TRIAL EXHIBIT 17

Case 3:15-cv-01857-SI Document 409-5 Filed 10/15/20 Page 1 of 3
"""" VISALUSN INDEPENDENT PROMOTER (VIP) APPLICATION CHALLENGE Fax Form to 1.877.547.1570 

STEP 1 i 11 r.o nMO TER SYSTEMS 

STEP 3 

All addllional product orders wlD be prt>ar.>sed ontl shippocl wilh ~r enrollme~ poctage. 

STEP 4 

30 CHILDREN'S SHAKE 

MEALS DONATION $2• 

QTY· ~ 

lholle M9cd for Meal Match! 

Plta\t~alllique1Mmoam ~toaccesyoor\t53-.8ad:Olllca. 

CITT ITEN l'IAME ITEll PllCf AllrO-SHP OM!-TllE OTT ITE)f N.IME ITEM PRICE AUTO.SHIP ONE-TIME W ~eltl tr Uetrmm choke ls mbllt, IWMlrdl mull lllM! 6-16 d!111c:11:itn ..-~n111tMldoldlcpxmolbar andcormticii.a.oee"'1tlclldOM 50 Tomr ?odes S2!iO 0 0 Nutra-Coold•'"': Pld' o Flavor nmt:I«. n=nbef.t.Q.. n!!lbll:Z. 

2S Sl'7te·Po::b SB! D 0 oatmcd~J1 ~ 0 D P•"""'I - - - -- - - ----- !ill~ Clftt~ ViSclus ~-2 OL SMti $'4!1fbc* 0 0 ~ !k.l!llf U\fbac 0 0 

"'""'""~°""'""' ,,_ D D """"""""' """"' LI 11 v,,... "' D D See ProdUd Plitt> St.eel. !of 1"11:11 Nunlror; and pr:ciftg inbrro:ion. 

STEP 5 

IPtorSSN: _________________ _ 

Enroller Last Name:.,,...,-..,.--=-=-o-c-- Rrst Nam~--,-..,.-,--,-,-=c,---,--,­ TRErroHerilansi:itbJIPwhoi""1.i.lff'F. Thtfnrcll«cinFmlllt,_1P.,,.timinttitdtfithoflislhtrall}if'i:at1Gn. 

Onttlht~tntpmcmlsaim~lelttbetmlltrunidd/dmlgtspgmot"lnfa!tMll .. 111 ~'YAblglll:om•fai.odln~ 

last Name: _______ _ Fintlilme: _______ _ 

SSNorTaxl): -------- BirthDe:__J __J __ 

CompanyName: ------------------

If doing business as a legal entity, complttt and attKh tht Cmn11any Enrollmtnt form. (Rtqulml) 

Shipping/M1ilmg Adlh<s: 

Apl/Sult~ 

Gty: State: Zip: 

BBllngAddrm: 

Apt/Suite: 

Gty: State: Zip: 

Communication Preferences: 

Ho!Tle'Phonel: ______ _ Mobile Phone I: ____ _ 

MobftePhoneProvider: Reqtiredfur~SalusMobileUpdates(SMS) ______ _ 

E~allAddress: ________________ _ 

Rea!iveVISalus News& Updates via: Ott<katltastone 

0 Phone 0 Email 0 Mom~ Text Message (IMS) 0 Non• 

LanguagePrerereme: OEnglish 0Spani!h 0 Both 

Gender: 0 Male 0 female 

Billing lnfonnatloo: 

FullNameonCreditCard: ______________ _ 

CreditCanlNumbecl_l __ J_Ll-1- 1-1--1-LLl-Ll-l-1-1 

h:pirationDate: $e(urityCode: _ ____ _ 

CanHype: 0~,. OMasterCanl ODiscover OAmeri"nOpre!s 

Can:lhclderSignan.rre: _______________ _ 

Cl.lai» v&:il1.111to t"1C1i9""C1CtNll:k:r!hecm::.uitlislec.l~l:>poy:u:t.Cl'l"C.l"(t>andin~goiemsig1hetoecl"-""1 cad. l~111Ct'£<*.1...i1~~~it'iPF ngon:liwln;fiig~lol!'fQl'd:m. r,. 

O'der~l.Llo&ipcrcll"Ol11ilt\4.Netliill*ier'l,lah:riaVf'.dU5'1G!l"ipfdlcltgttt.!eprodt.dltn.'.l'tfff.Ccnoll:c:ionsmi,sit be~<tla::il5da;'lp1ortotl'.e.tlJloS'!od<Jeot~bllngd.»e. 

