PLEASE ATTACH A
RECENT, CLOSE UP
PHOTO OF BOTH
TEAM MEMBERS!
NEW ITV GAMESHOW - A GOGGLEBOX ENTERTAINMENT & VICTORY TELEVISION
PRODUCTION FOR ITV1
SERIES 1 CONTESTANT APPLICATION FORM
Please read the application form carefully before completing and signing.
You are both applying to be considered as contestants in ITV’s newest and most exciting game show
which GOGGLEBOX ENTERTAINMENT and VICTORY TELEVISION intend to produce for initial
transmission by ITV (the “Broadcaster”). The show requires teams of two to pair up to answer
general knowledge questions and work together under pressure for the chance to win a very big cash
prize.
Please fill out the application form legibly, using black ink if posting or clear black font if sending in
electronically. If you run out of space answering any questions, please use the back of the form and
reference the question(s) accordingly.
Deadline for applications is: Monday 24.10.11 but we reserve the right to extend the closing date and
time at our sole discretion.
You must both fill out the entire application form. Please do not leave any question unanswered. If
any question is not applicable to you, write N/A in the space provided.
Please complete the application form, attach a recent photograph of yourselves and return by e-mail
to: [email protected] or post to: GAME SHOW APPLICATIONS,
Gogglebox Entertainment, 64 New Cavendish Street, London, W1G 8TB
We will be calling and inviting successful teams for an audition but please do not contact us for
any feedback. If you do not hear from us, you have not been successful this time.
Many thanks for applying to be on the show.
PROGRAMME ELIGIBILITY REQUIREMENTS
1.
You must both be aged at least 18 (eighteen) years of age due to the chance for contestants to
win a cash prize.
2.
You must both be resident and currently living in the United Kingdom.
3.
Neither of you can be currently employed by us or any of our group of companies, affiliates,
subsidiaries, agencies or persons professionally associated with the Programme and/or the
Broadcaster and/or the provider of the Prize, or be sufficiently connected with the Programme (for
example a live-in partner or immediate relative of an employee of ours or the Broadcaster) such
that your participation in the Programme could create the appearance of impropriety, unless
otherwise approved by us.
(the foregoing shall be collectively referred to as the “Eligibility Requirements”)
You both hereby undertake the information you give in this application form is correct and that you
both meet each of the eligibility requirements as detailed above as well accepting the 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
selected to go forward to the next stage of the selection process, you agree to immediately inform us
of the nature of any such change. You hereby acknowledge that in the event we select you to appear
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in the Programme and you have given false information on this application form or fail to comply with
the Terms and Conditions or any of our other reasonable instructions or directions, then we shall be
entitled to terminate your participation in the Programme.
Please fill out these first two sections individually and then go on to answer the subsequent
sections as the relevant Applicant 1 or 2.
PERSONAL INFORMATION – APPLICANT 1
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.
Relationship to team
mate? How long
have you known
each other?
Family Status
(Single/Married with
Kids etc)
Address:
Home Tel:
Mob:
Work Tel:
Can you accept
phone calls at work?
E-mail:
Do you have any
medical conditions
that the production
team should be
made aware of,
including any
disabilities?
Yes / No
If you have answered “yes” please specify details below (including any special
requirements you may have for any audition or studio appearance):
We require this information in order to ensure that we meet our duty of
care to you as an auditionee or a contestant, including the provision of
suitable access to audition and studio venues.
Have you ever been
convicted of a crime
or are you the
subject of ongoing
criminal
proceedings? If yes,
please give details.
Do you have any
County Court
Judgments against
you? If yes, please
give details.
2
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.
PERSONAL INFORMATION – APPLICANT 2
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.
Relationship to team
mate? How long
have you known
each other?
Family Status
(Single/Married with
Kids etc)
Address:
Home Tel:
Mob:
Work Tel:
Can you accept
phone calls at work?
E-mail:
Do you have any
medical conditions
that the production
team should be
made aware of,
including any
disabilities?
Yes / No
If you have answered “yes” please specify details below (including any special
requirements you may have for any audition or studio appearance):
We require this information in order to ensure that we meet our duty of
care to you as an auditionee or a contestant, including the provision of
suitable access to audition and studio venues.
Have you ever been
convicted of a crime
or are you the
subject of ongoing
criminal
proceedings? If yes,
please give details.
Do you have any
County Court
Judgments against
you? If yes, please
give details.
3
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.
EMPLOYMENT AND QUALIFICATIONS
What is your present
occupation? (Please
provide a description
of your job)
1.
What qualifications
do you hold
(educational,
academic, vocational
professional etc.)?
