MEDIACORP CONTESTANT APPLICATION FORM Start-UP Season 2 Full Name: PART I: YOUR PERSONAL DETAILS Mailing Address: Identity Card No: Handphone No: Home Phone No: Work Phone No: E-mail Address: Birth date (mm/dd/yy): Age (as of 1 st Oct 2014): Gender (Male/ Female): I am a Citizen of (Nationality): Passport Number: Expiration Date: Occupation: Highest Level of Education: School(s) Attended: Degree(s) Completed: Emergency Contact(s): Have you ever acted, performed or appeared on television or film? Describe (If YES): What other reality/game TV shows have you applied to or been on? Please list shows, dates of application & airdates: Are you currently being considered for any other reality shows, including any game or contest shows? Describe (If YES):
PART II: YOUR STARTUP IDEA Criteria We are looking for innovative startups with high potential growth. How old is your startup? (You can be a brand new startup or in operation for no longer than 5 years.) Product Describe your product. Do you own the IP rights to your product? What stage of development is it in? Has it gone to market and has it been sold? Market How large is the overall market? Who is your target customer segment? What is your business strategy and business model? How will you make money, why will you make money? Who are your competitors? How will you get customers? Direct sales, resellers, distributors, advertising?
Management List down the credits of at least 3 most important people (founder/management) in your team: Name: Role: Experience: Management Experience: Education: Awards (Professional or Educational): Previous Startup (if applicable): What is the staff strength? How many shareholders/partners are there in your company? What is your share of the company? Valuation/Funding What's your valuation expectation? How did you arrive at your valuation? How much money are you raising? How long have you been raising fund for your product/company? Have you approached any VCs for fund raising? If so, please list the names of the VCs and result. Have you successfully raised any funds for your business? If so, please disclose the amount of funds raised, stage of funding, and the VCs involved. Have you taken a loan from family/friends/banks? If so, please disclose amount and source. Have you received any grant(s)? If so, please disclose amount and source. Others Where do you see your company in 5 years?
PART III: YOUR PROFILE How would someone who really knows you describe your best qualities? How would someone who really knows you describe your worst qualities? What are you like in a room full of strangers? What types of people intimidate you? How competitive are you? How do you react when you lose? How well do you work in groups? Are you a confident presenter? How important is money to you? Who are your role models and why? What is the biggest sacrifice you ve made for your dreams? Complete this sentence. If I weren t an entrepreneur, I would be. Complete this sentence. If only I knew,.
PART IV: YOUR HISTORY Have you ever hit someone in anger or self defense? Yes / No (Circle one) If YES, tell us about it, how old were you, what happened?) Have you ever been arrested or had a restraining order placed against you? Yes / No (Circle one) If YES, what was the charge and were you convicted?) Do you have any conditions, special needs, or fears that we should know about? Yes / No (Circle one) If YES, describe: Have you ever been charged with a violent offense or a felony? Yes / No (Circle one ) If YES, provide details: Have you ever been convicted of a violent offense or a felony? Yes / No (Circle one ) If YES, provide details: Have you now or have you ever owned or appeared on any web sites? Yes / No (Circle one ) If YES, explain: Do you know anyone else who is applying to be on the show? Yes / No (Circle one) If YES, give name(s) and describe your relationship with such person(s): Do you know anyone involved in the production of the show? Yes / No (Circle one) If YES, give name(s) and describe your relationship with such person(s): Have you ever been party to a lawsuit? Yes / No (Circle one) If YES, provide details: If chosen to be on the program, is there any person or part of your life that you would prefer not to share on camera? (i.e., social organizations, activities, personal history, friends, family, etc.). Yes / No (Circle one) Explain below: Who is the one person we could call as your character witness outside of your family? Name & phone #(s): If chosen, are you prepared to commit a minimum of : a) 5 days for the casting selection process (Circle one) YES NO b) 5 weeks for filming of the show (Circle one) YES NO c) 1 week for publicity and promotional activities (Circle one) YES NO
PART V: ELIGIBILITY REQUIREMENTS The following eligibility requirements must be met in order to proceed with the application process: 1. You must be legally eligible to work and live in the country in which your startup business is based. Proof of such eligibility must be provided to Channel NewsAsia upon request. Acceptable forms of proof include (without limitation) a valid passport or combination of a valid driver s license and valid identity card. 2. You must be at least 18 years of age. 3. You must be in excellent physical and mental health. 4. You must not currently be a candidate for public office and must agree not to become one until six (6) months after initial broadcast of all episodes of the Programme in which you appear, if selected as a contestant. 5. You must be willing to travel to the casting location as scheduled by the producers for the final selection process. 6. If you are selected as a contestant, you must be willing to travel to and reside in Singapore during production of the show and production of the show for publicity and promotional activities. PART VI: APPLICATION TERMS AND CONDITIONS In consideration of MediaCorp Pte. Ltd. ( MediaCorp ) allowing me to participate in its programme, StartUp (the Programme ), I agree to be bound by, and to comply with, the terms and conditions set out below: 1. The Programme is produced by MediaCorp. These Terms and Conditions shall apply to all stages of the Programme and production thereof. 2. Each participant must complete MediaCorp s official application form (the Application Form ) and attend any and all requisite briefing and casting sessions which may be held at such times and venues to be determined by MediaCorp. 3. By submitting this application, I accept to be bound by these Terms and Conditions and by the rules and guidelines of the Programme ( Rules and Guidelines ) set by MediaCorp from time to time. 4. I confirm and warrant that I am at least 18 years of age. 5. I understand and acknowledge that the principal concept of the Programme is the evaluation of business proposals pitched by contestants by a panel of judges, and to provide opportunities for contestants to attract potential investors for their business proposals. I understand that I may or may not be presented with such opportunities to meet with potential investors and/or to negotiate potential investments into my business proposals, but I acknowledge and agree that any decision which I may make with regards to such investment matters is entirely at my sole discretion and at my own risk, and I shall not hold MediaCorp liable in any way for such decision or any circumstances arising out of such decision. I warrant and acknowledge that I have not relied upon any expertise, representation, warranty or statement whatsoever of MediaCorp in choosing to participate in the Programme.
