THE ONE THAT GOT AWAY

THANK YOU FOR YOUR INTEREST IN "THE ONE THAT GOT AWAY"

Please take a few minutes to scroll through this application before getting started.

You will need to fill it out in one sitting and that can take up to 30 minutes. We suggest you do it on a computer and not your smart phone.

YOU MUST ALSO HAVE THE FOLLOWING PREPARED:

1. A two to four minute video prepared telling us about yourself, your current dating life, and why you would be great for this project. If this video is shot on your phone, please make sure that you are in landscape mode ( phone is horizontal and not vertical ) If you are REALLY good and just a natural in front of the camera, there is an option to record your video straight from the application.

2. At least two (2) photos of yourself. We request a close up of your face and one full length shot, head to toe showing your own unique personal style / look. If possible, we always like to see an action / candid shot of you having fun as well. PLEASE DO NOT UPLOAD FILTERED OR PROFESSIONAL PICTURES. NATURAL / CANDID / FUN IS BEST.

APPLICANTS MUST BE LEGALLY ALLOWED TO WORK IN THE U.S., ADDITIONAL ELIGIBILITY REQUIREMENTS WILL APPLY.

FIRST NAME *

LAST NAME *

FULL LEGAL NAME *

NICKNAME OR ALIAS(ES): *

HOME ADDRESS: *

CITY: *

STATE: *

ZIP CODE: *

CELL PHONE *

EMAIL: *

DATE OF BIRTH *

DOB REQUESTED FOR AGE VERIFICATION PURPOSES ONLY.

FACEBOOK: *

TWITTER HANDLE: *

INSTAGRAM: *

TIK TOK: *

YOUTUBE: *

PLEASE PROVIDE LINKS TO ANY OTHER SOCIAL MEDIA ACCOUNTS YOU HAVE. IF NONE, WRITE "NONE" *

WHAT IS YOUR WEBSITE LINK? If you do not have a website write "none" *

OCCUPATION: *

DO YOU HAVE A VALID PASSPORT? *

YES NO

IF YES, WHAT COUNTRY WAS YOUR PASSPORT ISSUED BY? *

IF YOUR PASSPORT WAS ISSUED BY ANY OTHER COUNTRY OTHER THAN THE UNITED STATES, HOW ARE YOU ABLE TO WORK IN THE U.S?

WHEN DOES YOUR PASSPORT EXPIRE?

Please Select

ARE YOU CURRENTLY SINGLE? *

HOW LONG HAVE YOU BEEN SINGLE? *

ARE YOU LOOKING FOR A SERIOUS RELATIONSHIP? EXPLAIN *

LIST ANY PEOPLE FROM YOUR PAST YOU WOULD HOPE TO RECONNECT WITH ROMANTICALLY OR OTHERWISE. *

PLEASE LIST FIVE (5) FRIENDS OR RELATIVES WHO WANT YOU TO FIND LOVE AND WOULD BE WILLING TO HELP US WITH OUR SEARCH. WE WILL ONLY CONTACT THEM ONCE THEY HAVE AGREED TO BE CONTACTED. *

WHAT WOULD MAKE YOU A GOOD CANDIDATE FOR THIS SHOW? *

HOW DID YOU HEAR ABOUT THIS PROJECT? *

PLEASE SUBMIT A CLOSE UP PHOTO OF YOURSELF. *

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PLEASE SUBMIT A FULL LENGTH PHOTO OF YOURSELF. *

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PLEASE UPLOAD A "FUN SHOT" OF YOURSELF.

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PLEASE UPLOAD / RECORD A TWO TO FOUR MINUTE VIDEO SHOWING US WHO YOU ARE. TELL US A LITTLE ABOUT YOURSELF, YOUR DATING LIFE, AND WHY YOU WOULD LIKE TO BE CONSIDERED FOR THIS PROJECT.

Important: Try to have fun with your video. Show is your personality, what makes you unique, and interesting. What sets you apart from other applicants. Its important to be well lit so please do not video yourself with a window or light behind you. The light should always be in front of you.

