Isagenic Form – Fill Out and Use This PDF

WELCOME TO ISAGENIX

SOLUTIONS TO TRANSFORM LIVES™

Weight Loss

30-Day Cleansing and Fat Burning System

Starting at $298/ about $10 per day

Energy Value Pak

Starting at $605/ about $21 per day

Energy System

Starting at $306/ about $11 per day

Performance Value Pak

Starting at $623/ about $21 per day

Performance System

Starting at $310/ about $11 per day

Healthy Aging Value Pak

Starting at $629/ about $21 per day

Healthy Aging

and Telomere

Support System

Starting at $302/ about $11 per day

By signing, you authorize your enrolling sponsor to begin processing your customer membership application and your initial order (and Autoship order, if applicable) by using the information you supply here. The online Customer Application and Agreement Terms and Conditions, including the Isagenix Privacy Policy and Return and Refund Policy, contain the terms of your agreement. You will have the opportunity to review them at the time you enroll. They are also available online at Isagenix.com and may be provided to you via email. Please note that this form contains information to facilitate the enrollment process for new Isagenix members and is not intended as a substitute for full disclosure of membership terms and conditions. Here are a few things to know now:

Sales taxes and shipping charges apply and are determined by the ship-to address. We ofer a limited product satisfaction guarantee. For details please see our Return and Refund Policy available at Isagenix.com. A full copy of the policy will accompany your shipments. Isagenix Customer

Membership Accounts renew annually at the fee rate applicable to your Customer Type at the time of renewal, plus applicable sales tax.

The personal data disclosed in establishing your Isagenix account as well as personal data collected is used by employees, associates, and vendors taking part in the operation and management of our distribution network. Accordingly, you consent to the disclosure of your name, telephone number(s), fax number, and/or e-mail address(es), shipping address(es) and other contact information listed on your application or as updated, and information regarding your Isagenix purchases (excluding payment card/account information), to Isagenix’s internal departments, external service providers, Enrolling Sponsor, Placement Sponsor, and Support Team. You agree that Isagenix or a party acting on its behalf may contact you by telephone using automated technology (e.g., an auto-dialer or pre-recorded messaging), text messaging, and email, and consent and agree to being contacted in this manner at the telephone and fax number(s) and email address(es) that you provide. Your carrier’s standard rates will apply for calls and text messages. You may opt-out of receiving text messages, facsimile transmissions, telephone calls and emails by going through your online account

or by contacting us at the email address, physical address or telephone number below.

BY SIGNING, YOU AUTHORIZE ISAGENIX, ITS AFFILIATES, INDEPENDENT ASSOCIATES, AND REPRESENTATIVES, TO CONTACT YOU BY PHONE, FAX, MAIL, TEXT, AND E-MAIL CONCERNING ISAGENIX RELATED MATTERS.

The Isagenix products you purchase are for your personal use (or the personal use of your family members living in your same household) only and you may not ofer, display, sell, or facilitate the ofering, displaying, or selling of Isagenix’s products in any manner (including online auction websites, such as eBay or amazon, e-commerce websites, retail websites, bazaars, lea markets, etc.) by anyone else.

You may CANCEL this transaction without penalty or obligation, within THREE BUSINESS DAYS from the above date (five business days if you reside in Alaska, fifteen days if you reside in Wisconsin, and thirty days if you reside in Kentucky), or at any other time, by submitting a written notice to Isagenix in one of the following ways: mail/courier addressed to Isagenix International, LLC, Attn: Account Requests, 155 E. Rivulon Blvd, Gilbert, AZ 85297; facsimile at (480) 636-5386; or email from your email address on ile with Isagenix to AccountRequests@IsagenixCorp.com. Notices must contain your signature (unless sent from your email address on ile with Isagenix), printed name, address, and, if known, your Isagenix account number. Isagenix will process notices and issue refunds, if any, in accordance with applicable law.

I Would Like Monthly

Autoship

Rewards

Yes No

Best Value (Preferred Customer with Autoship): Save about 25% of suggested retail pricing on every BV product order for one year; save an additional 5% on any pak or system in today’s order when you pay a $29 annual Membership fee and set up a convenient monthly Autoship order.

Better Value (Preferred Customer without Autoship): Save about 25% of suggested retail pricing on every BV product order for one year when you pay a $39 annual Membership fee.

Good Value (Customer): Just for setting up a Customer Membership account, you’ll save about 10% of suggested retail pricing on every BV product order.

____ (customer initials) I wish to participate in the monthly Autoship program and authorize Isagenix to charge my credit card or debit card for the amount of my monthly

Autoship orders, or if applicable, deduct the amount from my bank account. I understand all Autoship orders are subject to applicable sales tax and shipping and handling costs, all of which will be added to the order total.

Sign up on Autoship. This optional program allows you to establish automatically recurring monthly product shipments. Your irst Autoship order will be shipped and billed about 28 days after your initial order. Subsequent Autoship orders will be shipped and billed on a 28-day rolling cycle. You must select at least one commissionable product to set up an Autoship order, but there is no minimum purchase requirement. You understand that periodic shipments of the products that you have ordered will occur without any further action by you. You are the only person who is authorized to establish, cancel, or change your participation in the Autoship program or to authorize others to do so on your behalf. You may cancel or make changes to your Autoship order at any time by notifying Isagenix by email at Support@IsagenixCorp.com or by phone at 877-877-8111. Changes and notice of cancellation must be received by Isagenix at least one (1) business day prior to your monthly Autoship processing date; otherwise, the changes or cancellation will become efective in the month following the month in which Isagenix receives your notice of cancellation. Please refer to the Customer Membership Terms and Conditions for additional details.

18-JB007-AB•030118