~ttal.b~a.i~P'CITIOlo'" ~D) r:JVSX w-iorfyq~lowbrril1*~ ieaipott'lis~:ttr.t 111;MJieadondi.n:iefstond'"5ofus'FO!dn andP:'OCOCUC'J tlrlc!Cainpe!i klliol'Plan, 

! Uhl ocbloM8dge lhcl rry a:t.ancenn in ll'e ViScM; rrot.51'"£ Poo is bmled so:ety upoi 118 acqisiBcn r:J vl'hlci ore naoonxecl by t"ll! :'ffe:-.ice henllr, arid agl'I'!& k) ob.de bf hm C!J r..y !TIOfbe :irr.erdfd al OIT(U... 

Qm:IT.-s./ol:y~dsolni>dsorlrefi:ngmo1e1a1, oro1erdanc»:i:l'D:nng caues,1s~ optialo!atd 

~ 

at rl1f ~~ I mso understand !hot ,f I ch:::icM lo erwcil Cf $p:)"80I' oti'8f irc'"llililtm b porridpa'.e in V.ScM' I U!easTAND THAT I MAY CANal. THIS AGIEEM:NT WITHOUT P9a.l.TY OR OIUGAllON AT ANT TIME. 0 wil oit(t:o~ ~ '.IP01 lheodirt'res doN'IPs k> ltee1C8111 othlrscle& TOOdlil FOll:ANYIE&SQN.IUNDEllS'TANDTHATMV NOTICE OF CAN~ MUSTBESl.BITimlHWIUTINGTO 

8y rry ~ bekJw ard i'lfiaii: ::ir t'19 IF TerrrG d ~TUt an 'be- le'«!~ sa, 1 o:::t"ICV'lledge ll'al 1 he\'!: TIE COMP.ANT Ill ITS PRltctPAL BIJSJNESS ADDRESS. Pl.EASE SEE On& SIDE FOR 1EIWS. 

cmetiilyl.ad\Ns~nr,:lfld Cf"lwilfing10~hllrfmtond:on::lilicnst-ef9in:J!'do.-ilriervi.e:w :ioo. 

~ltahr!orTi:alcttisdocurnen :holl t:ea bind ng~!llt)ll98.1V&il1; Clldrneood;ipon 

ApplicontSlglctute:X Date:-------------------- This ~IOJtion is not contidered comp ~ l..rlles5V&b RICeifts both the slgl'led and do!sd Application (page 1) cnd the lnllicled Terms of Agreement (page 2) ~ 

1607 E. alg a.av. Rd. s...... f"l 10, TIO'f', Ml ~0!5 • c.mum.. SllMQ un.'t'ISAWS • ~ ~ 20'Q ~loo. 1"'JIS-.~tp 

VISALUS_WAKEFIELD000035 

Case 3:15-cv-01857-SI Document 409-5 Filed 10/15/20 Page 2 of 3
By joining VISolusTM those are the Terms you have agreed to. Refer lo the 

Polkfes and Procedures for detailed Information. 

1. t ocknowledge that I am of legal oge to enter Into !his Agreement and that 

I am a real person. 

2. ~:~~;~a~ °a~~~~~o~o~~:.i_~~~ this Agrooment j, not binding until 

3. I agree that as a Promoter, I am responsible for determining my own 

~:;::!~t~~~ ~~~ti a°:r~~~s~1=~~r~~!=:/~?~\1 federal 

and state employment taxes and art( other tax requ ired under any federal, 

state or regu latory law. In the event that I fall to provide VISALUS a valid 

Social Security Number or employer identification number, VlSALUS may 

withhold commls.sloN due to ma until a voUd number Is provided. 

4. I understand that I am not being sold a franchiae or business opportunity. 

5. I may terminate this Agreement for arry reason, at Ortf time, by giving 

VISALUS prior written notice. VJSALUS may terminate this Agreement in 

writing upon violation of policies and procedures or In the ~nt I vtolate 

any part of this Agreement. In such event, no further commissions will 

bo paid by VISALUS. To terminate this Agreement, I must mall or dellver 

Fo~sSi~\~~~X6r~s~' ~;i~=~r~S~~ ~~~e ~~~t~~~~~~n~;~~:.on sont 

6. I agree that as a vtSALUS Promoter, I shall place primary emphasis 

upon the sate of Products and Services to non-Promoter cons~mers as o condition of my receipt of commissions. Commissions I racetW will 

be based upon fulfilling certain terms of quallficotlan a s set forth by" 

the Marketing Program and Compensation Plans as may be amended 

from time to ti me. A three ($3.00) Dollar processing fee will apply to all 

payments. 

7. I agree toked accurate records and to abide by I ~ed.eral, state, and 

~:ls:~:n m~~:~s Jr~~~c~~l~~o b~ ~~;~:~: ~.t~~.,P~u~: permits and licenses raqulred to perform undor this Agreement. 

8. I understand that no attorney general or other regulatory authority evor 

reviews, endorses, or approves any product, subscri ption, compansatlan 

program or company, and I will make no such claim to others. 

9. I understand that a $25 Administration Fee will be charged annually to my 

credit card on file with VISalus. This fee is for services, which include, but 

are not Jlmited to, downllne reporting. customer trcckln9 and accounting 

services. The Administration Fee will bo charged In the month al my 

enrollment anniversary and i1 not paid will result in rt'f'/ Promotershlp 

being placod on Rnandal Hold ior ~p to HO days. If the Adm!nlst~at on 

Fee remains unpaid 120 days aftor it was due, my Promotersh1p will be 

terminated and 1 wlll forfeit any commissions tha1 were held since the 

time I was placed on Ananclal Hokl. If my Promotershlp Is termlnotod, I 

understand that l must re-enroll as o brand new Promoter and will not be 

placed bock in my original spot if I wish to pursue the VISatus opportunity. 

10. I cgroa that VJSALUS shall not be liable under any circumstances tor 

any damage or loss of any klnd, Including indirect, special, puni1iv~. 

compensatory, or consequential damages, losses or profits which may 

result from any cause, Jncludlng but not limited to, breach of warranty, . 

delay, act, error or omiuion of VISALUS, or in the eYent cf d iscontinuation 

or modlllcction of a product or service offered by \11SALUS. 

11. VISALUS shell periodically make sales literature and/or promotional 

materlals ovallable. However, I am under no obligatlon to purchase any 

male-rials or literoture a1 any time. Refunds shall not be allowed under any 

circumstances, including. but not llmited to, termination of this Agreoment, 

~eb~~~~~~~~~ ~~~ :d 1:i::;r~~~2;1otional ma1erla ls, or any other 

12. I agree thot as a Promoter, this Agreement grants me the fimited authority 

to promote and sell the products VISALUS markets subject to the terms and 

conditions ostablishod by VISALUS. 

13. I will not make any false or misleoding statements aboLSt VISALUS or 

H• marketlng program. I agree that I will. operate in a lawful~ othlc~ I 

and moral manner and will not engage m or perform any misJC1admg, 

deceptive or unethical practices. In the event I violate any cf these 

conditions, my position may be terminated without further payment or 

compensatlon of any ~nd . 

14. I acknowledge that l am responsible for supervising and supporting 

Promoters I sponsor lnlo the program and In my commlsslonoble network. I 

agree to maintain monthly communication. and svpport to those i~d ~iducls 

Jn my commls:sionable network through written or verbal communica1ion 

and attendance at meetings. 

15.1 ad:nowledge tha1 VISAWS expressly r•StttWs all prcprietory rights to 

the company's trcd~rb. trcdenomes, logos ("'Proprietary Marb") and 

copyrighted mcterials. l understand, adcnowledge and agree that ony monies which I pay VISAWS a re Jn consideration at my receiving c nonexclusive l icense, during the term of this Agreement to uso tho Proprietary 

Marks of VISALUS as stlpulatod in the Pollclos and Procoduros and In 

conjunction with the marketing program provided to me. I lurttier agree 

that I will not use VISALUS's Proprietary Morles In any form whatsoever 

~~of:~=~~ ~"os~~:J:: ~:;~!to~";~7urt~~~n~~~~~~t::, I may not photocopy or duplicate Ortf materials provided by or purchased 

Fax Form to un.S41.1s10 

from VISALUS without wr1tten authorization and that the unauthorized use 

of any Proprietary Marie Is a violation of federal law and this Agreement, 

constituting grounds for termination of this Agreement by VISALUS. 

16. 1 understand that as a Promoter, I om free to select my own means, 

methods and manner of operation and that l am free to choooe the hour$ 

and location of my activities under this Agreement, subject only to the 

terms of thb Agreement and VlSAWS Polldes and Procoduros. 

17. J acknowtedge that I am not guaranteed a ny lncoma nor am I assured 

any profits or success. I certify that no dalms of gucrontlted profits or representations of expected earnings tha1 might rHUlt from my efforts have 

beon made by VISALUS or any VISAWS Promoters. In this connection, I 

shall not represent dlr&etly or Indirectly that any person may, can or will 

oarn any statod gross or not amount, nor that sponsorship of ethers Is easy 

to secure or retain, or that substantial ly all Promoters will succeed. 

18. l acknowledge that I hove the right to sign up as many personal cwtomers 

a• I wish. I will racaivo c commission each month from my personal 

custom~' purchases ond my downllne ngtNort: In accordonco with the 

VISALUS Compensation Pion then in affect. 

