APPLICATION FOR TALENT SEARCH

Must be filled out completely and be attached to your video entry

Contestant Information Sheet

Thank you for applying to be a contestant in the talent contest currently entitled;The Central Illinois Country Music Search”, Events Ltd, (Producer) reserves the right, exercisable at any time in its sole discretion, to disqualify you from the competition or the audition process should you at any stage supply untruthful, inaccurate, or misleading personal details or information or for any other reason whatsoever, in Producers sole discretion. Good luck!!!

NAME:___________________________________________________________________

HOME PHONE:____________________________________________________________

ADDRESS:________________________________________________________________

CELL PHONE:_____________________________________________________________

DATE OF BIRTH:__________________________________________________________

E-MAIL ADDRESS:________________________________________________________

THIS IS A SINGING COMPETITION; DO YOU ALSO PLAY AN INSTRUMENT?___

WHAT INSTRUMENT (if applicable):___________________________________________

HOMETOWN:_____________________ MARITAL STATUS:___________ SEX (circle one): F M

HIGHEST LEVEL OF SCHOOLING COMPLETED:_______________ OCCUPATION:________________________________

ARE YOU A LEGAL RESIDENT OF THE UNITED STATES? YES/NO__________

HAVE YOU EVER BEEN CONVICTED OF A MISDEMEANOR/FELONY?

YES/NO________ IF YES, PLEASE EXPLAIN ___________________________________________________________________

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AGENTS NAME & PHONE NUMBER (if applicable):_____________________________________________________________

MANAGERS NAME & PHONE NUMBER (if applicable):_________________________________________________________

ARE YOU REPRESENTED BY ANY ARTIST UNION(S)? YES/NO______

IF YES, WHICH UNION(S)?__________________________________________________________________________________

PLEASE LIST THE TITLE & COMPOSER/ARTIST OF EACH SONG YOU INTEND TO PERFORM (IF APPLICABLE):_____________________________________________________________________________________________ ___________________________________________________________________________________________________________

IF YOU ARE PERFORMING TO RECORDED MUSIC DURING YOUR AUDITION, PLEASE LIST THE TITLE, COMPOSER/ARTIST, & RECORDING LABEL OF THE RECORDING:___________________________________________________________________

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PLEASE LIST BELOW, TO THE BEST OF YOUR KNOWLEDGE, ANYONE YOU KNOW OR HAVE KNOWN; WHO IS NOW, OR HAS BEEN IN THE PAST TWO YEARS, AN OFFICER, EMPLOYEE, AGENT, OR REPRESENTATIVE OF or it’s affiliated or subsidiary companies, of Producer( Events Lt d.), WMBD, 97.3 River Country, Nexstar Broadcasting and Regent Broadcasting of Peoria or Peoria Civic Center, or their respective parent, subsidiary or affiliated companies;(B) Any television network, station or channel, cable network, or satellite network that may air the Program for which you are applying to be a contestant; (C) Any person or entity involved in any way in the development, production, distribution, or other exploitation of this contest or any variation thereof; (D) Any sponsor of the Program or its advertising agency; or (E) Any person or entity supplying prizes or other services to the Program.
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Producer (Events Ltd.), WMBD, 97.3 River Country, Nexstar Broadcasting and Regent Broadcasting of Peoria reserve the right to render ineligible any person whom any of them determines, in its sole discretion, is sufficiently connected with the production, administration, judging, or distribution of the Program, such that his or her participation in the Program could create the appearance of impropriety

PLEASE DESCRIBE ANY TELEVISION APPEARANCES THAT YOU HAVE EVER HAD

(IF NONE, PLEASE STATE NONE IN THE SPACE BELOW):

______________________________________________________________________________________________________________

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HAVE YOU EVER HAD A RECORDING, SONGWRITING, OR AGENCY/MANAGEMENT CONTRACT? IF YES, PLEASE LIST BELOW AND INCLUDE COPIES WHEN RETURNING THIS INFORMATION SHEET (IF NONE, PLEASE STATE NONE IN THE SPACE BELOW):

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HAVE YOU EVER PERFORMED ON ANY MUSICAL SOUND RECORDING? YES/NO_____
IF YES, PLEASE EXPLAIN:______________________________________________________________________________________

WHAT MAKES YOU CENTRAL ILLINOIS GREATEST COUNTRY SINGING CONTESTANT?

______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________

As used herein, Producer” shall include Events Ltd., WMBD-TV, 97.3 River Country, Nexstar broadcasting, and Regents Broadcasting of Peoria, its licensees, successors, and assigns, and each of their respective officers, directors, shareholders, employees, agents, and representatives. I agree that Producer may license, assign, and otherwise transfer this application and all rights granted by me under this application to any person or entity. I understand that Producer reserves the right to refuse an audition to any individual or act, in its sole discretion, for any reason or no reason.

I have read, understand, and agree with the foregoing.

Signature____________________________________________________________________

Date: _______________________________________________________________________

JUDGES DECISIONS
The decision of the judges is final in all matter

PRIZES AND AWARDS.
The Grand prize of a trip for two to Las Vegas, a room for two nights at the MGM Hotel and two tickets to the Academy of Country Music Must be taken on May 14, 2007 and return on May 16, 2007. No exceptions. Winning party or individual must be able to use the prize. It cannot be assigned or redeemed for cash. NO exceptions.

IMDEMNIFY
I will indemnify Producer (Events Ltd.) Nexstar Broadcasting and Regent Broadcasting of Peoria and the Releases against all claims, liabilities and expenses with respect to said Contestant Information Sheet, and that, knowing of Producer’s reliance hereon, I agree to cause said person to adhere to all of the provisions of said Contestant Information Sheet. In addition, in consideration for my possible participation in the Program, I hereby agree to be bound by and to perform all of the terms and conditions of the foregoing Contestant Information Sheet (including, without limitation, the provisions regarding release of all claims), as such terms and conditions may relate to my participation of the audition process, if any (including but not limited to the taping of my appearance in connection with the Program and the audition process and the use of my name, voice, likeness, etc

SIGNATURE:________________________________________________

DATE:______________________________________________________