Last Squad Standing bhmedia February 19, 2016 Your Name (required) What city do you live in? (required) Select a State (required) --Select--AlabamaAlaskaArizonaArkansasAmerican SamoaCaliforniaColoradoConnecticutDelawareFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerta RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaVirgin IslandsWashingtonWest VirginiaWisconsinWyomingDistrict of Columbia Date of Birth(pursuant to record-keeping requirements of 18 U.S.C. 2256) (required) Email (required) Phone Number (required) Skype Username How did you hear about the show? (e.g. Casting Director Name, Instagram, etc.) How did you meet? How would you describe your bond with your friends? How long have you known each other?: (required) Briefly describe each of your friends. Provide their name and age as well as a brief description of their personality and what role they play within your group.: (required) Please upload up to 5 photos of you and your friends-- make sure you include everyone. Group shots are OK. Please describe who is who in each of the photos you uploaded. 5 MB max per photo. Photo 1: (required) Description of photo 1: (required) Photo 2:(required) Description of photo 2:(required) Photo 3:(required) Description of photo 3:(required) Photo 4: Description of photo 4: Photo 5: Description of photo 5: Please Copy Code: Yes, I would like to be notified of future casting opportunities. I have read and agreed to the terms of service. Producer has no obligation to return any materials submitted by me as part of the participant selection process or in connection with my participation in the Program (the “Materials”) whether or not I am selected as a participant, and I hereby grant Producer the right to, and understand that Producer may, but is in no way obligated to, use any portion of the Materials in and in connection with the Program or any other program(s); and (x) Producer shall have the right to use my Likeness, the Recordings and the Materials in any manner, in whole or in part, in any and all media now known or hereafter devised in perpetuity throughout the universe.