in the future, from Producer for the use of any such music including, withoutlimitation, any applicable copyright, public performance, mechanical and synchronization royalties. Ifurther agree that Releasees may use my Likeness and the Materials in connection with any promotion,


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publicity, marketing or advertisement. I grant the rights hereunder whether or not I am selected toparticipate in the Program in any manner whatsoever. I understand that I will not be paid any moneyfor giving Releasees these rights or for signing this agreement.

(c) MY PARTICIPATION IN THE ACTIVITY IS AT MY OWN RISK. TO THE MAXIMUMEXTENT PERMITTED BY LAW, I AGREE NOT TO SUE RELEASEES, AND I RELEASERELEASEES FROM ANY AND ALL CLAIMS, ACTIONS OR LIABILITIES FOR INJURY ORDAMAGE TO ME, TO ANYONE ELSE OR TO ANY PROPERTY IN ANY WAY RESULTINGFROM MY PARTICIPATION IN THE ACTIVITY, REGARDLESS OF WHETHER OR NOT SUCHINJURY OR DAMAGE WAS CAUSED BY THE NEGLIGENCE OR WILLFUL MISCONDUCT OFRELEASEES OR ANYONE ELSE CONNECTED WITH THE PROGRAM. THE FOREGOINGINCLUDES, BUT IS NOT LIMITED TO, ANY AND ALL LIABILITY ARISING OUT OF THERECORDING OR USE OF MY LIKENESS AND/OR THE MATERIALS INCLUDING, WITHOUTLIMITATION, ANY CLAIM THAT SUCH USE DEFAMES ME, PLACES ME IN A FALSE LIGHTOR INVADES ANY RIGHT OF PRIVACY AND/OR PUBLICITY. THE RELEASED CLAIMSSPECIFICALLY INCLUDE, WITHOUT LIMITATION, ANY AND ALL CLAIMS, ACTIONS,

DAMAGES, LIABILITIES, LOSSES, COSTS AND EXPENSES OF ANY KIND RESULTINGFROM THE ACTIONS OF ANOTHER PARTICIPANT OR ANY OTHER THIRD PARTY AT ANYTIME.

TO THE MAXIMUM EXTENT PERMITTED BY LAW, I WAIVE ANY AND ALL RIGHTS I MAYHAVE UNDER SECTION 1542 OF THE CIVIL CODE OF CALIFORNIA, AND EVERY LIKEPROVISION IN ANY OTHER JURISDICTION. SECTION 1542 PROVIDES AS FOLLOWS:

A GENERAL RELEASE DOES NOT EXTEND TO CLAIMS WHICH THECREDITOR DOES NOT KNOW OR SUSPECT TO EXIST IN HIS OR HER FAVORAT THE TIME OF EXECUTING THE RELEASE, WHICH IF KNOWN BY HIMMUST HAVE MATERIALLY AFFECTED HIS OR HER SETTLEMENT WITH THEDEBTOR.

(d) I understand that it may be unlawful, unless disclosed to Producer prior to the exhibition of theProgram, if any, to do any of the following: (a) give or agree to give any member of the productionstaff and anyone associated in any manner with the Program or any representative of Producer anyportion of my compensation or anything else of value to arrange my appearance in the Program; or (b)accept or agree to accept anything of value to promote any product, service or venture on the air or touse any prepared material containing such a promotion. I represent and warrant that I gave nothing ofvalue nor did I agree to give anything of value to anyone so I could be in the Program. I know thatProducer does not permit it and that it may be unlawful not to tell Producer if I had. I shall immediatelynotify Producer and network or channel on which the Program will air if any person attempts or has

attempted to induce me to do anything in violation of the foregoing or which is in any way dishonest.

As used herein, Producer shall mean AXN Holdings, LLC and its licensees, successors and assigns, and eachof their respective officers, directors, parents, subsidiaries, shareholders, employees, agents and representatives.I agree that Producer may license, assign or otherwise transfer this Application and all rights granted by meunder this Application to any person or entity.

Whenever possible, each provision of this Application shall be interpreted in such manner as to be effective andvalid under applicable law, but if any provision of this Application is held to be prohibited by or invalid underapplicable law, such provision shall be ineffective only to the extent of such prohibition or invalidity, withoutinvalidating the remainder of such provision or the remaining provisions of this Application.


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I am proficient in reading, writing and speaking the English language and have fully read, understand, and agreewith the foregoing, and have voluntarily chosen to sign this Application.

This Application shall be governed by and construed in accordance with the laws of the State of California,

United States of America, without regard to choice of law principles. All actions or proceedings arising inconnection with, touching upon or relating to this Application, the breach thereof and/or the scope of theprovisions of this Application shall be submitted to JAMS (JAMS) for final and binding arbitration under itsComprehensive Arbitration Rules and Procedures if the matter in dispute is over US$250,000 or under itsStreamlined Arbitration Rules and Procedures if the matter in dispute is US$250,000 or less, to be held in LosAngeles County, California, in the English language before a single arbitrator who shall be a retired judge, inaccordance with California Code of Civil Procedure 1280 et seq. The arbitrator shall be selected by mutualagreement of the parties or, if the parties cannot agree, then by striking from a list of arbitrators supplied byJAMS. The arbitration shall be a confidential proceeding, closed to the general public. The arbitrator shallassess the cost of the arbitration against the losing party. In addition, the prevailing party in any arbitration orlegal proceeding relating to this Application shall be entitled to all reasonable expenses (including, withoutlimitation, reasonable attorneys fees). Notwithstanding the foregoing, the arbitrator may require that such fees

be borne in such other manner as the arbitrator determines is required in order for this arbitration clause to beenforceable under applicable law. The arbitrator shall issue a written opinion stating the essential findings andconclusions upon which the arbitrators award is based. The arbitrator shall have the power to enter temporaryrestraining orders and preliminary and permanent injunctions. Neither party shall be entitled or permitted tocommence or maintain any action in a court of law with respect to any matter in dispute until such matter shallhave been submitted to arbitration as herein provided and then only for the enforcement of the arbitratorsaward; provided, however, that prior to the appointment of the arbitrator or for remedies beyond the jurisdictionof an arbitrator, at any time, either party may seek pendente lite relief in a court of competent jurisdiction in LosAngeles County, California or, if sought by Producer, such other court that may have jurisdiction over me,without thereby waiving its right to arbitration of the dispute or controversy under this Application. Withoutprejudice to any other rights or remedies which Producer may have, I acknowledge and agree that damageswould not be an adequate remedy for any breach of this Application and the remedies of injunction, specificperformance and other equitable relief from a competent court with jurisdiction over me are appropriate for anythreatened or actual breach of this Application, for the protection of Producers rights and in the interest of theProgram. Notwithstanding anything to the contrary herein, I hereby irrevocably waive any right or remedy toseek and/or obtain injunctive or other equitable relief or any order with respect to, and/or to enjoin or restrain orotherwise impair in any manner, the production, distribution, exhibition or other exploitation of any motionpicture, production or project related to Producer, its parents, subsidiaries and affiliates, or the use, publicationor dissemination of any advertising in connection with such motion picture, production or project.

Signature:

Date:

Name (Please print):

Date of birth:

AXN - ContestantApplication

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