mail order form

JAY  EDWARDS
PO BOX 6247
MIRAMAR BEACH  FL 
32550

                             NAME ________________________________________________

                             ADDRESS ____________________________________________

                                               ____________________________________________
                   
                                               ____________________________________________

EMAIL ADDRESS ___________________________________________________ (REQUIRED)
(Without the email address, we cannot send your passwords to you)

1 MONTH MEMBERSHIP  $14.50


PAYMENT OPTIONS

____Cash    ____Money Order   ____Check
      ____Visa   ____Mastercard 


CREDIT CARD NUMBER______________________________________    EXP DATE__________


Checks payable to "JAY EDWARDS".   Charges appear on your statement as "Bond Group".  Due to the subscription-type nature of this service, REFUNDS ARE NOT OFFERED.  As soon as your order is received, your personal password will be sent to the email address you have provided above.  Your password is intended for your personal and private use only.  Each password assigned through this system remains the property of Jay Edwards and may be revoked at any time due to misuse or abuse, causing termination of your membership with no refund.  Your membership entitles you to view and/or download images for your personal and private use only.  All images and content in the site are copyrighted and may not be redistributed or used in any way without the expressed written permission of jayedwards.com.  Posting of any part of these images to newsgroups or other sites will result in the revocation of your membership and possible civil and criminal prosecution

I hereby certify that I am 18 years of age or older and aware that you are sending sexually-oriented material which is for my own individual use and will not be resold, copied, or in any way distributed by me, including to minors.  I further state and agree that this material complies with my local community standards.

SIGNATURE_____________________________________(Required)