1. Eligibility Requirements.

I hereby represent and warrant that I meet all of the eligibility requirements listed below:

(a)        I am a legal U.S. resident of the fifty (50) United States or District of Columbia, and am at least eighteen (18) years of age.

(b)       Neither I nor any of my immediate family members (spouse, ex-spouse, parents, siblings, children, step-children, step-parents, step-siblings) or household members (whether or not related) currently are, or have been within the past year, an employee, director or officer of:

  1. producer, its licensees, assigns, parents, or affiliated or subsidiary companies, or any person or entity directly involved in the development, production, distribution or other exploitation of the series or any variation thereof;

  2. network, any television station owned or operated by the network, and each of their respective parents, subsidiaries, affiliates or related entities;

  3. any known, major sponsor of the series or its advertising agency; or

  4. any person or entity supplying services or prizes to the series.

(c)        I am not currently a candidate for elected office, and if selected to participate in the series, I agree that I will not become a candidate for elected office until at least one (1) year after the initial broadcast or other exhibition of the final episode of the series in which I appear.

(d)       I have never been convicted of a felony.

(e)        I do not currently (at or prior to signing this Agreement) have any confidential knowledge of or access to any material, assignments, challenges or competitions for the series.

I further understand and agree that producer has the sole discretion to make determinations of eligibility in any and all respects, and that producer reserves the right to change any of the eligibility requirements at any time.

I understand and agree that producer reserves the right at any time to render ineligible any person who producer determines, in its sole discretion, is sufficiently connected with the production, administration or distribution of the series such that his or her participation in the series would create the appearance of impropriety.


  1. The list below contains the names of everyone I know who is, or has been in the past two (2) years, an officer, employee, agent or representative of: (i) producer (or any other person or entity involved in the development, production, distribution or other exploitation of the series or any variation thereof), including ITV plc, or any of their respective licensees, assigns, parents, or subsidiary companies, (ii) network’s television networks or any of their related entities, (iii) Enteractive Solutions Group, Inc. and Sullivan Compliance (together, “SCC”), (iv) any sponsor or advertiser of the series, (v) any person or entity supplying any prizes and/or services to the series.


Please do not leave the space below blank; if you do not know anyone in this list, please write “None.”  ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


  1. I will notify producer immediately if any of my relatives, friends or acquaintances appears in or is in any other way involved in the production of the series.


  1. The following are ALL of the television shows and digital programs in which I have EVER participated or appeared:


Name of Show                                                            Tape Date                                                     Air Date




  1. I represent and warrant that I have the full right and authority to grant the rights granted by me in this Agreement.  My series participation (if any) and the use of the Materials (defined below) by producer or anyone else as permitted by this Agreement will not violate or infringe upon any third party’s rights and will not cause me to be in breach or violation of any agreement.

  2. I agree that if selected to be a contestant on the series, I will appear as myself; my appearance will not be a performance, will not create an employment relationship between me and producer or network, will not be subject to any union or guild collective bargaining agreement, and will not entitle me to any wages, salary, corporate benefits, workers’ compensation benefits, or other compensation of any kind, under any collective bargaining agreement or otherwise.  No one has promised that I will be chosen as a contestant on the series or that I will be entitled to any Prize or other goods, services or money if selected for the series.  As used in this Agreement, the term “Prize” means, among other things, any awards, money, goods and services, but does not include travel to or lodging at any of the Locations (defined below) provided at producer’s expense.