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BUSINESS ENTITY ADDENDUM U.S. (Optavia)

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© 2021 OPTAVIA, LLC. All rights reserved. Business Entity Adendum: U.S. - Effective April 30, 2021
1
BUSINESS ENTITY ADDENDUM – U.S.
This Business Entity Addendum (“Addendum”) is being submitted by the partners/members (“Participants”) of the business
entity_________________________________, with an address at ____________________________________________________________________________________________________.
Please note that it is mandatory for the Participants to provide the below referenced information. If you do not provide
such information, you will not be able to register your business entity with the Company. This Addendum must also
designate the “Primary Participant” of the OPTAVIA Coach Business. The Primary Participant is an authorized agent of
the business entity listed above and has been formally authorized to sign and execute contracts on its behalf. The Com-
pany may rely and act upon any information provided to it by the Primary Participant. In addition, all other Participants
in the business entity (i.e., members, partners, directors, oicers, shareholders, or other positions), must be listed and
provide certain information below. With respect to a Business Entity, each Participant and every Ailiated Party, as that
term is defined in the OPTAVIA Policies, is also bound by, and must comply with, the Independent OPTAVIA Coach
Agreement and all terms and conditions contained therein, including but not limited to the OPTAVIA Policies.
By signing below, the Participants are airming that:
1. You do not own, operate or control or have any interest in any other OPTAVIA Coach business
(unless previously authorized by the Company in writing);
2. You have a valid Social Security Number or Federal Tax ID Number;
3. You have legal residence in the United States, a U.S. territory or U.S. military base; and
4. You agree to all the terms and conditions of the Independent OPTAVIA Coach Agreement located at
https://OPTAVIAMEDIA.com/pdf/terms-conditions/OPTAVIA-Policies.pdf.
Primary Participant Information:
Name
____________________________________________________________________________
Title (if applicable)
____________________________________________________________________________
Date of Birth (mm/dd/yyyy)
____________________________________________________________________________
Telephone Number
____________________________________________________________________________
Email Address
____________________________________________________________________________
Primary Participant Address
____________________________________________________________________________
Date (mm/dd/yyyy)
____________________________________________________________________________
Signature
____________________________________________________________________________
Other Participants Information (please include additional sheets if necessary):
Name
____________________________________________________________________________
Title (if applicable)
____________________________________________________________________________
Date of Birth (mm/dd/yyyy)
____________________________________________________________________________
Telephone Number
____________________________________________________________________________
Email Address
____________________________________________________________________________
Primary Participant Address
____________________________________________________________________________
Date (mm/dd/yyyy)
____________________________________________________________________________
Signature
____________________________________________________________________________
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© 2021 OPTAVIA, LLC. All rights reserved. Business Entity Adendum: U.S. - Effective April 30, 2021
2
Name
____________________________________________________________________________
Title (if applicable)
____________________________________________________________________________
Date of Birth (mm/dd/yyyy)
____________________________________________________________________________
Telephone Number
____________________________________________________________________________
Email Address
____________________________________________________________________________
Primary Participant Address
____________________________________________________________________________
Date (mm/dd/yyyy)
____________________________________________________________________________
Signature
____________________________________________________________________________
Name
____________________________________________________________________________
Title (if applicable)
____________________________________________________________________________
Date of Birth (mm/dd/yyyy)
____________________________________________________________________________
Telephone Number
____________________________________________________________________________
Email Address
____________________________________________________________________________
Primary Participant Address
____________________________________________________________________________
Date (mm/dd/yyyy)
____________________________________________________________________________
Signature
____________________________________________________________________________
Name
____________________________________________________________________________
Title (if applicable)
____________________________________________________________________________
Date of Birth (mm/dd/yyyy)
____________________________________________________________________________
Telephone Number
____________________________________________________________________________
Email Address
____________________________________________________________________________
Primary Participant Address
____________________________________________________________________________
Date (mm/dd/yyyy)
____________________________________________________________________________
Signature
____________________________________________________________________________
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit
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BUSINESS ENTITY ADDENDUM U.S. (Optavia)

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Completed 1 July 2021

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