19.1 ogroe to indemntty and hold hartrn~ss VISALUS ham any and all dolms losses, damages and expenses, including Ortf attorney's fees, arlsl~g out 

of my actions or conduct In vlolatlon cf this Agreement. Compensation Plan 

or any Polley or Procedure of VISALUS. I ogre• that tn order to recoup any 

damages ood •xpenses It has Incurred due to such vlolation(s}, VISALUS 

may offset any comm issions or other payments doe me. In tho event c 

dispute arises as to the respective rights, duties and obllgatlons under this 

Agroement, Compensation Plan or the Policies and Proceduros of VISALUS, 

It Is agreed that such d isputes shcill bo oxduslvefy res:olvod In the Circuit Court for Oakland County, Stele cl Michigan, or federal c;ourt located In 

Detroit, Michigan. Michigan low shaP apply to the resolution cf all disputes. 

Louisiana residents may choose Louisiana law and jurisdiction. 

20. t acknowledge that I havo read and tulty understand tho vtSALUS Policies 

and Procedures cod Compensation Pion, which are Incorporated herein 

by reference and are binding upon mo. In order to maintain a viable 

marbltlng program and to comply with chong~s ~ federal, sta~ or local 

laws or economic condttlons, VISALUS may revise its Compensot1on Pk::m 

and Polldos and Proc&duros from time to time. All changes thereto shall be 

effective upon verbal or written notice to me and become a binding part of 

this Agreement The homo office prior to use or publication must approve 

all advertisements using tho Proprietary Marks of VISALUS. 

21. I acknowledge that this Ag reement, Compensation Plan .and the Pol:icies 

and Procedures incorporcled herein by referenco, constitutG tho ont1re 

Agreement between the parties and shall nOI be modified or amended 

except In writing signed by VISALUS. This Ag roement shall be binding upon 

and inure to the benefit of heirs, successors, and permitted assigns al tt'I& 

parties hereto. It any provision of the Agreement is determined by any 

authority ot compcrtent Jurisdiction to bo Invalid or unenforcoable in ?<'.Ir~ or 

In whole for any raoson whatsoevClr, tho 110lidity of the remaining prov1s1ons 

or portions thereof shaD not be affected thereby. 

22. I agroo to abide by the terms of the noninterference and non-disdosuro 

policy cf VISALUS. 

23. During the term of this Ag reement (and any renewafs), I will not seU 

any other products for Ortf entity competing with VISAWS. I agree that 

l no longer promote any other organization tho! utilizes a mufti.tiered 

compensation pion. 

24. Ouriog the term of this Agreement (and any renewals) cod for ono (1) year 

thereafter; I understand and agree that 1 will not contact. soHcit,. or 1ecruit 

any VIP, whether active or lnac::live, Into Ortf organization that utilizes a 

multi-tiered compensation plan. This includes Indirect recruiting through 

Facebook or other social media. I acknowledge that my violation of this 

provision will result in immediate termination of my Promo1ership ond 

payments of any kind. 

25.1 understand that if for any reason a VIP violates any of tho tecms of the 

Agreemerrt and/or these Policies and Procedures, ViSalus. ~eserves the . 

right to lmmedlarety deactivate or termlnoto the VIP's pOSltion. Such action 

by \llSalus will terminate any and all rights o1 the VIP a nd any furthor 

payments of any kind and is effective at the time of said violation. 

26. ViSalus Executive and Business Opportunity Return Policy: An Independent 

Promoter who cancolo their Promotership within 30 days cl enraUment may 

return unused products from the Promoter Systems which are unopened 

and in resalable condition. A refund will bo issued fOf the value of the 

Suslness Opportunfly ($49) and the vclue of unused and saleable products 

up to $450. If on lndopendont Promoter cancels their Promotershlp within 

their first yoo r but more than 30 days ofter their enroNment date, the same 

gvidolines apply howover returned, saleable products will result in o 

product crodlt equal to the discounted value of those products {up to $450} 

rather ttran o refund and wlll be sublect to a restocking fee. 

Please initial here ___ to cd:nowledge that you have read and 

agree to the above Terms of Agreement. Your application is not complete 

unless you Initial thb poge a nd submit wtlh your Independent Promoter 

Appl<:ation. 

16G7 E. Sig S--- id.. S.Q t 110. Ticy, Ml 41085 • C...:o!ome1 s.,nna, 1.817.VIWUS • v<..c...n th C: ~1 \169 '°' 111C. ll 1D'Jl.zl'fl 

VISALUS_WAKEFIELD000036 

Case 3:15-cv-01857-SI Document 409-5 Filed 10/15/20 Page 3 of 3