1.
2.
2.
ABOUT YOURSELF
Tell us what you
enjoy doing in your
spare time?
(Hobbies,
collections,
interests, member of
club, society e.g.
The Scouts or
MENSA)
How would you
describe yourself in
five words?
1.
Please tell us an
interesting fact
about yourself.
1.
Do you work well
under pressure?
1.
2.
1.
2.
2.
2.
ABOUT YOUR TEAM MATE
How would you
describe your team
mate in five words?
1.
How does your team
mate cope under
pressure?
1.
How would you
describe your
relationship?
1.
2.
2.
2.
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Who is the leader
out of the two of
you?
1.
2.
PROGRAMME SPECIFIC QUESTIONS
What are your
strongest quiz
subjects?
1.
What are your
weakest subjects?
1.
How competitive are
you on a scale of 110?
1.
How good do you
consider your
General Knowledge
to be on a scale of
1-10? (1 being
terrible, 10 brilliant)
1.
How good do you
consider your team
mates General
Knowledge to be on
a scale of 1-10? (1
being terrible, 10
brilliant)
1.
Have you applied for
or appeared on any
other television
shows?
Yes / No
2.
2.
2.
2.
2.
1.
2.
If you have answered “yes”, please give details (including without limitation all
television appearances whether completed and pending (as applicable) of the
name of the show(s), nature of your participation, recording date, broadcast
date, channel, any prizes won and any other information as you see fit)
1.
2.
If you won £10,000
on the show what
would you spend
your winnings on?
PLEASE NOTE: If you progress further in the application process, we
reserve the right to carry out background checks to verify the above
information. Please be honest here, appearances on other shows and
previous winnings will not exclude you from selection
1.
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2.
Do you have any
unfulfilled ambitions
in life?
1.
2.
AUDITIONS
If you were invited to
an audition which of
the following cities
would be preferable
for you both? (Please
tick or mark
preference)
BELFAST [
]
BIRMINGHAM [
]
CARDIFF [
]
EDINBURGH [
]
NEWCASTLE [
]
LONDON [
]
MANCHESTER [
]







AVAILABILITY
Filming of the show
is scheduled to take
place in late
November/early
December. Are you
both available during
that period?
1.
2.
DATA RETENTION
We would like to
keep the information
you provide in this
application form for
future related use
when, for example,
producing a further
series of the
Programme or other
similar programmes.
We would like to
keep the information
for two years. 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
YES, I WOULD LIKE THE DATA SUPPLIED ON THIS APPLICATION FORM TO BE
RETAINED SO AS TO BE CONSIDERED FOR ANY POSSIBLE FUTURE SERIES OF
THE PROGRAMME OR OTHER SIMILAR PROGRAMMES
1. [ ]
2. [
]
NO, I DO NOT WANT THE DATA SUPPLIED ON THIS APPLICATION FORM TO BE
CONSIDERED FOR ANY POSSIBLE FUTURE SERIES OF THE PROGRAMME OR
OTHER SIMILAR PROGRAMMES
1. [ ]
2. [
]
By returning this completed application form you confirm that:
(i)
(ii)
(iii)
you have read, meet and agree to be bound by each of the Eligibility Requirements;
you have answered all the questions in this application form honestly and truthfully; and
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.
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Signature Applicant 1: (if emailing form type
in name):
Print Name:
Date:
Signature Applicant 2: (if emailing form type
in name):
Print Name:
Date:
REMEMBER, PLEASE COMPLETE THIS FORM AND SEND IT BACK TO US WITH A RECENT PHOTOGRAPH
OF YOURSELVES VIA ONE OF THE FOLLOWING METHODS:
EMAIL TO: [email protected] or post to: GAME SHOW
APPLICATIONS, Gogglebox Entertainment, 64 New Cavendish Street, London, W1G 8TB
Deadline for applications is: Monday 24.10.11 but we reserve the right to extend the closing date and
time at our sole discretion.
MANY THANKS FOR TAKING THE TIME IN APPLYING TO BE ON THE SHOW AND GOOD LUCK!
GOGGLEBOX ENTERTAINMENT & VICTORY TELEVISION
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
a.
These terms and conditions (the “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, and form part of your Application Form.
b.
Neither we nor the Broadcaster are liable to refund any costs or expenses incurred in applying to participate in the Programme, or
in participating in the Programme, 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 by us.
c.
We and our subcontractors do not accept any responsibility whatsoever for any technical failure, malfunction of or any other
problem with any computer network, system, server, provider, telephony system or otherwise or for any postal service failures
which may result in any application not being properly received.
d.
