Beg, Borrow and Deal application/questionnaire |
Please send us a 3-5 minute vhs or mini-dv videotape telling us
why you will be good for the show (5 minutes is absolute
maximum). Please include this audition tape when you mail us
your application to be a contestant on ESPN's Beg, Borrow and
Deal sports reality game show.
Send your videos to: Broken Twig Productions 7060 Hollywood Blvd Suite 1205 Hollywood, CA 90028 |
First Name: ______________________________________ |
Last Name: ______________________________________ |
Nickname (if any): _________________________________ |
Street Address: |
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City: ___________________________________________ |
State: __________________________________________ |
Zip: ____________________________________________ |
Phone Number: |
(Home) _________________________________________ |
(Work) __________________________________________ |
City: ___________________________________________ |
State: __________________________________________ |
Zip: ____________________________________________ |
Phone Number: |
(Home) _________________________________________ |
(Work) __________________________________________ |
Fax Number: _____________________________________ |
E-Mail: __________________________________________ |
Gender (please circle): M / F |
Age: ____________________________________________ |
Date of Birth: ______________________________________ |
Social security #: ___________________________________ |
Marital Status / Significant Other: ______________________ |
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Do you have any children? Please list their names and ages: |
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Height: _________________________________________ |
Weight: _________________________________________ |
What is your current occupation? |
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Please provide your employment history beginning with age 18, including name and address of employer, job description and title and period of employment: |
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Please list all schools attending beginning with high school, and all diplomas or degrees earned, if any: |
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Have you been treated for any serious physical or mental illness(es) (including any surgery or hospitalization or illness lasting more than one month) within the last five years? |
YES / NO If yes, please describe in detail, citing dates, diagnosis and any on-going problems: |
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Please list any allergies you have (medications, food, hay fever, dust, etc.) and your current treatment for them: |
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Have you ever been on television before? If so, when and on what shows? |
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Have you ever used deception for your own personal or business gain? Please describe the situation and the outcome: |
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How often do you travel? Business? Pleasure? |
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Where do you like to get away for a weekend? |
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Have you ever backpacked abroad? If yes, how long were your travels? How much money did you spend in a day? |
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Describe your three most adventurous travel experiences? |
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Do you prefer to work on small projects as a member of a team or as an individual? Why? |
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Have you ever worked with others to pull off a scam or a prank (fraternity/sorority/ sports teammates/club)? |
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What kind of outdoor survival experiences have you had? |
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How many meals do you eat in an average day? |
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How much sleep do you average a night over a week's time? |
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Please list any athletic activities that you participate in. |
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How would your friends describe you as a person? |
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Describe your overall knowledge of sports - professional, college, extreme, etc. |
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Please list three friends - with their phone numbers - that can act as personal references. |
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If you played the game Monopoly with four friends, who would be the banker? |
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Have you ever been arrested for a crime? If so, what was the disposition (conviction? dismissal? Etc.) |
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Through which cable, satellite or other provider do you watch ESPN? |
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Do you know anybody involved in the production of the Program? |
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Is there anything else you need or want to tell us? |
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PLEASE READ, SIGN AND DATE THE FOLLOWING STATEMENT: I hereby acknowledge that: (i) I have read and understand, and I meet and agree to be bound by, the eligibility requirements; (ii) I have answered the previous questions honestly, accurately and to the best of my ability and knowledge; (iii) If any of the above information is found to be false, this will be grounds for my dismissal from the "Beg, Borrow and Deal" selection process, and/or from "Beg, Borrow and Deal" if selected; (iv) Even if I meet the eligibility requirements, the Producer has no obligation to interview me and/or select me as a contestant; (v) Even if I am selected as a contestant, the Producer has no obligation to conduct the contest and ESPN has no obligation to telecast it, even if conducted and (vi) All decisions by the Producers concerning selection of the contestants and other matters is final and not subject to challenge or appeal.
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Signature: _____________________________________ |
Date: _________________________________________ |
PLEASE READ, SIGN AND DATE THE FOLLOWING STATEMENT: I acknowledge that I have read, understand, agree to be bound by and am in compliance with the Eligibility Rules of "Beg, Borrow and Deal"
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Signature: _____________________________________ |
Date: _________________________________________ |
PLEASE SIGN AND DATE THE FOLLOWING NAME AND LIKENESS RELEASE. By submitting this application I hereby consent to the recording, use and reuse by the Producer of the Program and ESPN, Inc. and any of their respective licensees, assigns, parents, subsidiaries, divisions, business units, or affiliated entities and each of their respective employees, agents, officers and directors (collectively "Releasees") of my voice, actions, likeness, name, appearance and biographical material (collectively "Likeness") in any and all media now known or hereafter devised, worldwide, in perpetuity, in any and all versions now known or hereafter devised (including digitized versions) in or in connection with the reality based television series currently entitled "Beg, Borrow and Deal" (the "Program"). I agree that Releasees may use all or any part of my Likeness, and may alter or modify it, regardless of whether or not I am recognizable. I further agree that Releasees exclusively own all right, title, and interest in and to the application and the video that I have provided in connection with the Program (the "Material") and all rights therein and thereto including, without limitation, the right to use and exploit the Material and my Likeness in any and all media now known or hereafter devised, worldwide, in perpetuity, in any and all versions now known or hereafter devised (including digitized versions). I further agree that Releases may use my Likeness and the Material in connection with any promotion, publicity, marketing or advertisement for the Program and/or ESPN and its affiliates and their programming and other services and products in any manner whatsoever. I irrevocably and absolutely grant the rights hereunder whether or not I am selected to participate in the Program. I release Releasees from any and all liability arising out of its use of my Likeness and/or the Material. I agree not to make any claim against Releasees as a result of the recording or use of my Likeness and/or the Material (including, without limitation, any claim that such use invades any right of privacy and/or publicity).
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I have signed this release on the _________ day of_____________, 2002. |
Signature: ___________________________________________________ |
Name (Please print or type): _____________________________________ |