BECOME A PARTNER

Partner Application

Apply for access to Defy Age partner resources and authorized pricing. All applications are reviewed before access is granted.

Fields marked with * are required.

Contact Name *Legal / Business Name *Business Type *Business Email *Phone Number *State(s) of Operation *Select all states where you operate. Use Ctrl (Windows) or Command (Mac) to select multiple states, then click Done.

Primary Business Address *

How do you intend to work with Defy Age? *

PARTNER AGREEMENT

Defy Age Partner Relationship & Operating Agreement — v1

Please review the agreement before submitting your application. It explains the relationship between Defy Age and its partners, including partner responsibilities, customer relationships, ordering, product research, and confidentiality.

Open Agreement Download PDF

Partner Agreement Acceptance

By signing below, I confirm that I have read and agree to the Defy Age Partner Relationship & Operating Agreement, version 1.

Authorized Representative * Business Name * Typed Signature * Date Agreed

I have read and agree to the Defy Age Partner Relationship & Operating Agreement, version 1. *

I confirm I am at least 21 years old. * I acknowledge Defy Age research-use and marketing requirements and understand approval is required before partner access is granted. * I agree to applicable partner terms, privacy and compliance requirements. *

Partner Application

Defy Age Partner Relationship & Operating Agreement — v1

Partner Agreement Acceptance

Thank you.