Take Me Out Application Form

Men’s

Name:
Date of birth: / Age:
Contact Number: / Email Address:
Where are you from?
Hobbies & Interests? Any party tricks?
How would you describe your ideal woman?
Please give us the contact name & phone numbers of next of kin that we could contact in case of emergencies. Please state relationship:
1.Name: ______Number: ______
Relationship:______
2.Name: ______Number: ______
Relationship:______
I confirm that I have read, understood and agree to the “Gracehill House Take Me Out” Application Terms & Conditions. I confirm that all information provided herein is accurate, truthful and is in no way misleading and I consent to this information being used in the competition.
Signed: ______Date: ______
Print Name: ______

Application Terms & Conditions

1. This is an application to take part in a dating competition entitled “Gracehill House Take Me Out”. The information given by you in your application may be used in the competition should you be selected.

2. You acknowledge and agree to abide by the rules, regulations, terms and conditions for the competition as determined by the Event Organiser and you acknowledge that the Rules may be changed (including without limitation verbally) at any time by the Event Organiser at their sole discretion and that you will be bound by such Rules. The Event Organiser’s decisions shall be final.

3.You can apply to take part in the competition by going to the website at download the application there. The completed application form must be signed and sent by email to .

4.Applicants may be invited to attend an introduction day to meet the Event Organiser and get to know your surroundings and to have a run through for what will happen on the night.

5.The closing date and time for submitting your application is Sunday 14th February at midnight. This is also stated on the website. The Event Organiser may change the closing date and time at any time in their sole discretion for any reason without notice.

6. You must be single and aged eighteen or over at the time of the application. You will be asked to provide the Event Organiser with valid and current photographic ID in order to substantiate your age.

7. All personal details and/or information given in your application either in this form or otherwise must be truthful, accurate and in no way misleading. You agree to update the Event Organiser if any of the details in this form change.

8. In the event that you are invited to attend the show you hereby grant all consents necessary for the Event Organiser to record your introduction and to use recordings featuring your image and/or voice in connection with the show.

9.You must disclose to the Event Organiser details of any criminal convictions and/or unspent convictions other than driving offences which have not resulted in a ban or more serious sentence. You shall notify the Event Organiser immediately if there are any criminal charges brought against you or if any information you provide in your application becomes inaccurate between now and the date of the show.