Beach Bum Lifestyle Ambassador Enrollment

please fill out this form in full. your kit will be ordered +
you will be contacted by your Wellness Mentor within 24 hours.

Name *
Shipping Address *
Shipping Address
Phone *
Skin Type *
Please select the option that best describes your skin type. This will allow us to choose the best Celavive skincare kit for you!
Please select the combination of smoothie mixes you would like. *a small addition cost will be added for the vegan option.
Disclaimers *
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Health Disclaimer:  The Beach Bum Lifestyle Program is for information purposes only and is not intended in any way to be a substitute for professional medical advice, diagnosis, or treatment. The author is not a medical doctor and may not be held responsible for any adverse effects or consequences resulting from the use of any recipes, suggestions, or nutritional information. Readers should consult appropriate health professionals on any matter relating to their health and well-being.  Those under the age of 18 should not participate in the program, except on the advice of their physician. These statements have not been evaluated by the Food and Drug Administration (FDA) and the products are not intended to diagnose, treat, or cure any disease.

Payment Disclaimer:  This form does not process your payment.  Your payment will be processed through a secure and encrypted online sever through our product partner, USANA Health Sciences, Inc.  The charge on your statement will indicate USANA Health Sciences, Inc.

Additional Information:  You will receive an email directly from USANA Health Sciences, Inc. stating you have been enrolled as an Associate, as well as a personal welcome email from your Sponsor. This email will include your Associate ID and how to access your new business account.