Logo



  1. LINK: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html


  2. We have detected that you are using an unsupported browser. Please upgrade your browser.
    Drop image here or
    Select File
    Select File
  3. We have detected that you are using an unsupported browser. Please upgrade your browser.
    Drop image here or
    Select File
    Select File
  4. Use your mouse or finger to sign above
    By signing this Release, I have voluntarily agreed to be photographed, filmed, videotaped or otherwise recorded (including, without limitation, self-filmed, -recorded or -videotaped) and to provide photographs, films, videotapes or other recordings of myself in connection with my interest in being potentially considered to participate on the television show reflected in this application ("Program”). I hereby consent to the recording (including, without limitation, any self-recording), use and reuse by ITV America Inc., including its parents, subsidiaries, affiliates and assigns (collectively, “Producer”), any network or platform authorized to exhibit the Program (“Network”) and/or any of their respective licensees, assigns, parents, subsidiaries or affiliated entities and each of the respective employees, agents, officers and directors (collectively “Releasees”) of my voice (including, without limitation, my speaking and singing voices and musical compositions created by me), actions, likeness, name, appearance and biographical material, and any information contained in, derived from, or obtained in connection with my application to be a participant in the Program (collectively “Likeness”), as edited, altered, or modified by Producer, Network, or Releasees, in any and all media now known or hereafter devised, worldwide in perpetuity, in or in connection with: (i) my being considered for possible participation in the Program and (ii) the Program and associated promotion, marketing, advertisement, and/or other exploitation of the Program (in any form or media) thereof. 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 specifically agree that Releasees shall have full exclusive ownership of any right, title, and interest in and to any and all photographs, videos, and other recordings taken of, or provided by, me in connection with my application or the Program (the “Material”), and I shall have no rights whatsoever to the Material. I further agree that Releasees shall have the right to use, all or in part, the Material and my Likeness in any and all media now known or hereafter devised worldwide, in perpetuity. I grant the rights hereunder whether or not I am selected to participate in the Program in any manner whatsoever. I hereby irrevocably release Producer, Network, and their Releasees from any and all liability arising out of their use of my Likeness and/or the Material, my participation in the application and participant selection process, and/or any exploitation of the Program, my Likeness, or the Materials on any legal theory whatsoever (including, without limitation, personal injury, rights of privacy and publicity, false light and defamation) (the “Released Claims”). I agree not to make any claim against or sue Producer, Network, or their Releasees as a result of the recording or use of my Likeness and/or the Material or any claim based on any of the Released Claims. I understand that neither Producers nor Releasees make any representation that such Material will or will not be used in any way.
  5. Please Select


Powered by Casting Crane