Love Story Live

A. Smith and Co. Productions and a Major Network are now casting couples for an unforgettable Valentine's Day Television Special!

If you have a love story the world should hear, we want to hear from you!

First Name *

Last Name *

Date of Birth *

*Collected pursuant to 18 U.S.C. §§ 2256 et seq.

Phone Number *

Email *

City *

State *

Occupation *

Instagram *

If not applicable, write N/A

TikTok *

If not applicable, write N/A

Partner's Full Name *

Partner's phone number

Partner's Occupation *

Partner's Date of Birth *

*Collected pursuant to 18 U.S.C. §§ 2256 et seq.

Partner's Instagram *

If not applicable, put N/A

Partner's TikTok *

If not applicable, put N/A

How long have you been dating? *

Tell us how you met? *

What makes your relationship unique?

What excites you most about the future of your relationship? *

What are the next big milestones you hope to experience together? *

For example; moving in together? Buying a home? Getting Engaged? Etc.

What do you love about your partner? Explain. *

Why do you think your love story deserves to be shared with America? What makes your story special. *

Do you anticipate a proposal anytime soon? Explain.

What do your friends and family say about your relationship?

Please upload a recent photo of you two together *

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Personal Release-Casting Interv *

ELIGIBILITY REQUIREMENTS AND RELEASES 1) You must be at least 21 years of age as of August 1, 2026. 2) You must be a legal US resident. 3) You are not currently, nor do you currently intend to be, a candidate for public office, and if there is any change in this representation prior to the initial exhibition of the Program in which you appear, you must immediately notify NBCUniversal (as defined below) at ReportingCandidacy@nbcuni.com. Becoming a candidate before or around the time of the initial exhibition of the Program may under certain circumstances have legal implications on the exhibitor’s ability to exhibit the Program. 4) A. Smith & Co. Productions, LP (“Producer”) and NBCUniversal (as defined below) reserve the right to render ineligible any person who either of them determines, in their sole discretion, is sufficiently connected with the production, administration, judging, or distribution of the Program, such that his/her participation in the Program could create the appearance of impropriety. In making this decision, Producer and NBCUniversal may consider whether you are, or know or have known anyone who is, or has been within the last two (2) years, an employee, officer, director or agent of any of the following: (a) Producer or any other person or entity involved in the development, production, distribution or other exploitation of the reality-based program currently entitled “Love Story Live” (the “Program”) or any variation thereof; (b) NBCUniversal Media, LLC or any of its parent, subsidiary or affiliated entities, including, without limitation, its broadcast networks and studios, cable networks and studios, film businesses, digital businesses, parks and resorts (collectively, “NBCUniversal”) (for more information about NBCUniversal businesses, please visit http://corporate.comcast.com or http://www.nbcuni.com); (c) Any sponsor of the Program or its advertising agency; or (d) Any person or entity supplying goods, services or prizes (as applicable) to the Program. Please list any such relationships here; if none, write “None.” If you become aware of any such relationships after completing this application, please immediately notify Producer in writing. ____________________________________________________________________________________________________________________________________________________________________________ 5) If you are selected as a potential participant you must execute waivers and release agreements required by Producer and NBCUniversal or any of their licensees, successors or assigns. 6) You will need to be available to the production for four to five weeks, whether consecutive or spread out, and possibly longer or shorter, beginning sometime around January 2027 (dates subject to change in Producer’s sole discretion) and be willing to travel to various locations as part of production. 