Leia's
Custom Videos
Email me what you are looking for, length , and what you are offering to pay for the Video
and we will negotiate if it is a Video I will do.
HERE IS THE FORM THAT NEEDS TO BE
PRINTED AND FILLED OUT & MAILED WITH EACH CUSTOM ORDER.
Disclaimer and Order Form
DISCLAIMER
I certify that I am over
18/21 years of age(whichever is legal adult in yourplace of residence) or older, that
I am neither a member of law enforcement or a postal inspector, that I am aware that
material I am purchasing is sexual in nature, and is not to be viewed by minors, that the
materials purchased are to be viewed by me for my own personal use, that I will not show
any of the material to children, minors or persons under the age of 18. It is legal in my
state/community for me to have this type of material.
I understand that this video is protected
by copyright laws and that any duplication is unlawful. That none of this material will be
duplicated for any reason of any kind. I agree that if for ANY reason duplicate
copies are traced back to me, I AGREE to pay all Lawyer fees, detective fees, and will
face criminal charges and be sued to the fullest extent of the law.
Signed:_______________________
First Name:__________________
Middle Name:_________________
Last Name(include Jr,Sr,
etc..):_____________________
BIRTHDate:________________
Your Address:________________________
________________________________________________
Shipping Address If Different From
Above:________________________
___________________________________________________________
YOUR: Email
Address:_________________________
Description______________________________________________________________
_______________________________________________________________________
TOTAL AMOUNT DUE:_________ (Please make sure you have the CORRECT Amount
Enclosed with your order, to ensure no delays.)
________________________________________________________________
My Official use only: Date
Received:____________ $ Received:__________
Date Order
Shipped:____________
Mailed by:________________
Tracking/Cert #:_____________________
***Please note that your name and
information will NOT be given out to anyone for any use. This is for my Personal
Protection.. verifying age & legal issues |