WorldVentures Marketing, LLC Representative Agreement Applicant Information Full Name (Last, First, Middle) (Individual or Entity Representative) (Required): Company Name (optional):† Date of Birth (MM/DD/YY) (must be 18): Social Security/Tax ID/EIN #:* Email (Required): Address (NO P.O. Box): Address 2: City: State: Home: Mobile: Zip: Work: Fax: *Social Security or Federal Tax ID# is required for all Applicants. I certify that this number is my correct taxpayer identification number. † Business System Assumed Names and Business Entities -- If your WorldVentures business will be owned by a corporation, limited liability company (LLC), partnership or trust, or will be operated under an assumed name (e.g., XYZ Enterprises or John Doe & Representatives), you must complete a Business Entity Registration Form online and submit it within 30 days from the date this application. The form must be received by the home office via fax or registered mail. WorldVentures Representative Business System (RBS): $99.95 + $10.99/month* All Representative Applicants must purchase the RBS (Optional in North Dakota). This online system includes three Personalized Websites, a Back Office, Online Training Program, access to Sales and Marketing Tools, and a Representative Welcome Kit. Check here to purchase the RBS only (no retail products). Check here to purchase the RBS and WorldVentures’ DreamTrips retail product. (See attached Product Order Form) Purchase the RBS and WorldVentures’ DreamTrips Life retail product (See attached Form) Take advantage of the Limited Time $200-Off Promotion! *First Month’s Fees are charged at time of purchase to payment info on file and automatically thereafter. You may change payment info at any time. * PSP Get the Premium Service Program (PSP) - Only $29.99/month Try the first month for only $1! If you’re serious about success with WorldVentures, you need the PSP! You’ll not only get the monthly 3-disc DriveTime University: Overdrive CDs, but you’ll ALSO receive the bimonthly 32-page Voyager newsletter, a subscription to SUCCESS magazine (12 issues/year with a CD/DVD DualDisc included), Enhanced Back Office Tools, and the incredible DreamTeamBuilder online marketing system with video emails, landing pages, contact management, auto-responders, and on-demand virtual training. Plus, when you refer four of your personally enrolled Reps to sign up for the PSP, yours is FREE! *Try the full service for a month for only one dollar ($1). If you like it, simply do nothing and you’ll be billed $29.99/month going forward. Please Choose ONE Form of Payment. ACH requires copy of a voided or cancelled check be submitted. ACH Bank Name: _________________________________________ Bank Telephone: ___________________________ City: ________________________________________________ State: _______ Zip: _______________________ Routing #: __________________________________ Account #: _________________________________________ Credit Card Type: MC VISA AMEX Name on Card: ________________________________________ Credit Card#: ________________________________ Exp. Date: _____/_____ 3- or 4-Digit Security Code: _______ Billing Address: ________________________________________________________________________________ City: ___________________________________________ State: ________ Zip: __________________________ I understand that I have the right to terminate my WorldVentures independent business at any time, with or without reason, by sending written notice to the Company at the address below. I have read and understand the Terms & Conditions listed here and on the back of this page and agree to abide by them. I affirm that none of the spaces intended to be filled out by me have been left blank. I understand that any intentional misrepresentation of any information I provide on this Representative Application may result in action by WorldVentures, up to and including termination of this Agreement. I am aware that I am entitled to a copy of this Agreement at the time I sign it. I may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction (5th business day if I reside in AK; 30th day if I reside in KY; 15th day if I reside in WI). I authorize WorldVentures to charge my credit card or checking account identified above for the order selected above and to immediately withdraw monthly fees for the product I have selected. Applicant’s Signature: ___________________________________________________ ENROLLER USE ONLY Received Rep Kit, Ship to Enroller. –or– Date: __________________ Ship to Address: ____________________________________________ Enroller Name: ____________________________________________________ Enroller ID# or Username: ____________________________________ Binary Placement: Name: ___________________________________________ ID#: ___________________ Left Right Notes: _____________________________________________________________________________________________________________________ Top Copy – For Enrolling Rep to Input into the System Bottom Copy – Customer Copy 5360 LEGACY DR., BUILDING 1, SUITE 300 • PLANO, TX • 75024 PH 972. 805.5100 • FAX 972.767.4039 • WWW.WORLDVENTURES.COM Ver 5.1 Rev 2011 Representative Terms and Conditions 1. I understand that as a WorldVentures Representative: a. I have the right to offer for sale WorldVentures products and services in accordance with these Terms and Conditions. b. I have the right to enroll persons in WorldVentures. c. I will train and motivate the Representatives in my downline marketing organization. 