OPERATION OUCH! Ouch & About APPLICATION FORM

OPERATION OUCH! Ouch & About
APPLICATION FORM
Operation Ouch! Ouch & About is back!
Are you fascinated by the human body?
Are you aged 8-12 years old and do you have a medical mystery that
you want to show off?
If you’re anxious about an ailment, or curious about a condition then
the Ouch-Mobile could be the place for you!
If you’re interested, print off the application form, fill it in and return it
to the address given.
All completed applications should be sent back to us
Friday 10th April 2015 as we will be filming in May 2015.
You must have your parent's or guardian’s permission before
completing the form and you must be available for filming
during May 2015.
There are more details about how to apply on the form. Please read
them carefully. We will consider everyone who applies equally. Only
people who have made it to the next round will be contacted by the
production team.
Thank you and good luck!
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OPERATION OUCH! OUCH & ABOUT
SELECTION CRITERIA
You need to be interested in and enthusiastic about the human body
– do you wonder how your body works, what it’s made of and why
yours does the things it does?
You should have an interesting medical condition, and be happy to
talk about it, and show it to Dr. Chris or Dr. Xand. (In the past we
have featured conditions such as eczema, warts, moles, birthmarks,
bendy limbs, flat feet and more – you may have something similar or
something completely different – we’re happy to consider all
conditions, whatever they may be).
You will want to find out more about your medical condition.
Your medical condition needs to be something we can see –
something you can show us.
If you think your condition will go away quickly, unfortunately we may
not be able to feature you.
You need to still have your medical condition in May 2015.
You will be filmed so don’t apply if you don’t like being on camera.
We will consider everyone who applies equally. Only people
who have made it to the next round will be contacted by a
member of the production team.
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OPERATION OUCH! OUCH & ABOUT
APPLICATION FORM:
To be completed by you
Please read the following carefully.
Once you have filled in your form you need to attach a recent
photograph of yourself, and your medical condition, AND make sure a
parent/guardian has signed it.
There are 2 ways to send in your application form.
Via email to:- [email protected]
Not forgetting to scan in the consent form with your
parent’s/guardian’s signature.
OR
Via Post to:OPERATION OUCH!
MAVERICK TELEVISION
3-7 RAY ST
FARRINGDON
LONDON
EC1R 3DR
REMEMBER to send a recent photograph of yourself and your
medical condition, and make sure a parent/guardian has signed it. If
your application isn’t signed by a parent or guardian then it cannot be
considered.
We are sorry, but photos cannot be returned.
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OPERATION OUCH! OUCH & ABOUT
APPLICATION FORM
ABOUT YOU
•
Name
•
Age
•
Date of birth
ABOUT YOUR MEDICAL MYSTERY/CONDITION
•
What is your medical
mystery / condition? •
Has it been diagnosed
by a doctor?
(Please detail any
treatment you have so
far)
•
Why would you like to
visit the Ouch-mobile?
•
Why would you like to
show your medical
ailment to Dr Chris or Dr
Xand?
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•
Are you happy to show
your medical condition
on TV and talk about it?
And if so, why?
•
What 3 questions would
you like to ask Dr Chris
or Dr Xand about your
medical ailment?
•
What hobbies do you
have?
•
How do your friends
describe you?
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•
Why do you think you
should be considered for
Operation Ouch! Ouch &
About?
THANK YOU FOR FILLING OUT OUR FORM
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PARENTAL CONSTENT FORM
To the Parent or Guardian:
Your child would like to apply to take part in the CBBC television programme
Operation Ouch! This programme is presented by twin doctors Dr Chris & Dr
Xand, and aims to explain to the audience everything they’d like to know about
the human body, and what makes it so amazing. We are looking for children
aged between 8-12 to take part in one of the show’s strands Ouch & About. This
is where children visit the Ouch-mobile, a mobile drop-in clinic for children to
show the doctors their medical ailments, and find out more about them. We do
not aim to diagnose conditions, so would always advise parents to seek medical
advice from their own GP.
