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Product Order Form - Coach

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<strong>Product</strong> <strong>Order</strong> <strong>Form</strong>CUSTOMER ORDER *Customer orders must include <strong>Coach</strong> info for proper credit to be given for the order.COACH (Required)DateCustomer nameAddressCity State ZIP CodePhoneEmail (required)*Customer product orders should be accompanied by a Team Beachbody sales receipt.<strong>Coach</strong> name<strong>Coach</strong> ID#Please fax the completed <strong>Coach</strong> <strong>Order</strong> <strong>Form</strong> to Team Beachbody <strong>Coach</strong> Relations at1 (213) 201-7225 or email the form to <strong>Coach</strong>Relations@TeamBeachbody.com.Please allow 24–48 hours for processing. Prices shown are not inclusive of applicablesales tax or shipping and handling charges, which will be added to each order duringorder processing. See below for product return and guarantee information.CUSTOMER NAME COACH NAMEHOME DIRECT ORDERSIf you purchase a product that includes the Home Direct Program, you will receive your selected products every month (or in some circumstances,90 days). Your order will be shipped and your credit card will be charged every thirty (30) days. You may cancel your Home Direct <strong>Order</strong> at any time.However, to avoid the next charge on your card, you must cancel your order at least one (1) business day before your next scheduled ship date. Tocancel, please contact Team Beachbody Customer Service at 1 (800) 470-7870.PRODUCT SATISFACTION GUARANTEETeam Beachbody ® offers a 100 percent money-back satisfaction guarantee (less shipping and handling charges) to all customers and <strong>Coach</strong>esfor almost all of its products (excluding certain trial offers). Please review the details and specific guarantee with each applicable product (whichrange from 30 days to 90 days for product returns depending on the product).RETURN PROCEDURESThe following procedures apply to all returns for refund or exchange:• All merchandise must be returned directly to the Team Beachbody fulfillment center according to the directions on the packing slip by the <strong>Coach</strong>or customer who purchased it directly from Team Beachbody.• All products to be returned must have a Return Authorization Number, which may be obtained by calling Team Beachbody Customer Service at1 (800) 470-7870. This Return Authorization Number must be written on the outside of each carton returned.• The return must be accompanied by:(a) A copy of the original dated retail sales receipt; and(b) The product in its original container.Proper shipping carton(s) and packing materials are to be used in packaging the product(s) being returned for replacement, and the best and mosteconomical means of shipping is suggested. All returns must be shipped to Team Beachbody with shipping prepaid. Team Beachbody does notaccept shipping-collect packages. The <strong>Coach</strong> is responsible for risk of loss in shipping of returned product. If returned product is not received bythe Team Beachbody Distribution Center, it is the responsibility of the <strong>Coach</strong> to track and locate the shipment.