7) Any offer to become a participant may be subject to or conditioned upon your submission to a background check. In addition, any offer to become a participant may be subject to or conditioned upon your submission to physical and psychological examinations to be conducted in locations designated by Producer, by medical professionals (selected by and paid for by Producer), the submission of medical information to production, and the certification of the medical professionals that you meet all physical and psychological requirements. ***** 8) You give the following representations, warranties, acknowledgements, consents and releases: (a) By signing below, I represent, warrant, acknowledge, and agree that: (i) I have read and I meet and agree to be bound by the eligibility requirements; (ii) I have completed this application honestly and accurately; (iii) if any of the information in this application is found to be false or incomplete, this will be grounds for dismissal from the Program participant selection process, and/or from the Program contest (if any), if selected; (iv) even if I meet the eligibility requirements, Producer has no obligation to further contact me, interview me, and/or select me as a participant; (v) even if I am selected as a participant, Producer has no obligation to conduct the Program contest (if any) or produce the Program and NBCUniversal has no obligation to exhibit it, even if produced; (vi) I agree to keep strictly confidential all information about the Program that I may acquire during the participant selection process and/or during my participation in the Program (if applicable), except as otherwise expressly provided in this application; (vii) all decisions by Producer concerning selection of the participants are final and not subject to challenge or appeal; and (viii) Producer has no obligation to return any materials submitted by me as part of the application whether or not I am selected as a participant. (b) By submitting this application, I consent to the recording, use and reuse by Producer, NBCUniversal, and any of the Released Parties (as defined in Paragraph 10 below) of my voice, actions, likeness, name, appearance, biographical material, and any information contained in, derived from or obtained in connection with my application to be a participant in the Program or in any materials submitted by me in connection with my application (collectively “Likeness”), as edited, altered, or modified by Producer or by any of the other Released Parties, in any and all media now known or hereafter devised, worldwide in perpetuity, in or in connection with the Program or any other work. I agree that the Released Parties or any of them may use all or any part of my Likeness, and may alter or modify it regardless of whether or not I am recognizable. I further agree that the Released Parties exclusively own all right, title, and interest (including, without limitation, all copyrights) in and to any and all recordings made by them and in and to any and all video that I have provided in connection with my application and any other materials that I have provided or may provide in connection with my application or the Program (collectively, the “Materials”), including, without limitation, the right to edit, alter or modify the Materials and to use all or part of the Materials and my Likeness in any and all media now known or hereafter devised worldwide, in perpetuity. Without in any way limiting the foregoing, if I perform or include any music (other than music supplied to me by Producer) in connection with my application or the Program, I represent and warrant that I own all rights to such music, and I grant Producer the right to record, reproduce and publicly perform any such music in and in connection with the Program or any other work. Without in any way limiting the waivers and releases set forth herein, I waive any claims to royalties of any kind, whether accruing now or in the future, from Producer and NBCUniversal for the use of any such music, including, without limitation, any applicable copyright, public performance, mechanical and synchronization royalties. I further agree that Released Parties may use my Likeness and the Materials in connection with any promotion, publicity, marketing or advertisement. I grant the rights hereunder whether or not I am selected to participate in the Program in any manner whatsoever. I understand that I will not be paid any money for giving Released Parties these rights or for signing this application. (c) I authorize Producer and any person or entity designated by Producer to investigate, access and collect information about me, about any of the statements made