Coach App Jason

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Welcome!

Youre on your way to ofcially becoming a Team Beachbody Coachand the CEO of your own health and tness business. Begin YOUR success story with a Beachbody Challenge
Pack. As a Coach, you wont sell miracles. Youll share successes! Choose a Challenge Pack below so you can experience REAL results rsthand. Youll nd that telling your own story is
much more powerful than any sales script.
APPLICANT INFORMATION
First Name Last Name
Business entity name (if you will operate your business under a company, LLC, or corporation)
Social Security Number Federal Tax ID Number (if operating under a business entity)
Residence Address
City, State, and ZIP code
Billing Address (if different from residence address)
City, State, and ZIP code
Shipping Address (if different from residence address)
City, State, and ZIP code
Phone Fax
Email Date of Birth
SPONSOR INFORMATION
Name
ID Number
Screen Name
Phone
Email
Sponsors Signature
By signing this Application and Agreement, I agree to fulll my obligations as the Sponsor
of the applicant as described in the Team Beachbody Policies and Procedures. I certify that
I have provided the most current version of the Team Beachbody Policies and Procedures
and Compensation Plan to the Applicant prior to his/her signing the Agreement.
Coach Application
Please print clearly in blue or black ink. Please note that this
Application cant be processed unless all fields are completed.
If you are an active member of the military, please check this box and list your title and branch of service.
Upon verification of application, active members of the military will have the cost of the Game Plan Tools Kit waived.
In addition, the monthly Business Service Fee will be waived for the duration of their active duty.
Yes

No Are you a Team Beachbody

Customer? If so, please include your customer number here:


Business Entity If your account will be owned by a business entity, you must complete the Business
Entity Application and submit it together with this completed Application and Agreement.
400 Continental Blvd., 4th floor, El Segundo, California 90245
Phone: 1 (800) 240-0913 Fax: 1 (213) 201-7225
I have carefully read the terms and conditions on the back of this Application and Agreement, the Team Beachbody Policies and Procedures, and the Team Beachbody Compensation Plan
(available online at TeamBeachbody.com or provided upon request), and agree to abide by all terms set forth in these documents. I understand that I have the right to terminate my Independent
Team Beachbody Coach business at any time, with or without reason, by sending written notice to the company at the address listed above. I further understand and agree that Team Beachbody may
terminate this Agreement, with or without reason, upon 30 days advance notice to me. By signing below, I certify that I am at least 18 years of age and that I have the right to enter into this Agreement
and execute this Application. Application information is subject to verification for proper registration. Applicants will be contacted with any discrepancies and will have 72 hours from notification to cure.
You, the buyer, may cancel this transaction and obtain a refund of all charges paid at any time
prior to midnight of the 3rd business day after the date of this transaction (the 5th business
day for Alaska residents). See the reverse side of this form for an explanation of this right.
Payment Information (Participation requires payment by credit card) Visa MasterCard American Express Discover
Card Number ______________________________________________________________________ Expiration Date _________________________________ CVV (security code) __________
Name As It Appears on Card ________________________________________________________ Authorized Signature ___________________________________________________________
Address Where Card Statement Is Mailed ___________________________________________________________________________________________________________________________
I expressly authorize Team Beachbody/Beachbody, LLC, to charge the credit card number above for all charges indicated on this Application and Agreement.
Authorized Signature Date

$160 CHALLENGE PACKS (a $25.75 savings)
Choice of Fitness Program (Pick 1)
Power 90

Hip Hop Abs

Brazil Butt Lift

Turbo Jam

Slim in 6

Shakeology

your favorite flavor(s) delivered via Home Direct*


(Pick 1)
Chocolate Greenberry Combo Packets (12&12)
30-day FREE trial membership in the Team Beachbody Club**
Game Plan Tools Kit & Business Essentials Starter Program
$180 CHALLENGE PACKS (a $26.33 savings)
Choice of Fitness Program (Pick 1)
10-Minute Trainer

Body Gospel

RevAbs

ChaLEAN Extreme

INSANITY: THE ASYLUM

Shakeologyyour favorite flavor(s) delivered via Home Direct*


(Pick 1)
Chocolate Greenberry Combo Packets (12&12)
30-day FREE trial membership in the Team Beachbody Club**
Game Plan Tools Kit & Business Essentials Starter Program
$39.95 GAME PLAN TOOLS KIT
& BUSINESS ESSENTIALS STARTER PROGRAM ONLY
GAME PLAN TOOLS KIT:
Accelerate your success from day 1! The Game Plan Tools Kit
has been specifically designed to give you all the essentials youll
need to build a powerful Team Beachbody business. This CD/DVD
set includes:
Beachbodys most popular sharing videos
How-to instructions for holding great events
Support materials youll need to get started now
BUSINESS ESSENTIALS STARTER PROGRAM:
First months service fee
Customizable Web site that can act as your online store
Online support from Team Beachbody community
$205 CHALLENGE PACKS (a $44.69 savings)
Choice of Fitness Program (Pick 1)
P90X



INSANITY

TurboFire

P90X2

Shakeologyyour favorite flavor(s) delivered via Home Direct*


(Pick 1)
Chocolate Greenberry Combo Packets (12&12)
30-day FREE trial membership in the Team Beachbody Club**
Game Plan Tools Kit & Business Essentials Starter Program
Note! Business Service Fees
As a Coach, youll have instant access to a network of more than 65,000 Coaches and an additional 600,000
Team Beachbody Club members! To make sure your business, Web sites, and detailed reporting stay
up and running, we require a small monthly fee of $14.95 (or less than $.50/day). Your credit card will be
automatically charged once per month. You can cancel any time to avoid future charges.
Mail the completed, signed original Application and Agreement to: Team Beachbody, 400 Continental Blvd., 4th floor, El Segundo, California 90245, or fax to 1 (213) 201-7225. If this application is faxed, you must fax both the front and
back of the application. Please allow up to 48 hours for processing of this application.
* After your rst 30 days, you will be automatically charged. The cost is just $89.99 a month (or about $3.00/day) and includes FREE shipping to your doorstep. Your credit card will be charged once per month. You can cancel at any time to
avoid future charges.
**After 30 days, you will be automatically charged. The cost is just $2.99 a week, billed $38.87 a quarter in advance to the credit card you enter today. You can cancel at any time to avoid future charges.
Rev. 01/30/12
Jason Paul
101079
Jason Paul
850-658-8940
[email protected]

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