First Name :

Last Name :

Your legal name as it appears on your government-issued ID:

DOB:

Hometown City/State:

Are you employed full time? :

Where?:

Occupation Title:

Current Street Address:

City :

State :

Zip:

The closest major airport to your current home:

Cell Phone:

Alternate Phone:

Email:

Myspace/Website/Blog i.d. (if any) :

Emergency Contact Name and Relationship to you:

Emergency Contact Phone Number:

Emergency Contact Email Address: :

How did you hear about this opportunity? :

NOW LET'S GET TO KNOW YOU

How long have you been living in Oahu? :

Have you lived anywhere else in Hawaii? Where and when? :

If Oahu is not your home-town, why did you move to Oahu and why did you stay? :

*Please list all details of years of marriage if applicable:

Do you have any children? If yes, please list ages :

Do your children live with you? :

How would you describe your role in your group of friends? What is your personality type? :

Briefly describe your social network and lifestyle in Oahu. What do you do for fun? Describe your scene. :

Please list 5 single friends who are sexy and interesting in Oahu who may want to participate in this project:

Phone Number :

Name :

Phone Number :

Name :

Phone Number :

Name :

Phone Number :

Name :

Phone Number :

What would your friends say are your best assets? :

What would your friends say are your worst qualities? :

What would you name a television show that features you and your best friends living, working and partying in Oahu, and why? :

If you could bring any friend, family member, ex or partner living on the mainland to join you in Oahu to participate in this project, who would it be?:

Relationship to You :

Phone Number :

Email :

Name :

Relationship to You :

Phone Number :

Email :

Have you ever appeared on television before? List program title, network or channel, dates of air and any other details:

In your words describe; in an open letter, journal or blog entry your character type. In other words, if you were apart of a docu-soap cast, what role would you fulfill?:

Explain where you stand in your life – what major decisions are you about to make or have you just made? Are you looking for love? Are you starting your own company? Ending a serious relationship? What crossroads are you at? Spill it! Why would your life be perfect for a docu-soap series?

Appearence Release

For other good and valuable consideration, the receipt of which I hereby acknowledge, I grant to CLEAN SWEEEP Productions, LLC and its agents, successors, affiliates, subsidiaries, assigns and licensees (collectively, “you” and “your”), the universal and perpetual right to use, and to grant others the right to use, my name, likeness, biographical information, photographs, voice, personal characteristics, incidents in my life, and other personal identification (collectively “Likeness”) and videotape and sound recordings including, without limitation, any portrayal, impersonation, or simulation of me in any way, (collectively “Recordings”) in any and all manner and media, now known or hereafter devised, throughout the world, for any and all purposes including, without limitation, in connection with the project currently entitled “HAWAIIAN NIGHTS” (“Program”) and any other productions, and in connection with the advertising and promotion of the Program, and other productions. I hereby acknowledge that all of my actions and speech are subject to being recorded (and being included in the Recordings for all purposes hereunder) and that at all times during the taping process that some Recordings may be made using microphones and/or cameras which are at a distance and not immediately apparent. I agree that you may create and include in the Program such actual or fictional incidents, scenes, situations, dialogue, events, characters, names, biographical information and other material as you may, in your sole discretion, consider proper or necessary and you are free to edit, change and dub any recordings of me with any other material (for any purpose, including without limitation, for humorous or satirical effect), as you determine in your sole discretion.
I hereby represent and warrant that: (i) all the statements I have made to you and/or make on the Program are true; (ii) I knowingly and voluntarily assume all risks associated with my participating in the Program; (iii) I will not violate any rights or, cause any injury or damage to, any party or any party’s property; (iv) I will not be entitled to any additional consideration as a result of the exercise of the rights granted herein; and (v) you may rely upon this Consent and Release in producing, distributing and exploiting the Program and any other production.
I hereby release you and each of your related and affiliated entities, agents, employees, representatives, assigns and licensees from and against: (i) any liability based on any personal property, residual, re-use or other right which I may have by virtue of any such use of the Recordings, my Likeness, or related clips in which I appear, or as a result of the exhibition, telecast or distribution of the Program, any portion thereof or in connection with advertising and promotion for the Program; (ii) any claim arising out of any of my acts or statements made in connection with the Program (including but not limited to defamation, invasion of privacy, and any intentional or unintentional acts or omissions); (iii) any claim or damage on account of personal injury to me, including but not limited to, my consumption of alcoholic beverages during the Recordings, bodily injury, lost wages, loss of employment and infliction of emotional distress; and (iv) any claim for further consideration or compensation for the Program or the rights granted hereunder. Before appearing on the Program, I have been advised of the Program format and I have no objections to such format.
You shall not be under any obligation to actually use my Likeness or the Recordings or to include the same in any program or production. I acknowledge that the Recordings are your sole and exclusive property and you shall be entitled to all rights of ownership and all rights of copyright and copyright renewal therein in and to the Recordings. I acknowledge that the rights granted herein shall inure to the benefit of you, and your successors, licensees and assigns, and such rights are freely assignable by you.
I shall not be entitled for any reason to terminate or rescind this Consent and Release nor to enjoin, restrain or otherwise impair the exercise of any of the rights and privileges granted or to be granted to you hereunder, nor to restrain, enjoin or otherwise impair your property or assets , or the development, production, exhibition and/or exploitation of the Recordings or any advertising, publicity or promotion in connection herewith.
I further warrant to you that I am at least 18 years of age and have the full, complete and unrestricted right and authority to enter into this Consent and Release, and that I have not accepted and will not accept any money or other compensation from any third party to mention any person, product, service, trademark or brand name, as part of my appearance on the Program. If I am or have been a member of any performing arts union or guild, I hereby acknowledge and agree that my appearance on the Program does not constitute a performance, and that I am not entitled to any salary, wages or other similar compensation for such appearance. All travel I undertake before, during and after the taping of the Program will be at my sole risk and expense.
This Consent and Release contains the entire understanding of the parties hereto relating to the subject matter herein. I have the full right and legal capacity to sign this Consent and Release. I have read this Consent and Release prior to signing it and I understand its contents. I hereby acknowledge and agree that in the event of any dispute arising out of this Consent and Release, my appearance on the Program or in connection with the production, distribution or exploitation of the Program, I will first submit in writing to you the details of my claim or dispute arising out of this Consent and Release, my appearance on the Program, or any other use of any material in any media. You shall then have the absolute right and option, by giving notice to me within ten (10) business days after receipt of my notice, to require that the matter be resolved by binding arbitration in New York, New York before a single arbitrator acting under rules of, and appointed by, the American Arbitration Association. If you do not elect to enter into arbitration, I may commence a legal action if I choose, but solely in the state or federal courts located Los Angeles, California. In the event any such arbitration or legal action is commenced, I hereby acknowledge and agree that the laws of the State of New York shall govern.

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