More info    Application form Please fill in this form, attach a recent photo and send to:     Wife Swap     PO Box 1879     New York, NY 10116 Date submitted: Family name: His Name & Age: Her Name & Age: Home telephone number: Address (inc. City & State): Email: His cell number: Her cell number: His work number: Her work number: Names, ages of children from this marriage: Names, and ages of stepchildren: What is dad's job and work schedule? What is mom's job and work schedule? How long have you been together? If married, for how long? Who takes care of the following responsibilities in your family: Childcare? Shopping? Cleaning? Cooking? Money? Planning social life? Kid's homework? How do you spend your evenings? /weekends? What role do sports play in your life, both participating and viewing? What kind of family vacations do you take? What role does art and culture play in your life i.e. attending museums, the theatre, opera, ballet, etc... How do you discipline your children? What are your dreams for your children and how do you help them to make their dreams come true? What makes your family unique? How would you describe your relationship with your partner? If you were not born in the US, how long have you been here and where were you born? Where do you stand on politics? Please include your opinion on the following:   Race/interracial marriage:   Welfare/unemployment:   Birth control/abortion: Does religion play a part in your family's life? If so how? What pushes your buttons? (Both in your family and in general)? Are you a different person from who you were in high school/college and if yes how? What is your daily routine? What is your annual combined salary? How do you manage the household budget? What is your household philosophy? Do you or your partner have any siblings? If yes, how often do you see them?   You:   Your partner: Why would you and your family like to take part in this program? How did you find out about the program? Is there any feuding in your immediate or extended family, if so please elaborate? Do you or any member of your immediate family have any medical conditions-either physical or psychiatric? Please describe. Do any family members take prescription medicine on a regular basis? Please list. Have you or any member of your immediate family ever been charged with/or convicted of any crime? Has anyone ever filed for a restraining order against you or any member of your family? If yes, please give which family member and details relating to the charges/convictions/restraining orders, including the year they occurred. * * Please note: all chosen families will have to submit to extensive background checks (this includes criminal, medical and psychological screening as well as a drug test). We would appreciate your full disclosure now so that we can deal with the issues accordingly. If the information you have supplied us in this application is false, you will automatically be disqualified from participating on the show - thank you for your cooperation. In connection with answering the above questions and submitting them to RDF Media Limited ("RDF") for consideration for participation in "WIFE SWAP", you represent, warrant, and agree as follows: (i) you have read the foregoing questions and have answered them honestly and accurately; (ii) if any information you provide to RDF is found to be false or incomplete, RDF shall have the right to: (a) terminate its review of this application; (b) dismiss your household from the program participant selection process; and/or (c) if selected, dismiss your household from any program episode; (iii) even if your household meets the eligibility requirements (as determined solely by RDF), RDF will have no obligation to interview your household and/or select your household as a participant; (iv) you shall not be entitled to any compensation whatsoever for completing this application or for participating in this selection process; (v) RDF may rely upon the information provided hereunder as it relates to the participant selection process and/or the development of "Wife Swap;" (vi) you and all the members of your household are in excellent mental and physical health; (vii) RDF will have no obligation to use any information that you or other members of your household provides or to complete, distribute, exhibit or exploit "Wife Swap;" (viii) in no event will you or any other member of your household be entitled to enjoin or restrain the development, production, distribution, advertising or exploitation of "Wife Swap;" (ix) all decisions by RDF concerning selection of the participants are final and not subject to challenge or appeal; (x) you may be taped, filmed and/or otherwise recorded in connection with the selection process for "WIFE SWAP," and RDF and its successors, licensees, and assigns shall have the irrevocable, perpetual right to use your name, biographical data, picture and other reproductions of your physical likeness and voice (as the same may appear in any still camera photograph, any motion picture film or tape or otherwise) in and in connection with the exhibition of "Wife Swap" on television or otherwise and the advertising and promotion thereof (all household members who have been taped, filmed or otherwise recorded shall also sign below); (xi) you have the right to grant all rights granted herein without the consent of any third party, and RDF's exploitation of such rights and use of any materials submitted by you in connection herewith (including but not limited to this questionnaire) as permitted hereunder will not infringe upon the rights of any third party; (xii) RDF has no obligation to return any materials submitted as part of this application, whether or not you are selected as a participant; (xiii) neither you nor any member of your household is a member of SAG and/or AFTRA; and (xiv) you are over 21 years of age. Signature: _______________________________________ Date:         _______________________________________ << back to home