STATEMENT AND RELEASE.
BY CHECKING THE BOX, YOU ARE CONFIRMING THAT YOU HAVE READ, UNDERSTAND AND AGREE TO THE TERMS OF THIS RELEASE.
*

In consideration for my possible appearance in an audiovisual series currently known as “The One That Got Away” (the “Program”) and for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, I hereby agree as follows: I acknowledge that everything stated in the application (“Application”) that I am submitting along with this Appearance Release (the “Release”) is accurate and true. I understand that any falsely submitted answers, inaccurate submitted answers and/or incomplete submitted answers can and will be grounds for removal from the casting process and from my subsequent participation in the Program. Whether or not I am selected to be an on-camera participant in the Program, I acknowledge and understand that I may be taped and otherwise recorded during the interview and application process, and that Ten Ten Productions LLC (“Producer”) and its assignees, designees and/or licensees may use such recordings, and my name, voice and likeness, in any manner and for any purposes in and in connection with the Program (including, without limitation, in any related or derivative versions and/or uses of the Program, and in all advertising, publicity, promotion and marketing for the Program) in all media now known or hereafter devised throughout the world in perpetuity for no compensation. In order to be considered to participate in the Program, I represent and warrant that I meet all of the eligibility requirements as set forth in the Application or as otherwise required by Producer. I acknowledge and understand that all eligibility determinations shall be made by Producer in its sole discretion and are final and binding in all respects. Producer reserves the right to modify the eligibility requirements at any time. Producer has no obligation to select me even if I meet all of the above eligibility requirements. I acknowledge and understand that Producer has no obligation to me whatsoever (even if I meet all of the eligibility requirements) and I acknowledge that if I am selected as a potential participant in the Program, my participation is conditioned upon signing and returning certain additional waivers, releases and authorizations required by Producer and/or Network (as defined below) or any of their designees, licensees, successors or assigns and meeting other terms and conditions. I acknowledge and understand that if I am selection as a potential participant in the Program, my becoming a participant on the Program shall be conditioned upon, and I hereby authorize, my submission to a background check and psychological and physical examinations to be conducted by medical professionals (selected by and paid for by Producer) and the certification of the medical professionals that I meet all physical and psychological requirements. If I am selected as a potential participant in the Program, I specifically authorize investigation of my social media and Internet accounts and sites, employment records, medical records, and government records, including, but not limited to, my motor vehicle records, criminal records, employment records, litigation records, military records and credit and/or consumer report(s). Any information obtained by Producer hereunder may be used for (a) evaluation of my application to participate in the Program, (b) purposes of selecting participants in the Program, and (c) any other purposes designated by Producer in its sole discretion. Without in any way limiting the foregoing, any such information may be used, exhibited, distributed, advertised, publicized, promoted or otherwise exploited by Producer as part of the Program or otherwise, as Producer determines in its sole discretion. I hereby unconditionally and irrevocably release and forever discharge the Released Parties (as defined below) from any and all claims, actions, damages, liabilities and losses arising out of or in connection with any investigation or background check performed in connection with my participation on the Program. I further acknowledge and accept that the Application and any other materials (including, but not limited to, any photographs, videotapes, etc.) that I have submitted or will submit to Producer will become the property of Producer and will not be returned. By signing below, I hereby grant Producer and its assignees, designees and/or licensees the right, but not the obligation, to use my name, voice, actions, likeness, appearance and any biographical information contained in this application, my home video, taped interview and any other materials submitted by me (collectively, my “Likeness and Materials”) in any manner and for any purpose in and connection with the Program in all media now known or hereafter devised throughout the world in perpetuity without any compensation to me. Such rights shall include, without limitation, the right to record, use, publicize, distribute and otherwise exploit my Likeness and Materials in any manner and for any purpose in and in connection with the Program including without limitation in any related or derivative versions and/or uses of the Program, and in all advertising, publicity, promotion and marketing for the Program, including in any merchandising or commercial tie-ins, in connection with other productions and/or in connection with Producer). I further agree that Producer has the right to edit, rearrange, cut, dub, add to, modify or juxtapose my Likeness and Materials in any manner and to combine them with any other material. Producer shall have the right to edit or delete my Likeness and Materials, juxtapose any part of my