Attach a current photo of yourself: *
First Name *
Last Name *
Contact Number *
Date Of Birth *
Place Of Employment: *
Do you have a personal website, or are you a part of any social networking sites (Instagram, Facebook, Twitter, etc)? Please list:
How would you describe your personality: *
How would your friends describe you? *
Where did you grow up? What was your childhood like? *
What do you do for a living? How do you feel about your work? *
What is your ultimate goal professionally? And Personally? *
If you’re in a relationship, what is your relationship like?
If single, what is dating like for you?
What has been your experience so far with wellness, yoga, selfcare, etc.? *
What is your biggest struggle in life at the moment? Is anything holding you back?
(EXAMPLE: Are you dealing with major life challenges like divorce, a high stress job, relationship or family troubles, the loss of a loved one, a midlife crisis, sexual identity issues, commitment or anger issues, or anything else that you need help working through?) *
Why is NOW the perfect time for you to make a change? *
Why do you NEED this retreat in your life right now? *
What obstacles/challenges have you overcome to get where you are today? *
What are you hoping to gain from this experience?
Is there anyone (friend, family member, significant other) whom you’d like to have join you on this retreat? If so, please tell us who, and why.
(EXAMPLE: Are you trying to work something out with your partner, friend or family member and you'd like to have them join you on the program)
What is something people are surprised to learn about you? *
How did you hear about the casting?
Are you legally authorized to live and work in the United States? *
If no, please explain your residency status:
Are you currently or have you ever been in the Military? If yes, which branch, for how long, and what is your current status?
Have you ever acted, performed or appeared on television or in other media? *
If yes, please explain:
Are you currently being considered for any reality television shows, including, without limitation, any game or contest shows? *
Are you a member of any professional performing arts unions (e.g. AFTRA or SAG)? If so, please list:
Do you have a valid US Passport? *
Have you ever been convicted of a felony or a misdemeanor in the past 7 years? *
If yes, please give dates and details.
Have you ever had a restraining order issued against you? *
If yes, tell us about it (include dates, city & state)
Have you ever had a restraining order issued against someone else? *
If so, tell us about it (include dates, city & state)
CASTING RELEASE: *
ELECTRONIC SIGNATURES. This application may be executed by original, facsimile or electronic signature. Any signed copy of this application delivered by facsimile or electronic transmission shall for all purposes be treated as if it had been delivered containing my original signature and shall be binding upon me in the same manner as though an original signed copy had been delivered.
By signing below, I understand that it constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.