To take part a parent or guardian will be required to attend the filming.
The show will be transmitted on the CBBC Channel and possibly other BBC
channels, the BBC website and iPlayer.
Filming will take place in May 2015, and successful candidates will be required to
attend with a parent or guardian for the duration of one day.
Please note that more precise dates will be given nearer the time of filming.
For their application to be considered, your child needs to provide the completed
application form and a signed parental consent form, which should be sent
directly to the external production company, Maverick Television, who are
making the programme for the BBC.
As we are looking for a variety of different medical conditions from applicants and
receive a large number of applications, not everyone will be successful. Only
those who make it to the next round will be contacted by Maverick TV.
If the application is successful, the information provided may be used by the
programme, but it will not be used for any other purpose. Your details will not be
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stored in a database and all applications will be destroyed once they have been
processed.
Maverick Television has a Child Protection Policy and all staff are in compliance
with it.
FOR PARENTS TO COMPLETE:
1. I confirm that my child will be aged between 8 and 12 on 31ST May 2015, is not
a close relative of a BBC or Maverick Television employee and is a resident of
the UK.
2. Does your child (or any family member that the child lives with) have any other
medical conditions, aside from the condition we would feature on the show (e.g.
asthma, allergies, diabetes, epilepsy etc) that we should be made aware of? YES
[ ] NO [ ]
If yes please give details:
………………………………………………………………………………………….
………………………………………………………………………………………….
3. Does your child have any physical or mental disabilities that we should be
aware of? (We actively encourage applications from all children). YES [ ] NO [ ]
If yes please give details:
………………………………………………………………………………………….
………………………………………………………………………………………….
………………………………………………………………………………………….
4. Has your child appeared in any television programmes before? YES [ ] NO [ ]
If yes please give details:
………………………………………………………………………………………….
………………………………………………………………………………………….
………………………………………………………………………………………….
5. You must be able to commit to all the filming days required which are currently
expected to be 1 date within May 2015. Do you or your child have any days
within May 2015 for which you are unavailable? YES [ ] NO [ ]
If yes please give dates:
………………………………………………………………………………………….
………………………………………………………………………………………….
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6. When selecting applicants for Operation Ouch! Ouch & About the following
will be taken into account: nature of medical condition, enthusiasm, an interest in
the human body, lively characters who are comfortable being filmed. Initial
selection will be based on the application forms. In addition the producers may
(but may not) invite short listed applicants for an interview via skype or
telephone. We will be looking for a mix of finalists to reflect the range in age,
location, gender and diversity of children in Britain. The production team's
decisions regarding selection to the programmes are entirely at their discretion
and are final.
I understand that the information provided in my child’s application will be sent
directly to Maverick Television and not to the BBC: YES [ ] NO [ ]
I confirm that the information I have supplied is true and accurate and hereby
give consent for my child to proceed further in the application process, and if
successful, to take part in Operation Ouch! Ouch & About.
Signature of Parent / Guardian
………………………………………………………………………………………….
Please print name
………………………………………………………………………………………….
Date
………………………………………………………………………………………….
Email:
………………………………………………………………………………………………
Address:
………………………………………………………………………………………………
.
………………………………………………………………………………………………
.
………………………………………………………………………………………………
Contact Numbers: Home………………………….
Mobile………………………….
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Operation Ouch! Ouch & About Terms and Conditions of Entry
All applicants must be between the ages of 8 and 12 years as of 31st May
2015.
All applicants must be resident in the UK
Any child with immediate members of their family or members of their
household who are employees/directors/agents of either Maverick
Television or BBC are not eligible to appear on the programmes or
participate in the application process.
All applicants must be accompanied by a parent or a legal guardian at any
initial stages and during filming
Submission of an application form and compliance with the above does not
in any way constitute an offer to appear on the programme.
The production team’s decisions regarding selection to the programme are
final.
Selection to take part in the programme may be dependent on consents
being obtained, if needed, from schools and/or local authorities.
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