BuxomVixen Subscribe By Mail Membership Form Melissa Manning
for members access to : http://melissa.buxomvixen.com

Please print & fill out this form. (or copy the information onto a piece of paper if you can't print)

Please check-off one of the 3 subscription rates below:

___ $ 30 - 1 Month Subscription ($ 1.00 per day)

___ $ 60 - 3 Month Subscription ($ 20.00 per month)

___ $100 - 12 Month Subscription ($ 8.33 per month)

Make a Money Order for $30, $60, or $100 in US funds
payable to Berlin Blue and mail it to:

Berlin Blue
11684 Ventura Blvd. # 363
Studio City , CA 91604


Your Name:______________________________________

Address:_________________________________________

City:_______________________State/Prov.:____________

Zip/Postal Code:____________

Country:________________

Email Address:__________________________________________
this will be used to confirm your order and how you'll be notified
when your password has been activated

user name:__________________________

password:___________________________

Please choose a minimum of 8 characters with a mixture of letters & numbers,
both uppercase & lowercase.

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Your Signature
By signing you state that you are of legal age and have the legal right to possess adult material. By subscribing to melissa.buxomvixen.com, you certify that you are familiar with all local laws in your area affecting your legal right to access erotica or adult-oriented materials; that you have the legal right to access adult-oriented materials and melissa.buxomvixen..com has the legal right to transmit them to you; that you are requesting adult-oriented materials for your own private enjoyment and that you will never share these materials with a minor or in any way make these materials available to a minor. By accessing melissa.buxomvixen.com you accept full responsibility for any actions that may occur as a result of doing so, legal or otherwise.

Once we receive your payment, we will activate your account & contact you by the email address given.
**Please write CLEARLY** - thank you!