THE CHASE

First Name *

Last Name *

Phone *

Email *

Street Address *

City *

State *

Time Zone *

Occupation *

Have you ever appeared on television before? *

YES NO

Have you filmed any program, web series, or game show in the past two years, whether it has aired or not? *

YES NO

If you answered YES to either of these questions, please explain. Please list the network, show name, tape date, and air date, and any amount won if on a game show.

If you answered NO, please write "N/A" *

What makes you great at rapid-fire trivia? *

How did you hear about us? *

Please upload a recent photo of yourself. *

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APPLICATION RELEASE: *

I hereby acknowledge that I have read and I meet the Requirements for Eligibility. I hereby certify that all statements made in this application are true and complete. I understand that if any of the disclosures made by me on this application are false, this will be cause for disqualification of my consideration for this production. I further acknowledge and agree that this Casting Application, Application Release and any other form and any other materials (including, but not limited to, photographs, audiotapes, videotapes, and other recordings) which I have submitted or will submit to ITV America, Inc., and written materials photographs, audiotapes, videotapes and other recordings taken by ITV America, Inc. (all of which shall hereinafter be referred to as “Materials”) will become the sole and exclusive property of ITV America, Inc. and will not be returned to me. I understand that as the owners of the Materials, ITV America, Inc., shall have the right to edit, distribute and exploit the Materials in any manner in their sole discretion, including the right to exploit the Materials in this or any other production in all media now known or hereafter created, worldwide in perpetuity, but shall have no obligation to do so. By signing below, I grant to ITV America, Inc. the right to use the Materials, including but not limited to, any biographical information contained in this application, my home video or other recorded interviews, and to record, use, and publicize all the Materials, including home videotape or other recorded interviews, my voice, actions, likeness and appearance in any manner in connection with this or any other production, in all media now known or hereafter created, worldwide in perpetuity. I hereby release and indemnify ITV America, Inc. and the Network, and all of their respective licensees, assigns, successors, parents, affiliated and subsidiary companies, divisions, and joint ventures as well as their employees, officers, directors and agents (collectively, the “Released Parties”) from any and all claims or demands of every kind that I or any third party may now or hereafter have against the Released Parties in connection with my application to appear in the production and the exploitation of any and all of the Materials, including all the materials I have submitted in connection therewith, or any exercise by any or all of the Released Parties of any of the rights I am granting hereunder, or any other matter contained herein, including, but not limited to, any claims for defamation, violation of rights of privacy and/or publicity, negligence, and/or intentional infliction of emotional distress. In connection with the foregoing releases, I hereby expressly waive any and all rights and benefits conferred by the provisions of Section 1542 of the California Civil Code or by any similar law or provision of any jurisdiction throughout the world. Section 1542 reads as follows: “A GENERAL RELEASE DOES NOT EXTEND TO CLAIMS THAT THE CREDITOR OR RELEASING PARTY DOES NOT KNOW OR SUSPECT TO EXIST IN HIS OR HER FAVOR AT THE TIME OF EXECUTING THE RELEASE, AND THAT IF KNOWN BY HIM OR HER, WOULD HAVE MATERIALLY AFFECTED HIS OR HER SETTLEMENT WITH THE DEBTOR OR RELEASED PARTY.” I agree to keep in strictest confidence and to not use or disclose to any party any information or trade secrets obtained or learned as a result of this Casting Application, questionnaires, selection process or participation in the program (as applicable), including, without limitation, any information concerning or relating to the program, the events contained in the program, ITV America, Inc.’s or the network’s contestant selection and production activities relating to the program or the outcome of these activities that I read, hear or otherwise acquire or learn in connection with or as a result of this application, questionnaires, selection process or participation in the program (as applicable) (collectively, the “Confidential Information and Materials”) regardless of whether an episode of the program has been exhibited which may include some or all of the Confidential Information and Materials, without the express prior written consent of a duly authorized representative of ITV America, Inc. This Application Release may not be altered except in writing with permission of ITV America, Inc. This Application Release shall be governed by the laws of the State of California. In no event will I be entitled to rescind this Application Release or to seek injunctive or any other equitable relief, or any award of punitive damages. I have been given ample opportunity to read and I have carefully read this entire Application Release. I certify that I fully understand the contents of this Application Release, that I am of sound mind, and that I intend to be legally bound by this Application Release.

Please read and agree to the below representations, warranties, acknowledgments, consents, and releases

ELIGIBILITY AND INITIAL ACKNOWLEDGEMENTS

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.

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. 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.

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. *

If you do not know anyone in this list, please write “None.”

I AGREE *

I certify that I have read and meet the eligibility requirements and agree to the Application Release.