• If a <strong>Coach</strong> is returning merchandise to Team Beachbody that was returned to him or her by a personal retail customer, the product must bereceived by Team Beachbody within thirty (30) days of the date on which the retail customer returned the merchandise to the <strong>Coach</strong>, and mustbe accompanied by the sales receipt the <strong>Coach</strong> gave to the customer at the time of the sale. No refund or replacement of product will be made ifthese conditions are not met.SHIPPING INFO *Standard $00.01–$500.00 8.25% of order subtotal (subject to a $5.95 minimum charge)$500.01–$1000.00 6% of order subtotal (subject to a $5.95 minimum charge)$1000.01+ 4% of order subtotal (subject to a $5.95 minimum charge)Rush $.01+ 12% of order subtotal (subject to a $14.95 minimum charge)*Additional charges may apply for shipments delivered outside the United States, and to U.S. Territories, Alaska, and Hawaii.CREDIT CARD INFOVisa MasterCard American Express DiscoverCardholder’s nameCard numberI authorize Beachbody, LLC, dba Team Beachbody,to charge my credit card for my order, and allrecurring Home Direct Program orders, plusshipping, handling, and applicable sales tax.Expiration date (MM/YYYY) CVV Code (3 digits on back of card for VS, MC, DI —4 digits on front of card for AX)Address on the credit card statementxCity State ZIP CodeSignature of cardholderPage 1 of 4Rev. 09/19/2012


<strong>Product</strong> <strong>Order</strong> <strong>Form</strong>CHALLENGE PACKSPRODUCT DESCRIPTION RETAIL CLUB COACH H.D. QTY TOTAL160 Pack (Power 90 ® , Turbo Jam ® , Brazil Butt Lift ® ,Slim in 6 ® , Hip Hop Abs ® )180 Pack (INSANITY: THE ASYLUM ® ,ChaLEAN Extreme ® , RevAbs ® ,10-Minute Trainer ® , Body Gospel ® )205 Pack (P90X ® , P90X2 ® , INSANITY ® , Tai Cheng,TurboFire ® )$160 $160 $160$180 $180 $180$205 $205 $205220 Pack (Body Beast ) $220 $220 $220245 Pack (LES MILLS PUMP) $245 $245 $245305 Pack (Ultimate Reset ) $305 $305 $305FITNESSPRODUCT DESCRIPTION RETAIL CLUB COACH H.D. QTY TOTAL10-Minute Trainer ® —Heavy Resistance $79.90 $71.91 $59.9310-Minute Trainer ® —Medium Resistance $79.90 $71.91 $59.9310-Minute Trainer ® Deluxe—Heavy Resistance $159.80 $143.82 $119.8510-Minute Trainer ® Deluxe—Medium Resistance $159.80 $143.82 $119.8510-Minute Trainer ® Upgrade Pack—Heavy Resistance$79.90 $71.91 $59.9310-Minute Trainer ® Upgrade Pack—Medium Resistance$79.90 $71.91 $59.93Body Beast $89.85 $80.87 $67.39Body Beast + Huge Stack $200.70 $180.63 $150.53Body Beast + Beast Stack $67.39 $229.23 $191.03Body Gospel ® Package $79.90 $71.91 $59.93Body Gospel ® Deluxe Upgrade $59.90 $53.91 $44.93Body Gospel ® Deluxe Package $139.80 $125.82 $104.85Body Gospel ® Sweat and Sculpt DVD $19.95 $17.96 $14.96Body Gospel ® LIVE! DVD $19.95 $17.96 $14.96Brazil Butt Lift ® $59.85 $53.87 $44.89Brazil Butt Lift ® Deluxe $119.70 $107.73 $89.78Brazil Butt Lift ® Deluxe DVDs $29.85 $26.87 $22.39Brazil Butt Lift ® Deluxe Upgrade $59.85 $53.87 $44.89Brazil Butt Lift ® Leandro’s Secret Weapon $19.95 $17.96 $14.96ChaLEAN Extreme ® $89.85 $80.87 $67.39ChaLEAN Extreme ® Deluxe Package $179.70 $161.73 $134.78ChaLEAN Extreme ® Deluxe Upgrade - Lg Ball $89.85 $80.87 $67.39ChaLEAN Extreme ® Deluxe Upgrade - Med Ball $89.85 $80.87 $67.39ChaLEAN Extreme ® Deluxe DVDs $59.85 $53.87 $44.89Chalene Johnson’s Get On The Ball! - Lg Ball $39.90 $35.91 $29.93Chalene Johnson’s Get On The Ball! - Med Ball $39.90 $35.91 $29.93Get Real with Shaun T $19.95 $17.96 $14.96Great Abs Guaranteed! ® $9.95 $8.96 $7.46Great Arms Guaranteed! $9.95 $8.96 $7.46Great Body Guaranteed! ® $24.95 $22.46 $18.71Great Buns Guaranteed! $9.95 $8.96 $7.46Great Stretch Guaranteed! $9.95 $8.96 $7.46Hip Hop Abs ® Package $59.85 $53.87 $44.89Hip Hop Abs ® Ultimate Results Package $59.85 $53.87 $44.89Hip Hop Abs ® Extreme DVD $19.95 $17.96 $14.96Hip Hop Abs ® Deluxe $119.70 $107.73 $89.78Ho’ Ala ke Kino $9.95 $8.96 $7.46INSANITY ® 60-Day Total-BodyConditioning Program$119.85 $107.87 $89.89INSANITY ® Deluxe Package $164.70 $148.23 $123.53INSANITY ® Deluxe w/ Mat and Bonus Workout $239.70 $215.73 $179.78INSANITY ® Deluxe Workouts $44.85 $40.37 $33.64INSANITY: THE ASYLUM ® Base Kit $89.85 $80.87 $67.39INSANITY: THE ASYLUM ® Deluxe Kit $179.70 $161.73 $134.78INSANITY: THE ASYLUM ® Deluxe Upgrade Kit $89.85 $80.87 $67.39INSANITY ® Fast and Furious DVD $19.95 $17.96 $14.96Kathy Smith’s Project:YOU! Type 2 ® $99.95 $89.96 $74.96Keep It Up! $19.95 $17.96 $14.96LES MILLS COMBAT $59.95 $53.96 $44.96LES MILLS COMBAT DELUXE $89.95 $80.87 $67.39LES MILLS COMBAT ULTIMATE $119.85 $107.87 $89.89LES MILLS PUMP DVD Workout Package $165.85 $149.27 $124.39LES MILLS PUMP Ultimate Cross Training Deluxe $305.85 $275.27 $229.39LES MILLS PUMP Ultimate Cross TrainingDeluxe Upgrade$140.00 $126.00 $105.00FITNESS CONTINUEDPRODUCT DESCRIPTION RETAIL CLUB COACH H.D. QTY TOTALLES MILLS PUMP Ultimate Cross TrainingDeluxe DVDs$40.00 $36.00 $30.00LES MILLS PUMP CORE DVD $19.95 $17.96 $14.96P90X ® Extreme Training System Package* $119.85 $107.87 $89.89P90X ONE on ONE ® $19.95 $17.96 $14.96P90X ONE on ONE ® Full Edition, Vol 1 $239.40 $215.46 $179.55P90X ONE on ONE ® Full Edition, Vol 2 $239.40 $215.46 $179.55P90X ONE on ONE ® Full Edition, Vol 3 $239.40 $215.46 $179.55P90X ® Peak Results Package $269.70 $242.73 $202.28P90X ® Plus $59.90 $53.91 $44.93P90X2 ® Base DVD* $119.85 $107.87 $89.89P90X2 ® Base Blu-ray $149.85 $134.87 $112.39P90X2 ® Additional Extreme Workouts DVD* $59.85 $53.87 $44.89P90X2 ® Additional Extreme Workouts Blu-ray $65.85 $59.27 $49.39P90X2 ® Deluxe DVD* $239.70 $215.73 $179.78P90X2 ® Deluxe Blu-ray $299.70 $269.73 $224.78P90X2 ® Ultimate DVD* $329.55 $296.60 $247.16P90X2 ® Ultimate Blu-ray $389.55 $350.60 $292.16P90X2 ® Deluxe Upgrade Kit DVD* $119.85 $107.87 $89.89P90X2 ® Deluxe Upgrade Kit Blu-ray $149.85 $134.87 $112.39P90X2 ® Ultimate Upgrade Kit DVD* $209.70 $188.73 $157.28P90X2 ® Ultimate Upgrade Kit Blu-ray $239.70 $215.73 $179.78Power 90 ® In-Home Boot Camp $59.85 $53.87 $44.89Power 90 ® Master Series $59.85 $53.87 $44.89Power 90 ® Master Series DVDs $19.95 $17.96 $14.96Power Half Hour ® Package $39.90 $35.91 $29.93RevAbs ® —Your 90-Day Ab Solution Package $89.85 $80.87 $67.39RevAbs ® Deluxe Package + Stability Ball and