Likeness and Materials with any other materials, change the sequence of events, and make any other changes in my Likeness and Materials as Producer chooses in Producer’ sole discretion. Producer and its assignees, designees and/or licensees shall be the sole and exclusive owner of all rights (including, without limitation, copyrights) in and to my Likeness and Materials which shall be deemed “works made for hire” specially ordered as part of a motion picture or other audio-visual work, and I waive the exercise of any “moral rights,” “droit moral,” and any analogous rights, however denominated, in any jurisdiction of the world, which I have. I acknowledge and represent that I have the right to enter into this Release, grant the rights granted in this Release and to participate in the Program without permission from, consent of or payment to any third party, and that I am, at least, twenty one (21) years of age and that neither Producer nor its assignees, designees and/or licensees have any obligation to me, nor to use my Likeness and Materials, whatsoever. If applicable, I am agreeing to all of the terms and conditions of this Release, including the granting of all rights hereunder, and I represent and warrant that I have the full authority to do so and no other permission or consent of any kind is required. I further represent and warrant that the Likeness and Materials were created solely by and are original with me and all right and title therein and thereto is owned and/or controlled exclusively by me and that such Likeness and Materials will not infringe the copyright in any other work or violate the rights to privacy or publicity of any person or constitute a defamation against any person, or in any other way violate the rights of any person. The foregoing notwithstanding, if any part of the Likeness and Materials are owned and/or controlled by a third party (“Third Party Materials”), I acknowledge that I have provided Producer with written notice of same in the Application. I further represent and warrant that I am able to grant (without the need for any other permission or consent of any kind), and do hereby grant, to Producer and the applicable network/platform on which the Program will be aired (the “Network”) a gratis, perpetual, transferrable, irrevocable license to use the Third Party Materials in and in connection with the production, distribution, promotion and/or exploitation of the Program in any and all media, whether now known or hereafter devised, throughout the universe in perpetuity, as further set forth herein. Any and all information disclosed to or obtained by me and/or my representatives, and/or agents (each a “Related Party” and collectively the “Related Parties”) concerning or relating to the Program, including but not limited to the premise and concept of the Program, the nature of certain events in the Program, the outcome of the Program, and other elements relating to casting, pre-production, production and post-production of the Program (collectively, the “Confidential Information”), shall be strictly confidential, and I hereby agree not to disclose, and to cause each of the Related Parties (if any) not to disclose, any such Confidential Information to any individual or entity in perpetuity; provided that I and/or Related Party(ies) may disclose Confidential Information only to the extent that Producer has granted its prior, specific, express written approval of the content, timing, means, manner and recipient(s) of such Confidential Information (and the specific Related Party(ies), if applicable). I acknowledge and agree that any disclosure of such Confidential Information by me or any Related Party in violation of this Release shall constitute a material breach of this Release and shall cause Producer and its assignees, designees and/or licensees irreparable injury. I further agree that in the event of any disclosure by me or any Related Party in violation of this Release, I shall be liable to and shall pay Producer, as liquidated damages, and not as a penalty, the sum of One Million United States Dollars (US $1,000,000.00), which amount represents the result of a reasonable endeavor by Producer and me to ascertain the fair average compensation for any harm that Producer will sustain as the result of such disclosure. I expressly agree that this liquidated damages amount represents reasonable compensation for the harm which will be incurred by Producer as a result of such disclosure, that this liquidated damages provision is necessary because Producer will in fact suffer significant damages as a result of violation of this Release, and that the amount of those damages is impracticable to calculate or ascertain with certainty or specificity. In addition, I agree that in the event of such disclosure in violation of this Release, Producer shall have the right to seek, among other things, (a) injunctive relief, without posting any bond, to prevent and/or cure any breach or threatened breach of this Release by me or any Related Party, (b) recovery or disgorgement of the monies or other consideration received in connection with such disclosure, if any, and (c) recovery of Producer’ attorneys' fees incurred to enforce this Release. I acknowledge that any breach by me of any of the provisions of this Release would cause Producer, its assignees, designees and/or licensees, irreparable injury and damage that cannot be reasonably or adequately compensated by damages in an action at law. I hereby expressly agree that all such parties shall be entitled to injunctive and other equitable relief (without posting any bond) to prevent or cure any breach or threatened breach of the provisions of this