ARRANGED CONTRIBUTOR RELEASE – FEE

CELEBS GO DATING – SERIES 7

Company: LIME PICTURES LIMITED of 102 St Pancras Way, London NW1 9ND (together with its
parents, successors, licensees and assigns)

The Programme: ‘CELEBS GO DATING’ (including without limitation any spin-off or tie-in programme and
associated digital & online content) is a one hour week nightly stripped reality show. The
format features an elite dating agency, "The Celebrity Dating Agency", setting up celebrities
on a series of dates with members of the public. Our dating agents will scrutinise the Celebs’
various dating techniques and dish out honest, funny feedback with the ultimate aim - at the
end of the series – that each Celeb will find their “perfect” match.

The Contributor: ……………………….…………….…………………..……………..…(“You” / “Your”)

Address: ……………………….…………….…………………..………..……………..……………

………………………………………………………………….……………..…………….

Email address: ………………………………………………..……………………………………......……

Location Filmed: The Great Gatsby Experience

…………….…………………………………………………………………...………

Contributor Description: ………………….…………………………………………………………………...………

(i.e. hair colour/style, clothing, distinguishing features)

Date(s) Filmed: 18th June, 2019

……………..………………………………………..………
(plus any other filming dates as mutually agreed with You thereafter).

Fee: £ 100 – BUY OUT payable on completion of the services hereunder within 30 days of receipt
of a valid invoice.

1. In consideration of the Fee (sufficiency of which is hereby acknowledged) and being given the opportunity to
appear / perform in or take part in the making of the Programme, You agree to the recording and/or
broadcasting and/or live relay of Your interview/appearance/performance on the Date(s) Filmed (the
“Contribution”) during the course of making the Programme and the taking of and use of any photographs or
“stills” by the Company and You hereby give all consents necessary for the use, reproduction, exhibition,
transmission, broadcast and exploitation thereof throughout the world without time limit by all means and
media (whether now known or hereafter invented) without liability or acknowledgement to You.

2. You hereby agree that the copyright (if any) and all other rights in the Contribution and the Programme shall
vest in and are hereby assigned to the Company and You grant all necessary consents that may be required
under any legislation or regulation in any jurisdiction to permit the Contribution or any part of it (whether as
part of the Programme or otherwise) to be exhibited or otherwise exploited by all means and in all media and
formats throughout the universe for the full period of copyright and all renewals, revivals, reversions and
extensions thereof and thereafter so far as may be possible in perpetuity. Further, You irrevocably and
unconditionally waive all moral rights in and to the Contribution to which You may or may be at any time in
the future entitled. You confirm that the Company shall be entitled to cut and edit the Contribution as it deems
fit and shall not be obliged to include all or any of the same.
3. You warrant and undertake that You will not individually or through any publicity representative or otherwise
circulate, publish or otherwise disseminate any information (including without limitation on social media)
relating to the Company, the Programme, your participation, or any other contributor to the Programme.
Under no circumstances should any information relating to the same be passed to the press or any other
organisation or individual.

4. You warrant that You have no criminal convictions (other than those already notified to the Company,
either via the self-disclosure attached hereto, or otherwise) that your Contribution will be entirely honest
and truthful and that You are not deceiving the Company in any way.

5. By necessity, the Company will process the Contributor’s personal data, including the Contributor’s image and
voice, as part of producing the Programme. The Company will do so in accordance with all relevant data
protection law and the Contributor can find out more information about how the Company processes the
Contributor’s personal data here http://www.limepictures.com/cast-crew-and-talent-privacy-notice/.

6. UK broadcasters are researching diversity on their productions. If You provide the Company with Your e-mail
address we will enter this in a system called Silvermouse. You will be invited to provide, and may do so at
Your option, Your diversity characteristics - gender, ethnicity, disability, age, gender identity and sexual
orientation. The broadcaster, as data controller, is responsible for this data and will have access to reports
compiled from it for purposes of the research. Further information can be found here:
http://creativediversitynetwork.com/diamond/contributors.

