| Hardcore Sweethearts |
| Purchase Membership by Mail |
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| ***Please make sure all information
clearly appears when printed. Include this form with your cash,
check or money order. |
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| Account Information (Please fill all fields) |
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| Membership Type (Check only one please) |
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| Please make your check or money order payable to: MARKETING
EXTENSIONS INC. |
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Please mail your cash, check or money order to:
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Marketing Extensions Inc. 99 Atlantic Ave. Suite 204
Toronto, Ontario, Canada
M6K 3J8 |
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| By signing below you hereby swear that you are of
at least eighteen (18) years of age (21 in some jurisdictions) and have
legal capacity to enter into agreements of this nature. You further represent
and warrant that you understand the nature of the content published by
Marketing Extensions, namely, sexually explicit material and you voluntarily
and knowingly choose to view such material. |
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| Sign here:_______________________________ Date:____________ |