Bands $179.70 $161.73 $134.78RevAbs ® 4x4 Workout DVD $19.95 $17.96 $14.96RevAbs ® Deluxe Upgrade Package +Stability Ball and Bands$89.85 $80.87 $67.39RevAbs ® 4x4 Workout DVD $19.95 $17.96 $14.96Rockin’ Body ® $19.95 $17.96 $14.96Rockin’ Body ® Rockin’ Results $19.95 $17.96 $14.96Shakeology ® —The Workouts $29.95 $26.96 $22.46Shaun T’s Dance Party Series $39.90 $35.91 $29.93Shaun T’s Fit Kids ® Club $19.95 $17.96 $14.96Slim in 6 ® Rapid Results $59.85 $53.87 $44.89Slim in 6 ® Deluxe $119.70 $107.73 $89.78Slim in 6 ® + Greenberry Shakeology ® $164.84 $148.36 $123.63Slim in 6 ® + Greenberry Shakeology ® HD $164.84 $148.36 $123.63Slim in 6 ® + Chocolate Shakeology ® $164.84 $148.36 $123.63Slim in 6 ® + Chocolate Shakeology ® HD $164.84 $148.36 $123.63Slim Series ® Express $29.95 $26.96 $22.46Slim Series ® Package $59.85 $53.87 $44.89Tai Cheng DVD Package w/ TBB Bonus $119.85 $107.87 $89.89Tai Cheng Master Upgrade DVD Package $119.85 $107.87 $89.89Tai Cheng Master DVD Pkg w/ TBB Bonus $239.70 $215.73 $179.78Tai Cheng Master DVDs w/ Calendar and Band $44.85 $40.37 $33.64Tai Cheng Body Align. for Better Living DVD $19.95 $17.96 $14.96Thin Thighs Guaranteed! ® $9.95 $8.96 $7.46Tony & The Folks! $9.95 $8.96 $7.46Tony & The Kids! $9.95 $8.96 $7.46Total Body Solution ® $29.95 $26.96 $22.46TurboFire ® Package $119.70 $107.73 $89.78TurboFire ® The Complete System $239.40 $215.46 $179.55TurboFire ® Advanced Deluxe Package $119.70 $107.73 $89.78TurboFire ® Advanced DVDs $59.70 $53.73 $44.78TurboFire ® Starter Pack $39.95 $35.96 $29.96TurboFire ® Keep on Burnin’ DVD $29.95 $26.96 $22.46Turbo Jam ® Fat Burning Elite $59.85 $53.87 $44.89Turbo Jam ® Live! $24.95 $22.46 $18.71Turbo Jam ® Package $59.85 $53.87 $44.89Yoga Booty Ballet ® Ab & Butt Makeover $39.90 $35.91 $29.93Yoga Booty Ballet ® Baby on the Way $19.95 $17.96 $14.96Yoga Booty Ballet ® Classic Package $39.90 $35.91 $29.93Yoga Booty Ballet ® Goddess Package $24.95 $22.46 $18.71Yoga Booty Ballet ® Guided Meditation CD $19.95 $17.96 $14.96Yoga Booty Ballet ® Master Series $59.85 $53.87 $44.89Yoga Booty Ballet ® Pure and Simple Yoga $19.95 $17.96 $14.96Page 2 of 4Rev. 09/19/2012


<strong>Product</strong> <strong>Order</strong> <strong>Form</strong>NUTRITION & SUPPLEMENTSPRODUCT DESCRIPTION RETAIL CLUB COACH H.D. QTY TOTAL2-Day Fast <strong>Form</strong>ula ® —Chocolate $19.95 $17.96 $14.962-Day Fast <strong>Form</strong>ula ® —Vanilla $19.95 $17.96 $14.96ActiVit ® Multivitamins—Metabolism <strong>Form</strong>ula $29.95 $26.95 $22.95Beachbody Ultimate Reset $229.95 $206.96 $172.46Beachbody Ultimate Reset with Ultimate HD $229.95 $206.96 $172.46Beachbody Ultimate Reset with Deluxe HD $229.95 $206.96 $172.46Beachbody Harcore Base Shake $59.95 $53.96 $44.96Beachbody Fuel Shot $49.95 $53.96 $37.46Beachbody MAX Creatine $29.95 $26.96 $22.46Beachbody Super Suma $29.95 $26.96 $22.46Beachbody Ultimate Reset ® —Optimize—30-Day Supply$59.95 $53.96 $44.95Beachbody Ultimate Reset ® —Alkalinize—30-Day Supply$49.95 $44.96 $37.46Beachbody Ultimate Reset ® —Detox—30-Day Supply $69.95 $58.46 $48.71Beachbody Ultimate Reset ® —Revitalize—30-Day Supply$34.95 $31.46 $26.21Beachbody Ultimate