7. You warrant and undertake to the Company that You will comply with all applicable country laws relating to
anti-corruption and anti-bribery, including the UK Bribery Act; and You will not perform, offer, give and
receive bribes or corrupt actions in relation to the procurement or performance of this Agreement. For the
purposes of this section, bribes or corrupt actions means any payment, gift or gratuity, whether in cash or in
kind, intended to obtain or retain an advantage, or any other action deemed to be corrupt under the applicable
country laws.

8. Your personal property shall remain Your responsibility at all times and the Company accepts no liability
whatsoever for any loss of or damage to the same.

9. This Agreement shall be the entire agreement between us in relation to Your Contribution. You agree that any
form of electronic signature, including but not limited to signatures via scanning, digital e-signature software
or email may substitute for an original signature and shall have the same effect as an original signature.

10. Nothing in this Agreement shall constitute an undertaking by the Company to produce the Programme, and/or
include the Contribution therein. The Company shall not be liable to You under any circumstances in respect
of any claim for loss of opportunity to enhance Your reputation.

11. You agree that in the event of any breach of this agreement by the Company, You shall not be entitled to
injunct the exploitation of the Programme and any legal remedy You may have shall lie in an action at law for
damages.

12. This Agreement shall be freely assignable by the Company. This Agreement and any dispute or claim
(including non-contractual disputes or claims) arising out of or in connection with it or its subject matter or
formation, shall be governed by and construed in accordance with the laws of England and Wales. The parties
irrevocably submit to the exclusive jurisdiction of the English Courts.

Signed: ............................................................. Date: ..................................

For and on behalf of the Company

By signing this Agreement I, the above named, confirm that I understand the nature and content of the
Programme and my Contribution therein and confirm that I understand, accept and agree to the terms set out
above.

Signed: ....................................................……. Date: ...................................

Contributor

2
 CELEBS GO DATING SERIES 7
Self-Declaration Form

Full Name:_________________________________________________ Date of Birth:_____________________

Any other name by which you are known:_________________________________________________________

Address:___________________________________________________________________________________

Convictions/Proceedings
select one

Have you ever been convicted of any offence (likely, pending, or previous)? YES*/NO

Are there any criminal proceedings against you (likely, pending or previous)? YES*/NO

Have you ever been arrested for any offence? If so, please provide full details including any arrests YES*/NO
in respect of which you were not subsequently charged or where charges were subsequently
dropped.

Are you the subject of any criminal or civil legal proceedings (likely, pending or otherwise)? YES*/NO

Have you ever been involved in any kind of violent situation (e.g. fights in pubs/clubs, fights with YES*/NO
ex-partners etc.)?

Is there any reason why someone might think that you should not take part on Celebs Go Dating YES*/NO
(e.g. claims of anti-social behaviour, violence (including domestic violence), assault (including
sexual assault), possession or sale of drugs, even if they are not true as far as you are concerned?)

*If you answered YES to any of the questions above, please provide full details below.

Conviction/Proceedings Statement
If you answered YES to any question above, please provide full details (including circumstances giving rise to the
offence).

Consent to Obtain a Criminal Records Check

By signing this form, you consent to Lime Pictures Limited (“Lime”) obtaining a basic Disclosure and Barring Service
check (DBS) in your name (or international equivalent background screening). By necessity, Lime will process the
personal data that you provide on this form (and contained in any background check report) as part of the production
process for the Programme and in accordance with all relevant data protection laws. You can find out more about how
Lime will process your personal data here: http://www.limepictures.com/cast-crew-and-talent-privacy-notice/

Declaration

Should any changes to this declaration occur, it is your responsibility to make sure the information is known to the
Company.

I confirm that all information provided above is true and accurate and I will inform the Company immediately
of any changes

Signature: Date: