TiedGirls.com Mail Subscription Form

This form is for those that prefer not to use the web for their order, or prefer not to use a credit card. Please remember to include your email address.  Our process involves emailing you when your login & password is activated, orders cannot be processed without an email address. If you give an incorrect email address, or we can't read your handwriting clearly, you will not receive notification when your membership starts. Cash is not acceptable for payment and we are not responsible for cash lost in the mail.

 Print Name
(REQUIRED)

  

 Address

  

 City, State

  

 Zip (Postal Code)

  

Country

  

 Email Address
(REQUIRED)

  

Preferred Username
(6 TO 12 CHARACTERS)

  

Preferred Password
(6 TO 12 CHARACTERS)

  


Please choose the membership option you would like:
 
(check one option)
(circle payment method)

30 Day Access - $19.95

-     cashier's check    -    money order    -

90 Day Access - $54.95 (3 month)

180 Day Access - $96.00 (6 month)

One Year Access - $180.00


"My signature below certifies that I am an adult, 18 years of age or older, and am lawfully entitled to receive, access and/or view adult materials in the community where I live. I understand that I am requesting material of an adult nature. I believe this material to be within the community standards of the area in which I live. I understand that this membership is for one person only and is non-transferable. I agree that I am solely responsible for protecting my username and password and keeping them completely confidential, known only to myself. I certify that I will not copy, duplicate, post, upload, share, transmit, email nor snail-mail the material I access or receive via this membership to any other person, website, computer, server, newsgroup, entity, group or company. I certify under penalty of perjury that all of the aforementioned is true and correct to the best of my knowledge."

 Signature
(REQUIRED)

 

Mail this form and your payment to: