Chica's Place Membership Mail Order Form

 

Please complete this form and send it along with your cash, check or money order to:

CP Productions Inc.

15111 N. Hayden Road, Suite 160-146

Scottsdale, AZ  85260

 

IMPORTANT: Make check or money order payable to: "CP Productions Inc.".

I declare under the penalty of perjury to the following:

1)  I am at least 18 years of age.

2)  I will not exhibit this material minors.

3)  I personally warrant that the material I am requesting is acceptable and meets my community standards.

 

Signature:

 

Full Name:

 

Email:

 

 

 

Membership Term

___ 1 Month = $29.95 USD        ___ 3 Months = $59.95 USD

 

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NOTE: I will send you an email letting you know when I received this completed form with payment.   Thanks for joining my site...enjoy!

Rev. 2011-11-27