6. I acknowledge and agree that no obligation will be incurred by MediaCorp by reason of my participation in the Programme or by reason of anything done or omitted to be done by me as a result or on account of this Programme. MediaCorp shall not be liable or responsible for any and all losses, damages, costs and/or expenses (of any nature whatsoever) suffered by me arising from or in relation to my participation in the Programme, including but not limited to the failure of any potential investors to make good on any agreement with or promise or offer to me. 7. For the avoidance of doubt, I shall be responsible for my own costs and expenses incurred by me for participation in the Programme and in the course of the production thereof and no reimbursement may be sought from MediaCorp, except for certain specific expenses expressly approved by MediaCorp in writing (if any). 8. For the avoidance of doubt, I am solely responsible for obtaining all rights, licences, authorizations, permissions, legal permits etc required for the operation of my business, whether in Singapore or any other relevant jurisdictions. 9. I AM SOLELY RESPONSIBLE FOR ANY AND ALL THIRD PARTY CLAIMS AND ALL BUSINESS AND OPERATIONAL RISKS ARISING FROM THE OPERATION OF MY BUSINESS, AND I SHALL INDEMNIFY MEDIACORP FROM ANY AND ALL THIRD PARTY CLAIMS, ACTIONS, DAMAGES, LIABILITIES, COSTS AND EXPENSES (INCLUDING LEGAL COSTS ON AN INDEMNITY BASIS) ARISING OUT OF THE OPERATION OF MY BUSINESS ON THE PROGRAMME. 10. Filming for the Programme will be on such date(s) as notified by MediaCorp at MediaCorp s studios at Caldecott Broadcast Centre, or such other places as may be designated by MediaCorp. MediaCorp will notify participants of the recording dates accordingly. At MediaCorp s option, there may be additional recording(s) conducted and I agree to attend any and all such additional recording sessions. Notwithstanding the foregoing, MediaCorp has the discretion to amend or reschedule all recording dates by notifying me in advance. 11. With full title guarantee I hereby irrevocably assigns to MediaCorp, and shall procure all my employees appearing on the Programme to assign to MediaCorp, (including present assignment of future copyright) the entire copyright and all other rights of whatsoever nature in and to its contributions to the Programme, including but not limited to auditions, performances, appearances and interviews, such that MediaCorp shall be entitled to use and exploit and license others to use and exploit such contributions by all means and in all media and formats whether now known or hereafter invented throughout the Universe for the full period of copyright including any extensions and renewals thereto and thereafter insofar as is possible in perpetuity. Furthermore, I irrevocably grant, and shall procure my employees appearing on the Programme to grant, all consents and waivers as may be required under the Copyright Act of the Republic of Singapore (as may be amended from time to time) (the Act ) or any similar laws of any jurisdiction to enable MediaCorp to make fullest use of the Programme or any part thereof without restriction. 12. I shall ensure and procure all of my employees to irrevocably waive in respect of their respective contributions to the Programme, including but not limited to auditions, performances, appearances and interviews, any and all moral rights which such employees may have now or in the future including without limitation any of their rights under the Act or any similar laws of any jurisdiction and acknowledge MediaCorp s right to use their names, likeness, voice and any personal particulars and information, photographs and recordings separately from or in conjunction with the Programme or sponsorship thereof in all media and formats throughout the Universe including but not limited to Programme-related web-sites or other online media and in advertising, publicity, sponsorship and exploitation material. 13. I warrant that my contributions and my employees contributions to the Programme shall not infringe the rights (including copyrights) of or defame or embarrass any person, firm or company (including MediaCorp or any company in the MediaCorp Group).
14. MediaCorp s decision at all stages of the Programme is final. No enquiries, appeals, verbal or written, shall be entertained. I shall accept and abide by any and all decisions made by MediaCorp concerning, without limitation, these Terms and Conditions, the Rules and Guidelines, and any other matters relating to the Programme. 15. If I am selected as a contestant, I confirm and undertake that I shall not withdraw from any stage of the Programme for any reason whatsoever, otherwise I shall reimburse MediaCorp on demand for all losses, costs and expenses suffered or incurred by MediaCorp as a result of such withdrawal. I agree that a statement issued by MediaCorp as to the amount of such losses, costs and expenses suffered and/or incurred by it shall, in the absence of manifest error, be conclusive and binding upon me. 16. MediaCorp reserves the right to change the format of the Programme as it deems fit including without limitation changing the dates, times and venues of interviews, filming, production, registration, adding auditions/rounds to the Programme and requesting re-recordings, and I agree to make myself available for such re-recordings. 17. MediaCorp reserves the right at any time to disqualify or render ineligible any participant determined at MediaCorp s sole discretion to be: (a) in breach of these Terms and Conditions or any Rules and Guidelines, or (b) sufficiently connected with MediaCorp or any sponsors of the Programme or any contractor or party supplying services to the Programme, such that its participation in the Programme could create the appearance of impropriety. 18. I shall make full and honest disclosure of all particulars requested in the Application Form and as requested by MediaCorp from time to time. I understand and accept that particulars and information stated in the Application Form and any information supplied by me may be used by MediaCorp for purposes in connection with the promotion, marketing, publicity or obtaining sponsorship of the Programme for broadcasting and the exploitation of the Programme throughout the world. I consent to the disclosure by MediaCorp of such information and particulars to any third parties, including but not limited to the judges, the media, sponsors and the public. 19. MediaCorp shall be under no liability whatsoever to me or my employees, in respect of any loss, damage or injury to life or property sustained by me or my employees at any stage of the application, the Programme and during production thereof, unless such loss, damage or injury is caused by MediaCorp s gross negligence. 20. If I fail to attend rehearsals, recording sessions or other events related to the Programme and/or production thereof, I may be disqualified if the reasons for such absence are found to be unacceptable by MediaCorp. MediaCorp further reserves the right, without any liability to me, to disqualify me from the Programme on the grounds of undesirable conduct. 21. I shall not at any time disclose or publicise the terms of participation in the Programme or any other information relating to the Programme without the prior written consent of MediaCorp, and I shall keep confidential at all times any and all information acquired relating to MediaCorp and the Programme. Without prejudice to the generality of the foregoing, I undertake not to disclose in any way any results or other information relating to the Programme before the broadcast of the episodes of the Programme. I shall not, without the prior written consent of MediaCorp, speak to the press or other media nor give any interviews or comments relating to the Programme and/or production thereof, its participation in the Programme or other contestants nor disclose any information whatsoever relating to MediaCorp and/or any company in the MediaCorp Group. 22. I shall not give any interviews or statements or appear or take part in any event or activity in my capacity as a participant of the Programme, whether before, during or after the broadcast
of the Programme, without first obtaining MediaCorp s express written consent. 23. I shall not, whether before, during or after the broadcast of the Programme, use or exploit in any way any name, logo, trademarks, or other identification of MediaCorp or the Programme for any purpose whatsoever. 24. I confirm that I am not currently a candidate for public office, and if I am selected as a contestant, I agree not to become one until six (6) months after initial broadcast of all episodes of the Programme. 25. MediaCorp reserves the right to substitute, add to or alter any item on the list of prizes offered (if any). All prizes won on the Programme (if any) shall not be transferable nor exchangeable for cash or otherwise. 26. MediaCorp reserves the right to edit, adapt, translate or remove any part of my performance and/or contribution at MediaCorp s sole discretion, and I shall procure my employees to waive any and all rights relating to their contributions pursuant to the provisions of the Copyright Act (Cap. 63), and any other moral rights in their contributions to which the employees may be entitled under any applicable legislation. 27. MediaCorp reserves the right to amend or vary any of these Terms and Conditions or the Rules and Guidelines at any time without prior notice to any participants. 28. I shall indemnify and keep MediaCorp and its related/affiliated companies, officers, agents and employees (the Indemnified Parties ) fully indemnified against any and all loss, damage, claims and costs (including legal costs on a full indemnity basis) suffered and/or incurred by any of the Indemnified Parties as a result of any breach of any of these Terms and Conditions or the Rules and Guidelines on my part. 29. In the event of any inconsistency between these Terms and Conditions and the Rules and Guidelines, these Terms and Conditions shall prevail. 30. For the avoidance of doubt, I acknowledge and agree that the copyright and all intellectual property rights in and to the format of the Programme and the Programme itself shall vest solely in MediaCorp. 31. These Terms and Conditions shall be governed by and construed in accordance with the laws of Singapore. I irrevocably submit to the non-exclusive jurisdiction of the courts of of Singapore. No third party shall have any rights to enforce any of these Terms and Conditions against MediaCorp under the Singapore Contracts (Rights of Third Parties) Act. Signature : Name : NRIC/Passport No : Date :