Release by me. I will defend, indemnify and hold harmless Producer, its assignees, designees and/or licensees, their parent, subsidiary and affiliated companies, and each of their respective officers, directors, agents, representatives and employees, from and against any and all claims, actions, damages, liabilities, losses, costs and expenses (including, without limitation, attorneys’ fees) that in any way arise out of or result from my breach of any of the provisions of this Release. RELEASE, AGREEMENT NOT TO SUE AND INDEMNITY. To the maximum extent permitted by law, I, for myself and on behalf of my heirs, executors, agents, successors or assigns, hereby release, hold harmless, and forever discharge Producer, the Network and any other distributor or network that exhibits the Program, and each of their respective parent, subsidiary, related and affiliated entities, licensees, successors, assigns, sponsors and advertisers of each of the foregoing, and each of their respective officers, directors, principals, executives, on-air talent, agents, contractors, partners, shareholders, representatives and employees (the “Released Parties”), from any and all claims, actions, damages, losses, liabilities, costs, expenses, injuries or causes of action whatsoever that in any way are caused by, arise out of or result from this Release, my appearance and participation, my Likeness and Materials, the Program, or in the advertisements therefor, or the broadcast or other exhibition of the Program, and/or my Likeness and Materials, on any legal theory whatsoever (including, but not limited to, personal injury, rights of privacy and publicity, defamation, or false light), regardless of whether caused by the negligence or willful misconduct of the Released Parties (collectively, the “Released Claims”). To the maximum extent permitted by law, I agree that I will never sue any of the Released Parties because I do not like the manner in which Producer or its licensees, designees or assignees took or used my Likeness and Materials for any cause of action based on any of the Released Claims. I will defend, indemnify and hold the Released Parties harmless from any and all such claims, actions, damages, losses, liabilities, costs, expenses, injuries or causes of action, as well as all those that in any way are caused by, arise out of or result from any breach or alleged breach by me of any of the representations or warranties made by me in this Release. To the maximum extent permitted by law, I waive any and all rights I may have under Section 1542 of the Civil Code of California, and every like provision in any foreign jurisdiction. Section 1542 provides 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 acknowledge that, in the event of any breach by Producer or any third party, or any other act or omission giving rise to liability, the damage, if any, caused me thereby will not be irreparable or otherwise sufficient to entitle me to seek injunctive or other equitable relief. My rights and remedies in such event will be strictly limited to the right to recover monetary (but not punitive or consequential) damages, if any, in an action at law, and I will have neither the right to rescind or terminate this Release or any of Producer’ rights hereunder, nor the right to enjoin the production, distribution, exhibition, or other exploitation of the Program or any other program or otherwise or subsidiary or allied rights with respect thereto. I further agree that this Release shall be governed by the internal laws of the State of California and that any action arising out of this Release shall be brought in the state or federal courts located in the City of Los Angeles, State of California, I irrevocably submit to the exclusive jurisdiction of any such court and waive objection that I may now or hereafter have to the venue of any such action or proceeding in any such court. In signing this Release, I am not relying on any representations or other statements that are not contained herein. As used herein, “Producer” shall include Producer, its licensees, successors, designees, and assigns, and each of their respective parents, subsidiaries, and affiliates, and each of their respective officers, directors, shareholders, employees, agents, representatives, successors, licensees and assigns. The Network is an express intended third-party beneficiary of this Release, with full standing to enforce each, every, any and all of its provisions as if it was an express party thereto. I agree that Producer may license, assign, and otherwise transfer this Release and all rights granted by me to Producer under this Release to any person or entity. This Release constitutes the entire agreement and understanding between the parties regarding the subject matter hereof, and cancels and supersedes all prior or contemporaneous agreements, communications and understandings (whether written or oral) between the parties relating to the subject matter hereof. I confirm that I have read and fully understand this document, and have not signed it in reliance on any statement, opinion or representation by Producer, Network or anyone acting on their behalf or otherwise. In the event that any term or provision of this Release shall be held invalid by a competent court or governmental agency, the remainder of this Release shall not be affected thereby, and the parties hereto shall continue to be bound by the remaining terms hereof. Nothing herein shall limit or derogate from Producer’s and/or Network’s rights as a member of the general public.

ACCEPTED AND AGREED: I have signed this STATEMENT AND RELEASE ON: *

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