2. I agree to present the WorldVentures Compensation Plan and WorldVentures products and services as set forth in official WorldVentures literature. 3. I agree that as a WorldVentures Representative I am an independent contractor, and not an employee, partner, legal representative, or franchisee of WorldVentures. I am not authorized to and will not incur any debt, expense, obligation, or open any checking account on behalf of, for, or in the name of WorldVentures. 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. I UNDERSTAND THAT I SHALL NOT BE TREATED AS AN EMPLOYEE OF WORLDVENTURES FOR FEDERAL OR STATE TAX PURPOSES. WorldVentures is not responsible for withholding, and shall not withhold or deduct from my bonuses and commissions, if any, FICA, or taxes of any kind. 4. I have carefully read and agree to comply with the WorldVentures Policies and Procedures and the WorldVentures Compensation Plan, both of which are provided by WorldVentures on its website and are incorporated into and made a part of these Terms and Conditions (these three documents shall be collectively referred to as the “Agreement”). I understand that I must be in good standing, and not in violation of the Agreement, to be eligible for bonuses or commissions from WorldVentures. I understand that these Terms and Conditions, the WorldVentures Policies and Procedures, or the WorldVentures Compensation Plan may be amended at the sole discretion of WorldVentures, and I agree that any such amendment will apply to me. Notification of amendments shall be published in official WorldVentures materials. Amendments shall become effective upon notice to all Representatives. The continuation of my WorldVentures business or my acceptance of bonuses or commissions shall constitute my acceptance of any and all amendments. 5. The term of this Agreement is one year from the date of its acceptance by WorldVentures. The Agreement shall thereafter automatically renew for successive one year terms unless either I or WorldVentures provides the other party with at least 30 days written notice of non-renewal. If either I or WorldVentures elects to not renew the Agreement, or if it is canceled or terminated for any reason, I understand that I will permanently lose all rights as a Representative. I shall not be eligible to sell WorldVentures products and services nor shall I be eligible to receive commissions, bonuses, or other income resulting from the activities of my former downline sales organization. In the event of cancellation, termination or non-renewal, I waive all rights I have, including but not limited to property rights, to my former downline organization and to any bonuses, commissions or other remuneration derived through the sales and other activities of my former downline organization. WorldVentures reserves the right to terminate all Representative Agreements upon 30 days notice if the Company elects to: (1) cease business operations; (2) dissolve as a business entity; or (3) terminate distribution of its products and/or services via direct selling channels. 6. I may not assign any rights or delegate my duties under the Agreement without the prior written consent of WorldVentures. Any attempt to transfer or assign the Agreement without the express written consent of WorldVentures renders the Agreement voidable at the option of WorldVentures and may result in termination of my business. 7. I understand that if I fail to comply with the terms of the Agreement, WorldVentures may, at its discretion, impose upon me disciplinary actions as set forth in the Policies and Procedures. If I am in breach, default or violation of the Agreement at termination, I shall not be entitled to receive any further bonuses or commissions, whether or not the sales for such bonuses or commissions have been completed. 8. WorldVentures, its parent or affiliated companies, directors, officers, shareholders, employees, assigns, and agents (collectively referred to as “affiliates”), shall not be liable for, and I release WorldVentures and its affiliates from, all claims for consequential and exemplary damages. I further agree to release WorldVentures and its affiliates from all liability arising from or relating to the promotion or operation of my WorldVentures business and any activities related to it (e.g., the presentation of WorldVentures products or Compensation and Marketing Plan, the operation of a motor vehicle, the lease of meeting or training facilities, etc.), and agree to indemnify WorldVentures for any liability, damages, fines, penalties, or other awards arising from any unauthorized conduct that I undertake in operating my business. 9. The Agreement, in its current form and as amended by WorldVentures at its discretion, constitutes the entire contract between WorldVentures and myself. Any promises, representations, offers, and other communications not expressly set forth in the Agreement are of no force or effect. 10. Any waiver by WorldVentures of any breach of the Agreement must be in writing and signed by an authorized officer of WorldVentures. Waiver by WorldVentures of any breach of the Agreement by me shall not operate or be construed as a waiver of any subsequent breach. 11. If any provision of the 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. 