by me in my application, any supporting documents and any other documents that I have signed or provided or do sign or provide in connection with my application to be selected as a participant in the Program, or any other written or oral statements I make in connection therewith, to the maximum extent permitted by law. Without limiting the foregoing, I irrevocably authorize Producer and any person or entity designated by Producer to secure information about me and my experiences from my current and former employers, associates, friends, family members, educational institutions, government agencies, credit reporting agencies, any branch of the military, and any references I have provided, and I irrevocably authorize such parties to provide information concerning me. I hereby unconditionally and irrevocably release and forever discharge Producer, the persons or entities designated by Producer, and all such parties and persons from any and all liabilities arising out of or in connection with any such investigation. To the maximum extent permitted by law, I specifically authorize investigation of my employment records, medical records, and government records, including but not limited to my motor vehicle records, criminal records, civil records, military records, credit reports, and consumer report(s). I acknowledge and agree that any such information obtained by Producer or by any person or entity designated by Producer pursuant to this paragraph or otherwise may be used for purposes of selecting participants in the Program or in the course of producing the Program, and may be described or otherwise related in and in connection with the Program, in and in connection with another program, and in and in connection with any advertising, promotion or publicity for the Program or other program, to the maximum extent permitted by law. (d) I understand that the participant selection process will involve subjective decisions made by certain individuals selected by Producer and NBCUniversal in their sole discretion. I understand that the participant selection process may also involve subjective decisions made by the public. I further understand that those certain individuals, NBCUniversal, Producer and other persons or entities may be acquainted with or have some familiarity with some or all of the applicants to varying degrees. I further acknowledge and agree that Producer reserves the right to consider and select participants who are not able to attend an open casting call and that Producer shall have sole discretion and control over every aspect of selecting participants. I understand and agree that all participant selection and elimination decisions shall be final and binding on me in all respects, and shall not be subject to challenge or appeal. (e) I understand that in and in connection with the participant selection process and the Program, I may reveal and/or communicate, and other parties (including, without limitation, other participants, the Producer, the Program talent and/or NBCUniversal) may reveal and/or communicate information about me of a personal, private, surprising, defamatory, disparaging, embarrassing or unfavorable nature, and that my actions and the actions of others participating in the participant selection process and/or in the Program may be embarrassing or of an otherwise unfavorable nature that may be factual or fictional. I further understand that my appearance, depiction, and/or portrayal in and in connection with the Program or otherwise, and my actions and the actions of others displayed in and in connection with the Program or otherwise, may be disparaging, defamatory, embarrassing or of an otherwise unfavorable nature, may expose me to public ridicule, humiliation or condemnation, and may portray me in a false light. I further understand that any information regarding me that Producer may disclose during the Program or otherwise may be more or less favorable than similar information disclosed by Producer regarding other participants. I acknowledge and agree that Producer, NBCUniversal, and any entity that sponsors, advertises in, exhibits or otherwise exploits the Materials, the Program or any other production, and any of their licensees, successors and assigns, shall have the right (but not the obligation): (a) to include any such information and any such appearance, depiction, portrayal, actions and statements in the Program or in any other exhibition or exploitation of the Materials, and (b) to exhibit, broadcast and otherwise exploit the Materials and the Program containing any such information and any such appearance, depiction, portrayal or actions. I understand and acknowledge that, while such conduct might otherwise constitute an actionable tort, I have freely and knowingly consented to such conduct. The waivers, releases and indemnities in this application and any other agreement that I have executed or that I may execute in connection with the Program and/or any other production expressly apply to any such inclusion and exploitation. 