MAXeVIDA Membership Application

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“A Division Of Total Health Intl., Inc.”

1102 S. Austin Avenue, Suite 110

Georgetown, TX 78626

Please complete ALL FIELDS unless are “N/A”, then mail or fax app with signed p4 of T&C to above.

MAXeVIDA Membership Application

PERSONAL INFORMATION

Name:

Business:

Date:

Phone:

Address:

State/Province: Zip/Postal:

City:

Country:

Email: Fax:

SSN/EIN:

Do You Have AlertPay? [] Y [] N

SIN:

Do You Have SolidTrust Pal? [] Y

[] N

Do You Agree To T&C? [] Y [] N

Membership? [] Silver [] Gold []

Ptatinum

How Would You Like To Be Paid Commissions? [] STP [] AlertPay [] Check ($2 Fee Deducted)

If Payment Via Check, What Name Will It Be Made To?

MEMBERSHIP/PRODUCT PURCHASE

Silver

– 1 product + S/H (total cost $32.95) Choose Product:

Gold – 2 products + S/H (total cost $58.95) Choose products:

Platinum

– 4 products + S/H (total cost $110.00) Choose products:

Interested In $13 Feeder Program? [] Y [] N | (Note: ID# will be random)

Product: / Quantity: | Product: / Quantity: Grand Total: $

AFFILIATE INFORMATION

Username (Choice #1): Username (Choice #2): Username (Choice #3):

Note: You will have 3 username options in case any 2 options are taken. Your username will also be your website URL, i.e. if you choose “joedoe2012” , your website URL will be: www.MAXeVIDA.com/?user= joedoe2012

Choose Password (will be same for Feeder program – case sensitive):

PAYMENT INFORMATION

Payment Method?** [] Money Order [] Certified Check (Make payable to: Total Health International)

SPONSOR INFORMATION

Sponsor Name: Sponsor Username:

**If making payment online, visit your sponsor ’s website. All applications processed in 24-48 hours in order received.

Terms and Conditions

MAXeVIDA INTERNATIONAL

Distributor Agreement/Terms and Conditions

This Web site is provided by MAXeVIDA International and the Terms and Conditions set forth in this agreement are for the benefit of MAXeVIDA International and its members (Retail Distributors). By using this site or purchasing materials or products from this sit,e you agree to abide by the terms and conditions set forth in this notice. If you do not agree to abide by these terms and conditions please do not use or purchase materials or products from this site. MAXeVIDA

Internaional, at its sole discretion, reserves the right to terminate, without notice, the account of any member caught in violation of the Terms and Conditions as stated below.

I, as APPLICANT, hereby apply for authorization as a MAXeVIDA Retail Distributor. Unless MAXeVIDA notifies me of this application’s rejection, approval is assumed and I will be immediately authorized as a Retail Distributor and granted the rights to sell MAXeVIDA products by referring Retail Customers to MAXeVIDA.

I understand that this authorization is for one calendar year. The Annual Fee of $19.00 is waived for my first year as a

MAXeVIDA Retail Distributor. Beginning the second year, and every year thereafter, on APPLICANT'S anniversary date, MAXeVIDA will automatically renew the Retail Distributor authorization by debiting the Retail Distributor's

Commission account in the amount of $19.00, unless the Retail Distributor notifies MAXeVIDA, in writing prior to the anniversary date that he/she desires to cancel the Distributorship.

Entire Agreement. This Agreement, in its current form and as amended by MAXeVIDA International at its discretion, together constitute the entire agreement between MAXeVIDA International and myself. Any promises, representations, offers, or other communications not expressly set forth in this Agreement are of no force or effect.

I understand that MAXeVIDA International is a mail-order Retail Distribution Company retailing top quality dietary supplements to the end user (Retail Customer or RC) worldwide.

I understand and agree that by making a product purchase through my referrer's MAXeVIDA website, as a Retail

Customer or RC, MAXeVIDA International will automatically upgrade my status to Retail Distributor or RD with the option to build a retail network by referring other Retail Customers/Distributors to MAXeVIDA.

I understand that as Retail Distributor of MAXeVIDA International:

I must be of legal age in the state or country in which I reside.

I have the right to offer for sale MAXeVIDA International products and/or services in accordance with these Terms and

Conditions.

I have the right to build a MAXeVIDA International sales organization.

I will help train and motivate the Retail Distributors in my downline marketing organization.

