miss lizz
 Membership by mail
We accept checks, money orders, and cash!
Please print out this form (or just write everything on a piece or paper) and include it with your payment. I need this information in order to process your account!
Name:____________________________________________
E-mail:___________________________________________
Birth Date:________________________________________
Please circle the subscription you would like:
Please choose a user name & password:
Letters and numbers are CaSe SeNsiTivE (Please Print Neatly)
User ID: __________________________________________
Password:________________________________________
Please Read, Date, & Sign:
I am a legal adult (at least 18 years of age in some areas, 21 in others) and I would like to order a membership to "Queen Of Farts." I understand that by becoming a member of this club, I will be gaining access to material that contains nudity/sexually explicit themes, and I wish to view such material. I also know that viewing such material in my locale is legal. I also understand that the QueenOfFarts bears no liability in the event of any misadventure from my use of this web site.
Date:__________________________________
Sign:__________________________________
Mail To:
Please E-Mail me to obtain my mailing address
|