9) CONFIDENTIALITY. I understand that Producer and Network are involved in a competitive industry in which confidentiality is a valuable asset. I acknowledge that, in my capacity with Producer and Network, I may be provided with Confidential Information and maintaining this Confidential Information is vital to the success of the Program and Producer’s and Network’s businesses. Whether or not I am selected to be a participant on the Program, I shall keep in strictest confidence and shall not, and shall not authorize or cause others to, directly or indirectly, use or disclose to any third party at any time (i.e., prior to, during, or after the taping or exhibition of any episode of the Program) any of the following, which is the exclusive property of Producer or NBCUniversal: any information or materials that I may read, hear or otherwise acquire or learn in connection with or as a result of my participation in or in connection with the Program, including without limitation, any information or materials concerning or relating to Producer or to NBCUniversal, the business of Producer or NBCUniversal, any program produced by Producer or exhibited by NBCUniversal, including, without limitation, any information concerning or relating to the Program, the participant selection process, the Program applicants, the Program participants, the location(s) of the Program, the events contained in the Program, the outcome of any episode of the Program, and the contents of this application or any other agreement or document that I sign, have signed or receive from Producer or NBCUniversal at any time(collectively, the “Confidential Information”). I acknowledge and agree that my obligations with respect to confidentiality set forth in this application shall continue in perpetuity or until terminated by NBCUniversal by giving me written notice of termination. In no event will I have the right to terminate my confidentiality obligations under this application. Without limiting the above, I acknowledge that the obligations set forth in this paragraph 9 prohibit me from using Confidential Information for personal profit or the profit of others, such as betting, trading and wagering based on such Confidential Information, or recommending or suggesting that anyone else do so. I acknowledge that in the event I breach the confidentiality or any other provisions of this application, my breach may, in the sole discretion of Producer or NBCUniversal, result in my being disqualified to participate as a participant in the Program. I further acknowledge that a breach by me of any of the confidentiality provisions of this application would cause Producer and NBCUniversal irreparable injury and damage that cannot be reasonably or adequately compensated by damages in an action at law, and, therefore, I hereby expressly agree that Producer and NBCUniversal shall be entitled to injunctive and other equitable relief to prevent and cure any breach or threatened breach of any of the confidentiality provisions of this application by me. I understand that nothing in this paragraph or this application generally prevents me from: (a) discussing or disclosing information about conduct that I have reason to believe is unlawful; or (b) discussing or disclosing any matter I am entitled to discuss or disclose under applicable law. I understand that nothing in this paragraph or this application restricts me from reporting or providing information related to potential legal violations to any governmental agency or entity (e.g., SEC, OSHA, DOJ) without notifying Producer or NBCUniversal (“Whistleblower Activity”). Producer and NBCUniversal will not retaliate against me for any Whistleblower Activity, and nothing in this application requires me to waive any monetary award that I may legally be entitled to as a result of Whistleblower Activity. 