Reset ® —Oxygenize—30-Day Supply$29.95 $26.96 $22.46Beachbody Ultimate Reset ® —Mineralize—30-Day Supply$15.95 $14.36 $11.96Beachbody Ultimate Reset ® —OxyMineral—30-Day Supply$45.90 $41.31 $34.43Cordastra $34.95 $31.46 $26.21Core Cal-Mag $17.95 $16.16 $13.46Core Nutrition Pack—Body Toning $59.95 $53.96 $44.96Core Nutrition Pack—Metabolism $59.95 $53.96 $44.96Core Omega-3 $21.95 $19.76 $16.46E&E Energy & Endurance $29.95 $26.96 $22.46Herbal Immune Boost—30-day supply $19.95 $17.96 $14.96Joint Support Super <strong>Form</strong>ula $22.95 $20.66 $17.21Meal Replacement Shake—Chocolate $39.95 $35.96 $29.96Meal Replacement Shake—Vanilla $39.95 $35.96 $29.96P90X ® Peak Health <strong>Form</strong>ula $42.95 $38.66 $32.21P90X ® Peak Performance Protein Bars—Café Mocha$23.95 $21.56 $17.96P90X ® Peak Performance Protein Bars—Chocolate Fudge$23.95 $21.56 $17.96P90X ® Peak Performance Protein Bars—Peanut Butter$23.95 $21.56 $17.96P90X ® Peak Performance Protein Bars—Wildberry Yogurt Flavor$23.95 $21.56 $17.96P90X ® Peak Performance Protein Bars—Variety Pack$23.95 $21.56 $17.96P90X ® Results and Recovery <strong>Form</strong>ula ® Packets $54.95 $49.46 $41.21P90X ® Results and Recovery <strong>Form</strong>ula ® Tub $49.95 $44.96 $37.46Performance <strong>Form</strong>ula—30-day supply $24.95 $22.46 $18.71Performance Pack $62.85 $56.57 $47.14Renewal Pack $62.85 $56.57 $47.14Results Pack—Chocolate $99.90 $89.91 $74.93Results Pack—Vanilla $99.90 $89.91 $74.93Shakeology ® Boost—The Fiber $24.95 $22.46 $18.71Shakeology ® —Chocolate $119.95 $107.96 $89.96Shakeology ® —Chocolate Vegan $129.95 $116.95 $97.66Shakeology ® —Greenberry $119.95 $107.96 $89.96Shakeology ® —Tropical Strawberry $129.95 $116.95 $97.46Shakeology ® Alternating Flavor Chocolate andGreenberry Home Direct$119.95 $107.96 $89.96Shakeology ® Single Serve Packets—Chocolate $119.95 $107.96 $89.96Shakeology ® Single Serve Packets—Chocolate Vegan$129.95 $116.95 $97.46Shakeology ® Single Serve Packets—Greenberry $119.95 $107.96 $89.96Shakeology ® Single Serve Packets—Tropical Strawberry$129.95 $116.95 $97.46Shakeology ® Single Serve Packets—Mixed Flavors$119.95 $107.96 $89.96Shakeology ® Fast Start Pack—Chocolate NA NA $89.96Shakeology ® Fast Start Pack—Greenberry NA NA $89.96Shakeology ® Fast Start Pack—Tropical Strawberry NA NA $97.46Slimming <strong>Form</strong>ula—30-day supply $29.95 $26.96 $22.46Slimming Pack $54.80 $49.32 $41.10Strength & Muscle Men’s <strong>Form</strong>ula—30-day supply$19.95 $17.96 $14.96Strength & Muscle Men’s <strong>Form</strong>ula—78 servings $43.90 $39.51 $32.93Whey Protein Powder—Chocolate $39.95 $35.96 $29.96Whey Protein Powder—Vanilla $39.95 $35.96 $29.96BEAUTYPRODUCT DESCRIPTION RETAIL CLUB COACH H.D. QTY TOTALACCESSORIESPRODUCT DESCRIPTION RETAIL CLUB COACH H.D. QTY TOTALDoor Attachment Kit + Resistance Bands(pink, magenta, red)$44.95 $40.46 $33.71Door Attachment Kit + Resistance Bands(magenta, red, green)$49.95 $44.96 $37.46Agility Ladder $19.95 $17.96 $14.96Ankle Weights, set of 2 $19.95 $17.96 $14.96B-LINES ® Resistance Band Black (B10)incl. handles$22.95 $20.66 $17.21B-LINES ® Resistance Band Green (B8)incl. handles$21.95 $19.76 $16.46B-LINES ® Resistance Band Magenta (B4)incl. handles$19.95 $17.96 $14.96B-LINES ® Resistance Band Pink (B3)incl. handles$19.95 $17.96 $14.96B-LINES ® Resistance Band Red (B6)incl. handles$20.95 $18.86 $15.71B-LINES ® Resistance Bands Upgrade Kit $9.95 $8.96 $7.46B-LINES ® Resistance Bands Complete Kit $119.95 $107.96 $89.96B-LINES ® Resistance Bands Extreme Kit $39.95 $35.96 $29.96B-LINES ® Resistance Bands Standard Kit $39.95 $35.96 $29.96B-LINES ® Resistance Bands Super Kit $39.95 $35.96 $29.96Beachbody ® Balance Ball (55 cm)—M(under 5'4")$29.95 $26.96 $22.46Beachbody ® Balance Ball (65 cm)—L(5'5" or taller)$34.95 $31.46 $26.21Beachbody ® Squishy Ball $12.95 $11.66 $9.71Beachbody ® Jump Mat $59.85 $53.87 $44.89Beachbody Ultimate Reset Dry Brush $19.95 $17.96 $14.96Body Fat Tester $14.95 $13.46 $11.21Bowflex ® Strapless Heart Rate Monitor $74.85 $67.37 $56.14Chin-Up Max $39.90 $35.91 $29.93Dry Brush $19.95 $17.96 $14.96Dumbbell Set $59.90 $53.91 $44.92Heart Rate Monitor w/ Strap $59.85 $53.87 $44.89P90X ® Chin-Up Bar $59.85 $53.87 $44.89LES MILLS PUMP ® Complete Barbell Set $89.90 $80.91 $67.43LES MILLS PUMP ® Barbell w/ Safety Clips $56.90 $51.21 $42.68LES MILLS PUMP ® Weights 2.5 lbs. (Box of 2) $9.90 $8.91 $7.43LES MILLS PUMP ® Weights 5 lbs. (Box of 2) $16.90 $15.21 $12.68LES MILLS PUMP ® Weights 10 lbs. (Box of 2) $31.90 $28.71 $23.93LES MILLS PUMP ® Weights 25 lbs. (Box of 2) $61.90 $55.71 $46.43LES MILLS PUMP ® Speed Safety Clips $11.90 $10.71 $8.93LES MILLS PUMP ® Step w/ 4 Risers $99.90 $89.91 $74.93Premium Stability Ball (55-cm) $36.95 $33.26 $27.71Premium Stability Ball (65-cm) $41.95 $37.76 $31.46Medicine Ball (4-lb) $29.95 $26.96 $22.44Medicine Ball (8-lb) $46.95 $42.26 $35.21Medicine Ball (12-lb) $63.95 $57.56 $47.96Plyometrics Mat $89.95 $80.96 $67.46Push-Up Stands, set of 2 $19.95 $17.96 $14.96P90X2 Foam Roller $29.95 $26.96 $22.46P90X2 RumbleRoller ® $69.90 $62.91 $52.43Resistance Band Soft Handles $4.95 $4.45 $3.71RevAbs ® Ab Straps $29.85 $26.87 $22.39Sculpting Band (green) $9.00 $8.10 $6.75Sculpting Band (purple) $9.00 $8.10 $6.75Speed Rope $9.95 $8.96 $7.46Strength Band—Beginner—Yellow $6.95 $6.26 $5.21Strength Band—Medium—Green $6.95 $6.26 $5.21Strength Band—Heavy—Red $6.95 $6.26 $5.21Tai Cheng Foam Roller $19.95 $17.96 $14.96Tai Cheng Rumble Roller $49.95 $44.96 $37.46Tony Horton’s PowerStands ® $39.90 $35.91 $29.93Walking Bands—1 set $29.95 $26.96 $22.46Weighted Gloves Set $19.95 $17.96 $14.96Yoga Blocks, set of 2 $29.95 $26.96 $22.46Yoga Mat $29.95 $26.96 $22.46RumbleRoller is a registered trademark of Ronald Johnson.PowerStands is a registered trademark of Tony Horton.SubtotalShipping & Handling (see shipping table on p.1)TaxGRAND TOTALDerm Exclusive ® 4pc 30-Day - 1 ship $49.95 $44.95 $37.46Derm Exclusive ® 4pc 30-Day Entry Kit $39.95 $35.95 $29.96Derm Exclusive ® 4pc 90-Day Entry Kit $119.85 $107.86 $89.88Derm Exclusive ® 4pc 90-Day Continuity $119.85 $107.86 $89.88Derm Exclusive ® 7pc Ultimate Entry Kit $164.55 $148.09 $123.41Derm Exclusive ® 7pc Continuity $164.55 $148.09 $123.41Page 3 of 4