12. This Agreement will be governed by and construed in accordance with the laws of the State of Texas, without regard to principles of conflicts of laws. All disputes and claims relating to WorldVentures, the Representative Agreement, the WorldVentures Compensation Plan or its products and services, the rights and obligations of an independent Representative and WorldVentures, or any other claims or causes of action relating to the performance of either an independent Representative or WorldVentures under the Agreement or the WorldVentures Policies and Procedures shall be settled totally and finally by arbitration in Dallas, Texas, or such other location as WorldVentures prescribes, in accordance with the Federal Arbitration Act and the Commercial Arbitration Rules of the American Arbitration Association, except that all parties shall be entitled to discovery rights allowed under the Federal Rules of Civil Procedure. All issues related to arbitration shall be governed by the Federal Arbitration Act. 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. Each party to the arbitration shall be responsible for its own costs and expenses of arbitration, including legal and filing fees. This agreement to arbitrate shall survive any termination or expiration of the Agreement. Nothing in the Agreement shall prevent WorldVentures from applying to and obtaining from any court having jurisdiction a writ of attachment, a temporary injunction, preliminary injunction, permanent injunction or other relief available to safeguard and protect WorldVentures’ 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. The parties consent to jurisdiction and venue before any federal or state court in Dallas County, State of Texas, for purposes of enforcing an award by an arbitrator or any other matter not subject to arbitration. 14. Notwithstanding the foregoing, Louisiana residents may bring an action against the Company with jurisdiction and venue as provided by Louisiana law. 15. Montana residents may terminate this Agreement within 15 days and receive a 100% refund of the Representative Business System purchase price. 16. If a Representative wishes to bring an action against WorldVentures for any act or omission relating to or arising from the Agreement, such action must be brought within one year from the date of the alleged conduct giving rise to the cause of action. Failure to bring such action within such time shall bar all claims against WorldVentures for such act or omission. Representative waives all claims that any other statutes of limitations applies. 17. I authorize WorldVentures to use my name, photograph, personal story and/or likeness in advertising/promotional materials and waive all claims for remuneration for such use. 18. I understand that participation in WorldVentures does NOT guarantee or assure any profits or success. I certify that no such representations of income or success have been made to me by WorldVentures or any Independent Representative. 19. By completing and submitting this Application, I specifically authorize WorldVentures, Inc. to communicate with me by electronic mail at the email address I have entered on the front of the Application. I understand that such emails may include offers and solicitations for the sale and purchase of WorldVentures products, sales aids, and services. 20. A faxed copy of the Agreement shall be treated as an original in all respects. NOTICE OF CANCELLATION DATE OF TRANSACTION: ___________ Customer Name (Please Print): ___________________________________________ You may CANCEL this transaction without penalty or obligation, within THREE BUSINESS DAYS from the above date (Five business days if you reside in Alaska, thirty days if you reside in Kentucky, and fifteen days if you reside in Wisconsin). If you wish to cancel this agreement, you may do so by delivering or mailing a written notice to WORLDVENTURES. To prove that you canceled, it is recommended that you send the notice by certified mail or overnight delivery. If you deliver the notice personally, you are entitled to a receipt. Your notice must state that you do not wish to be bound by the agreement. Be sure to keep a photocopy of the notice of cancellation which you mail. Notice of cancellation, if given by mail, shall be deemed to be given as of the date the mailed notice was postmarked. If you cancel, any property traded in, any payments made by you under the contract of sale, and any negotiable instrument executed by you will be returned within TEN BUSINESS DAYS following receipt by the seller of your cancellation notice, and any security interest arising out of the transaction will be cancelled. To cancel this transaction, mail or deliver a signed and dated copy of this Cancellation Notice or any other written notice, or send a telegram to WorldVentures, 5360 Legacy Dr., Building 1, Suite 300., Plano, TX 75024 NOT LATER THAN MIDNIGHT OF the third business day following the date set forth above. I HEREBY CANCEL THIS TRANSACTION. Signature: ___________________________________________________ Date: _______________ Top Copy – For Enrolling Rep to Input into the System Bottom Copy – Customer Copy 5360 LEGACY DR., BUILDING 1, SUITE 300 • PLANO, TX • 75024 PH 972. 805.5100 • FAX 972.767.4039 • WWW.WORLDVENTURES.COM Ver 5.1 Rev 2011
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