Bootygirlz
Purchase Membership by Mail
 
* Please make sure all information clearly appears when printed.

* Include this form with your cash, check or money order.
 
Account Information (Please fill all fields)
First name :
Last name:
Email address:
Preferred Username: or
Preferred Password:
Renewal: (Check if you are renewing your membership)
 
Membership Type
7 Days Membership - $7.95
30 Days Membership - $9.95
90 Days Membership - $19.95
180 Days Membership - $29.95
 
Please make your check or money order payable to: Akcents
 
Please mail your cash, check or money order to:

Akcents
 P.O. Box 45232
ST LOUIS, MO. 63145-5232
 
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 Akcents, namely, sexually explicit material and you voluntarily and knowingly choose to view such material.
 
 
Sign here:_______________________________     Date:____________