Sales ReceiptCUSTOMER INFORMATIONName3301 Exposition Blvd., 3rd Floor, Santa Monica, CA 90404Customer Service: 1 (800) 470-7870ORDER DATETeamBeachbody.comShipping Address (if different from residence address)City, State, and ZIP CodeTelephoneCOACH INFORMATION<strong>Coach</strong> name (required)Email (required)<strong>Coach</strong> ID# (required)DESCRIPTION PRICE QTY EXTENDEDSubtotalShipping & HandlingLocal Sales TaxTOTALHOME DIRECT: If you purchased a product that includes Home Direct (HD), every 30 days (or with some products, 90 days) you will automatically receive a new supply of the product, shipped direct to your door andbilled to the credit card you provided today. Call Customer Service to cancel at any time.MONEY-BACK GUARANTEE: Team Beachbody offers a money-back guarantee (less shipping and handling) on almost all of its products. Please check TeamBeachbody.com for details of the guarantee for theproduct you ordered.RETURNS: Contact Customer Service at 1 (800) 470-7870 and review the packing slip you receive for details on how to return a product.Resistance bands and other products provided by Beachbody include Natural Rubber Latex, which can cause severe allergic reactions.NOTICE OF RIGHT TO CANCELYou may CANCEL this transaction, without any penalty or obligation, within 3 (THREE) BUSINESS DAYS from the above <strong>Order</strong> Date (5 [FIVE] business days for Alaska residents). If you cancel, anypayments made by you under the contract or sale, and any negotiable instrument executed by you will be returned within 10 (TEN) BUSINESS DAYS following receipt by the seller of your cancellationnotice, and any security interest arising out of the transaction will be canceled. If you cancel, you must make available to the seller at your residence, in substantially as good condition as whenreceived, any goods delivered to you under this contract or sale, or you may, if you wish, comply with the instructions of the seller regarding the return shipment of the goods at the seller’s expenseand risk. If you do make the goods available to the seller and the seller does not pick them up within 20 (TWENTY) days of the date of your Notice of Cancellation, you may retain or dispose of thegoods without any further obligation. If you fail to make the goods available to the seller, or if you agree to return the goods to the seller and fail to do so, then you remain liable for performance of allobligations under the contract. To cancel this transaction, fax, email, or deliver a signed and dated copy of this Cancellation Notice or any other written notice to Team Beachbody, 3301 Exposition Blvd.,3rd Floor, Santa Monica, CA 90404, fax 1 (213) 201-7225, email: CustomerService@TeamBeachbody.com, NOT LATER THAN MIDNIGHT of the 3rd business day following the date set forth above.I HEREBY CANCEL THIS TRANSACTION.Buyer’s signature: ________________________________________________________ Date: _______________________The above 3-day notice is required by U.S. federal law. Team Beachbody also has a 30–90 day satisfaction guarantee,depending on the product being returned.Buyer retains TWO copies.Seller retains ONE copy.Page 4 of 4Rev. 09/19/2012

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