You agree that any application forms which are incomplete or incomprehensible, incorrectly addressed, lost in transit, containing
insufficient postage, not received by us at the relevant postal or email address or sent in after any specified closing date may not
be considered.
e.
You accept that, due to the large number of applications we receive, we will not acknowledge or respond to each and every
application but only to those of successful applicants. We will review your application and shall decide which applications are
suitable to be put forward to the next stage of the selection process. You accept and agree that contestants will be selected at our
sole discretion, that such decisions shall be final and that there will be no right of appeal against any decisions taken by us on this
matter.
f.
You accept that receiving an application form and/or a phone call from a member of the Programme production team and/or
attending an audition and/or attending any recording days DOES NOT automatically mean that you will be appearing on the
Programme and we reserve the right, at our sole discretion, to stand you down at any time during the production process, even if
you have been given a date to attend auditions or recordings.
g.
We do not represent, undertake or warrant that we will produce or broadcast any episode of the Programme or to include any
applicant’s participation.
2.
YOUR OBLIGATIONS
a.
You agree to abide by the rules and regulations of the Programme as shall be notified to you in writing or verbally. You accept that
such rules and regulations may be varied by us from time to time and that our decisions in this matter are final.
b.
You agree to attend any auditioning processes, heats and promotional activities relating to the Programme if required by us on any
dates as shall be notified to you.
c.
You agree to undertake a medical and/or psychological assessment, conducted by a certified practitioner, if so required by us.
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d.
You warrant that you comply with each of the Eligibility Requirements above 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 background searches if so required by us
to substantiate the information provided in this Application Form.
e.
You warrant that nothing in this Application Form will:
i.
ii.
iii.
iv.
f.
infringe the copyright or any other right of any third party;
breach any contract or duty of confidence;
constitute a contempt of court or expose us to any civil or criminal proceedings; and/or
otherwise be intended to bring us or any other party into disrepute.
You warrant that you have truthfully and accurately completed this Application Form 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:
i.
ii.
iii.
iv.
v.
you
you
you
you
you
supply or have supplied any untruthful, inaccurate or misleading details and/or information;
fail to abide by the rules and regulations of the Programme;
otherwise deceive us about your identity;
fail to abide with any of our other reasonable instructions or directions; and /or
are otherwise in breach of any of these Terms and Conditions.
g.
You agree 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.
h.
You agree to notify us of any changes to the circumstances and/or information and/or data provided in this Application Form,
including any criminal charges and/or convictions which are brought against you, during your continued participation in the
Programme selection process.
i.
You agree to indemnify us and our assigns and licensees against any and all claims, 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 and
representations under this Agreement.
3.
INTELLECTUAL PROPERTY RIGHTS
a.
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 (the “Contribution”) and the use of your
Contribution in the Programme in whole or in part or not at all.
b.
You irrevocably grant and assign to 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.
c.
You further agree that any photographic material(s), video material(s) and/or any other materials you have submitted as part of
your application to appear as a contestant in the Programme and/or as part of your Contribution (collectively referred to as the
“Submission”) may 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.
d.
You grant us a worldwide, perpetual, royalty free and transferable licence (with the right to sub-licence) to use, edit, record,
modify, translate, distribute, make available to others, prepare derivative works of and exploit your Submission by any medium or
method whether now known or later developed throughout the world for the full term of copyright and other rights and all
renewable and extension thereof. 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 in respect of the Submission. You agree to provide us with details of all such
licences, rights, consents and permissions relating to the Submission if we so request.
e.
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.
f.
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
a.
The personal information you provide to us will be used to assess whether or not to select you for the Programme and you agree
that we may share your information with the Broadcaster of the Programme as part of the selection process. If you are selected as
a contestant, you agree that your information and data may be used in connection with the production and exploitation 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 from us. You consent to us
retaining your data for the purposes of complaints, further programmes (if you have indicated your consent in the Application Form)
and as otherwise specified herein and consent to us sharing your data with professional advisors and/or ITV plc group companies as
is necessary.
b.
You agree and accept that we may use the information you have provided in this Application Form to verify your age, identity and
other information as is deemed necessary and to carry out background checks with data handling agencies, law enforcement and
government agencies.
c.
By completing and submitting this Application Form, you consent to any sensitive personal information that you provide (for
example, information relating to your health or to criminal convictions) being used for the purpose of assessing your suitability for
the Programme and, if your successful, for the production of the Programme.
5.
CONFIDENTIALITY
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).
6.
MISCELLANEOUS
You agree that we may freely assign or licence this Agreement and that 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.
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