10) RELEASE AND AGREEMENT NOT TO SUE. To the maximum extent permitted by law, I irrevocably and unconditionally release each of the Released Parties from any and all liability arising out of my participation in or in connection with the Program, including, without limitation, the recording of my Likeness and the Materials, my participation in the participant selection process, and any exploitation of the Program, my Likeness or the Materials, on any legal theory to the extent that such claims are caused by, arise from, or relate in any way to the negligence of the Released Parties (collectively, the “Released Claims”). The term “Released Parties” shall mean and refer to Producer, Network (as defined below), all entities and platforms of NBCUniversal Media, LLC, Comcast Corporation, any other licensees or assignees of the Program or the Materials, the other participants in the Program, all other persons and entities connected with the Program, all parent, subsidiary, related and affiliated entities, licensees, successors, assigns, sponsors and advertisers of each of the foregoing, all of the respective directors, officers, principals, executives, on-air talent, employees, agents, contractors, partners, shareholders, representatives and members of each of the foregoing, and the respective heirs, next of kin, spouses, guardians, representatives, executors, administrators, successors, licensees and assigns of each of the foregoing. 11) As used herein, “Producer” shall include, its licensees, successors, and assigns, and each of their respective officers, directors, shareholders, employees, agents, and representatives. As used herein, “Network” shall mean one or more of the television networks or platforms (e.g., Peacock streaming platform) of NBCUniversal Media, LLC or its related and/or affiliated entities. I agree that Producer may license, assign, and otherwise transfer this application and all rights granted by me to any person or entity. 12) To the maximum extent permitted by law, I waive any and all rights I may have under section 1542 of the Civil Code of California, and every like provision in any foreign jurisdiction. Section 1542 provides as follows: A general release does not extend to claims that the creditor or releasing party does not know or suspect to exist in his or her favor at the time of executing the release and that, if known by him or her, would have materially affected his or her settlement with the debtor or released party. 13) MEDIATION & ARBITRATION. WHERE ANY CONTROVERSY, DISPUTE, OR CLAIM IN CONNECTION WITH THIS AGREEMENT OR MY PARTICIPATION IN THE PROGRAM (INCLUDING THE ENFORCEMENT, SCOPE, OR APPLICABILITY OF THIS AGREEMENT TO ARBITRATE) (A “DISPUTE”) ARISES AND CANNOT BE RESOLVED BETWEEN THE PARTIES, THE PARTIES AGREE TO FIRST TRY TO RESOLVE SUCH DISPUTE THROUGH CONFIDENTIAL MEDIATION. IF MEDIATION IS UNSUCCESSFUL, THEN ALL DISPUTES, INCLUDING THE SCOPE OR APPLICABILITY OF THIS AGREEMENT TO ARBITRATE, SHALL BE RESOLVED BY FINAL AND BINDING ARBITRATION BEFORE A SINGLE NEUTRAL, ADMINISTERED BY JAMS OR ITS SUCCESSOR (“JAMS”) IN ACCORDANCE WITH ITS COMPREHENSIVE RULES AND PROCEDURES (COLLECTIVELY, “JAMS RULES,” AVAILABLE AT WWW.JAMSADR.COM AND PROVIDED IN HARD COPY UPON REQUEST). THE JAMS RULES FOR SELECTION OF MEDIATORS AND ARBITRATORS WILL BE FOLLOWED, EXCEPT THAT ANY MEDIATOR OR ARBITRATOR WILL BE: (A) EXPERIENCED IN THE ENTERTAINMENT INDUSTRY AND] LICENSED TO PRACTICE LAW IN CALIFORNIA; OR (B) A RETIRED JUDGE. TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, I AGREE TO WAIVE MY RIGHT TO COMMENCE, TO BECOME A PARTY TO, OR TO BE OR REMAIN A PARTICIPANT IN, ANY GROUP REPRESENTATIVE, CLASS, COLLECTIVE, OR HYBRID CLASS/COLLECTIVE ACTION IN ANY COURT, IN ANY ARBITRATION, OR IN ANY OTHER FORUM ARISING FROM OR RELATING TO THIS AGREEMENT OR MY PARTICIPATION ON THE PROGRAM IN ANY WAY, UNLESS OTHERWISE PROHIBITED BY APPLICABLE LAW. I AGREE THAT ANY CLAIM BY ME SHALL BE HEARD IN ARBITRATION WITHOUT CONSOLIDATION OF SUCH CLAIM WITH ANY OTHER PERSON OR ENTITY’S CLAIM, EXCEPT AS OTHERWISE AGREED TO BY PRODUCER AND ME. UPON THE CONCLUSION OF ANY ARBITRATION PROCEEDINGS, THE ARBITRATOR SHALL RENDER FINDINGS OF FACT AND CONCLUSIONS OF LAW AND A WRITTEN OPINION SETTING FORTH THE BASIS AND REASONS FOR ANY DECISION REACHED. ALL SUCH PROCEEDINGS WILL BE CONDUCTED IN THE COUNTY OF LOS ANGELES. MY AGREEMENT TO MEDIATE AND ARBITRATE ANY AND ALL DISPUTES SHALL EXTEND TO THE RELEASED PARTIES. THE PARTIES AGREE THAT WITH RESPECT TO THE MEDIATION OR ARBITRATION OF ANY