NEW Prices For Summer Time! www.esexchannel.com membership by mail & email. Complete this form, print, and mail along with your cashiers check, & money order,to: PQ Enterprises 23580 Alessandro blvd. P.O.BOX#7263 Moreno Valley, Ca. 92553-7263 Also send us an email huey@esexchannel.com when you mailed off your payment. With your username, and password. Thx -------------------------------------------------------------------------------- IMPORTANT Select a username and password for esexchannel.com. Remember, both are case sensitive. Username:_________________________ Password:_________________________ Email Address:_______________________ Make checks payable to PQ Enterprises. Payment by cashiers check or money order will activate your membership upon receipt. Include your payment of $10.95 for a 30 day membership, $24.95 for a 90 day membership, or $75 for a one year membership. -------------------------------------------------------------------------------- PLEASE REVIEW THE FOLLOWING I am at least 21 years of age; The material I'm viewing is for my own personal use and isn't to be viewed by minors or anyone else but myself; I am not a U.S. POSTAL OFFICIAL or LAW ENFORCEMENT AGENT or acting as an agent thereof, attempting to obtain any evidence for the prosecution of any individual or CORPORATION or for the purpose of entrapment; I desire to receive and haven't notified the POSTAL SERVICE or any OTHER, GOVERNMENTAL AGENCY to intercept sexually explicit material I can stop receiving such material at any time by logging off now and not returning; I believe, that as an adult, I've the unalienable right to read and/or view any type of material that I choose; That at no time, will minors be subjected to said material of any kind; By going to the home page and/or by looking at anything on this site you are agreeing that the material contained herein is not obscene or offensive in any way nor could ever be construed to be so, nor could any sexually explicit material of any kind ever be considered obscene or offensive. You also certifying that the material presented here is not illegal or considered obscene in your street, village, community, city, state, province or country. All of the above is understood and the following is true. I ACCEPT ALL RESPONSIBILITY I also release esexchannel.com and my internet service provider from all liability. Signature ______________________________ -------------------------------------------------------------------------------- CUSTOMER INFORMATION Name ___________________________________________________________________________ Address _________________________________________________________________________ Address _________________________________________________________________________ City _____________________________________________ State ____________ Zip ___________ Phone ______________________________________ Fax _________________________________