I will comply with all federal, state, county, municipal laws, ordinances, rules, and regulations, and shall make all reports and remit all withholding or other deductions as may be required by any federal, state, county, or municipal law, ordinance, rule, or regulation.

I will perform my obligations as a Retail Distributor (RD) with honesty and integrity.

I will use only the sales agreements and order forms which are provided by MAXeVIDA International for the sale of

MAXeVIDA products and/or services, and I will follow all policies and procedures established by MAXeVIDA

International for the completion and processing of such agreements and orders.

I agree that applicable state and local taxes must be imposed on purchases of MAXeVIDA International products based on the set product prices.

2. Presenting MAXeVIDA International Products and Services.

I agree to present the MAXeVIDA International Compensation Plan and MAXeVIDA International products and/or services as set forth in any official MAXeVIDA International literature or official website.

3. Independent Contractor Status. I agree that as a MAXeVIDA International Retail Distributor, I am an independent contractor [and not an employee, agent, partner, legal representative, or franchisee of MAXeVIDA International]. I am not authorized to, and will not, incur any debt, expense, or obligation, or open any checking account on behalf of, for, or in the name of MAXeVIDA International. I understand that I shall control the manner and means by which I operate my MAXeVIDA International business, subject to my compliance with these Terms and Conditions and any other

MAXeVIDA International policies and procedures which may be distributed from time to time.

I agree that I will be solely responsible for paying all expenses incurred by myself, including but not limited to travel, food, lodging, secretarial, office, long distance telephone, and other expenses as they relate to my MAXeVIDA business. I UNDERSTAND THAT I SHALL NOT BE TREATED AS AN EMPLOYEE OF MAXeVIDA INTERNATIONAL

FOR FEDERAL OR STATE TAX PURPOSES. MAXeVIDA International is not responsible for any withholding and shall not withhold or deduct from my bonuses and commissions, if any, FICA, or taxes of any kind, unless such withholding becomes legally required.

4. MAXeVIDA International Policies.I have carefully read and agree to comply with these Terms and Conditions. I understand that I must be in good standing and not in violation of any of the terms of this Agreement in order to be eligible to receive any bonuses or commissions from MAXeVIDA International. I understand that these Terms and

Conditions or the other policies and procedures which may be distributed by MAXeVIDA International from time to time may be amended at the sole discretion of MAXeVIDA International, and I agree that any such amendment will apply to me. Notification of amendments shall be published in official MAXeVIDA International materials and on the Company's official corporate web site. The continuation of my MAXeVIDA International business or my acceptance of bonuses or commissions shall constitute my acceptance of any and all amendments.

I understand that my compensation in commissions and bonuses will be based on the actual product purchases during any given month. I further understand that I must maintain 'active' status with a product purchase made in the month for which I intend to be compensated. My failure to be qualify with a product purchase in any month will constitute forfeiture of my commissions and/or bonuses for that month. I understand that to qualify as 'active' with a product purchase during any given month, my product order must be made by midnight of the last day of my 30 day renewal period.

5. Term and Termination. The term of this Agreement, and each subsequent renewal, is one year. Either party may elect not to renew the Agreement upon each anniversary date. MAXeVIDA International may terminate my account for violation of the terms of the Agreement or the policies and procedures outlined herein. At its sole discretion,

MAXeVIDA International may terminate my account for any reason upon 30 days prior written notice. If my Agreement is not renewed, or if it is canceled or terminated for any reason, I understand that I will permanently lose all rights as a

Retail Distributor and I shall not be eligible to receive commissions, bonuses, or other remuneration from the activities of my former downline sales organization. In the event of cancellation, termination, or non-renewal, I agree to waive all rights I have, including but not limited to my former downline organization, and to any remuneration derived through the sales and other activities of my former downline organization.

6. Assignment.I may not assign any rights or delegate my duties under this Agreement without the prior written consent of MAXeVIDA International. Any attempt to transfer or assign this Agreement without the express written consent of MAXeVIDA International renders this Agreement terminable at the option of MAXeVIDA International and may result in termination of my business.

7. We Accept payment through Alertpay, Certified Checks and Money Orders.

8. Limitation of Liability and Indemnification. MAXeVIDA International, its directors, officers, employees, assigns, and agents (collectively referred to as "affiliates"), shall not be liable for special, indirect, incidental, consequential or exemplary damages. I release and agree to indemnify MAXeVIDA International and its affiliates from all liability arising from, or relating to my actions in the promotion or operation of my MAXeVIDA International business and any activities related to it (for example, but not limited to, the presentation of MAXeVIDA International products or Compensation

Plan, the operation of a motor vehicle, the lease of meeting or training facilities, etc).

9. Membership Cancellation. Membership at MAXeVIDA.com is voluntary and therefore may be canceled at any time by the member. MAXeVIDA.com will only cancel/terminate a membership if it’s deemed that the member is operating in conflict with MAXeVIDA.com terms and conditions.

10. Waiver and Severability. Any waiver by MAXeVIDA International of any breach of this Agreement must be in writing and signed by an authorized officer of MAXeVIDA International. Waiver by MAXeVIDA International of any breach of this Agreement by me shall not operate or be construed as a waiver of any subsequent breach. If any provision of this Agreement is held to be invalid or unenforceable, such provision shall be reformed only to the extent necessary to make it enforceable and the balance of the Agreement will remain in full force and effect.

11. Relationship. A member is neither an employee nor an independent contractor of MAXeVIDA.com.

12. Resolution of Conflicts. All issues relating to arbitration shall be governed by the US Federal Arbitration Act. Issues not related to arbitration will be governed by and construed in accordance with the laws of the State of Texas, without regard to principles of conflicts of laws, unless the laws of the state (US) in which I reside expressly require the application of its laws to this transaction (in which case such state law shall govern). All disputes and claims relating to the Agreement shall be settled through binding arbitration in Georgetown, Texas, or such other location as MAXeVIDA

International prescribes. Applicant waives all rights to a jury and/or court trial. Arbitration proceedings and discovery shall be governed by the US Federal Rules of Civil Procedure (except that there shall be no right of appeal), and the

US Federal Rules of Evidence shall apply. If a Retail Distributor files a claim or counterclaim against MAXeVIDA

International, he or she shall do so on an individual basis and not with any other Retail Distributor or as part of a class action. The decision of the arbitrator shall be final and binding on the parties and may, if necessary, be reduced to a judgment in any court of competent jurisdiction. This agreement to arbitrate shall survive any termination or expiration of the Agreement. Notwithstanding this Arbitration provision, nothing herein shall prevent MAXeVIDA International from applying to and obtaining from any court having jurisdiction a writ of attachment, a temporary restraining order, preliminary injunction, permanent injunction, or other relief available to safeguard and protect MAXeVIDA

International's interest prior to, during, or following the filing of any arbitration or other proceeding or pending the rendition of a decision or award in connection with any arbitration or other proceeding.

13. Governing Law. The parties consent to exclusive jurisdiction and venue before any federal court in Williams County or any state court in Texas, State of Texas, for purposes of seeking equitable relief and/or enforcing an award by an arbitrator or any other matter not subject to arbitration. If the law of the state in which the applicant resides prohibits consensual jurisdiction and venue provisions for purposes of arbitration and litigation, that state's law shall govern issues relating to jurisdiction and venue.

14. Use of Name and Image. I authorize MAXeVIDA International to use my name, photograph, personal story and/or likeness in advertising or promotional materials and waive all claims to remuneration for such use.

15. Counterparts. Faxed copies of this Agreement shall be deemed an original.

16. Data Protection. I give consent for MAXeVIDA International to process the personal data contained in this application/agreement.

You may CANCEL this transaction, without any penalty or obligation, within FIVE (5) BUSINESS DAYS from the date you signed the Retail Distributor Agreement.

If you cancel, you must make available to MAXeVIDA International, in substantially as good a condition as when received, any goods or products delivered to you under this contract or sale. You must, comply with the instructions of

MAXeVIDA International regarding the return shipment of the goods or products. If you fail to make the goods or products available to the seller, or if you agree to return the goods or products to MAXeVIDA International and fail to do so, then you remain liable for performance of all obligations under the agreement.

To cancel this transaction, mail or deliver a signed and dated notice of Cancellation, or send a telegram to MAXeVIDA

International, 703 Garden Meadow Drive., Georgetown, TX, 84604, NO LATER THAN MIDNIGHT of the third business day following the date set forth above.

By signing below, I acknowledge that the information I have provided is true to the best of my knowledge and I agree to be bound to the MAXeVIDA International Distributor Agreement upon acceptance of my application. I have read and agreed to be bound by the Terms and Conditions of the MAXeVIDA International Distributor Agreement.

Name: _________________________________________ Signature: ______________________________________

Address: ______________________________________________________________ Date: _____/_____/________

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