FEDERAL OR STATE CLAIM I BRING THAT ARISES FROM UNWAIVABLE PUBLIC RIGHTS, WHETHER STATUTORY OR NONSTATUTORY, THE FOLLOWING SHALL APPLY: THE BURDEN OF PROOF SHALL BE THE SAME AS IT WOULD BE IN A JUDICIAL PROCEEDING AND THE DECISION SHALL BE BASED ON THE INTERNAL SUBSTANTIVE LAWS OF THE STATE OF CALIFORNIA, TO THE EXTENT THAT SUCH LAWS DO NOT CONFLICT WITH THE FEDERAL ARBITRATION ACT, WHICH GOVERNS THIS AGREEMENT TO ARBITRATE, THE ARBITRATOR MAY AWARD ANY REMEDY THAT WOULD HAVE BEEN AVAILABLE IN COURT; THE PARTIES SHALL BE PERMITTED DISCOVERY ADEQUATE TO SECURE THE NECESSARY INFORMATION TO PRESENT SUCH CLAIM OR DEFEND AGAINST SUCH CLAIM; AND PRODUCER SHALL PAY ALL TYPES OF COSTS THAT ARE UNIQUE TO MEDIATION OR ARBITRATION. THE PARTIES WILL OTHERWISE BEAR THEIR OWN FEES AND COSTS, INCLUDING ATTORNEYS’ FEES AND EXPERT FEES. ANY DISPUTES AS TO THE REASONABLENESS OF COSTS AND EXPENSES SHALL BE DETERMINED BY THE ARBITRATOR. IN THE EVENT OF ANY ACTUAL OR ANTICIPATED BREACH BY ME OF MY EXCLUSIVITY, PUBLICITY, OR CONFIDENTIALITY OBLIGATIONS UNDER THIS AGREEMENT, PRODUCER MAY SEEK AND OBTAIN INJUNCTIVE AND OTHER EQUITABLE RELIEF FROM ANY COURT OF COMPETENT JURISDICTION. PRODUCER MAY ALSO PURSUE OTHER REMEDIES AGAINST ME FOR ANY BREACH OF THIS AGREEMENT. I AGREE THAT GIVEN THE UNIQUE NATURE OF THE ENTERTAINMENT INDUSTRY, AND THE IRREPARABLE DAMAGE TO PRODUCER, NETWORK AND THEIR LICENSEES THAT WOULD RESULT FROM DELAYING OR PREVENTING THE EXHIBITION OF ANY PROGRAM PRODUCED HEREUNDER, I MAY NOT SEEK OR OBTAIN INJUNCTIVE RELIEF IN CONNECTION WITH THIS AGREEMENT. TO THE GREATEST EXTENT PERMITTED BY APPLICABLE LAW, MEDIATION AND ARBITRATION SHALL BE CONFIDENTIAL (EXCEPT AS BETWEEN THE PARTIES AND THIRD PARTIES INVOLVED IN DISCOVERY), INCLUDING PLEADINGS, EXHIBITS, AND/OR TESTIMONY. A SUCCESSFUL PARTY MAY MAKE APPLICATION TO THE ARBITRATOR FOR AN AWARD OF ATTORNEYS’ FEES AND/OR COSTS, AND THE ARBITRATOR MAY AWARD SUCH FEES AND COSTS TO THE EXTENT CONSISTENT WITH APPLICABLE LAW. IF ANY PORTIONS OF THE DISPUTE RESOLUTION PROVISIONS IN THIS AGREEMENT ARE FOUND TO BE INVALID, ILLEGAL, OR UNENFORCEABLE, THAT PORTION SHALL BE SEVERED FROM THE REST AND SHALL NOT AFFECT THIS AGREEMENT TO RESOLVE ALL DISPUTES THROUGH MEDIATION AND ARBITRATION. 14) APPLICATION OF FAA AND GOVERNING LAW. I agree that the Federal Arbitration Act, 9 U.S.C. § 1, et seq. (“FAA”) governs any and all of the arbitration provisions contained herein and any arbitration proceeding related to or arising from this Agreement. Notwithstanding the foregoing, this Agreement shall be construed and enforced in accordance with the substantive laws of the State of California, to the extent they do not conflict with the FAA, without regard to the state’s conflict of law provisions. The exclusive venue for any dispute held to be non-arbitrable, shall be the Superior Court of California located in the County of Los Angeles and the United States District Court for the Central District of California, and the parties submit to the in personam jurisdiction of those courts and waive any objections thereto. 15) ELECTRONIC SIGNATURES. This application may be executed by original, facsimile or electronic signature in a form acceptable to Producer. 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. 16) SEVERABILITY. The illegality, invalidity or unenforceability of any provision of this application shall in no way affect the validity or enforceability of any of the remainder of this application, which shall be enforced to the maximum extent permitted by law. To learn more about how Producer collects and uses your personal information in connection with this production, refer to Producer’s Privacy Notice at https://asmithco.com/asc-privacy-policy/. To the extent NBCUniversal also collects and uses your information as a participant in connection with the production, please see https://www.nbcuniversal.com/privacy/participant. These notices may be updated from time to time. I have read, understand, and agree with the foregoing. I UNDERSTAND THAT I AM GIVING UP CERTAIN LEGAL RIGHTS UNDER THIS APPLICATION, INCLUDING, WITHOUT LIMITATION, MY RIGHT TO FILE A LAWSUIT IN COURT WITH RESPECT TO ANY CLAIM ARISING IN CONNECTION WITH THIS APPLICATION.

By checking this box, you agree to the above terms.

BY SIGNING BELOW, I ACKNOWLEDGE AND AGREE THAT I HAVE READ, UNDERSTAND, AND AGREE WITH THE FOREGOING.

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* Collected pursuant to 18 U.S.C. §§ 2256 et seq.