SURFACE ORDER FORM AND AGE VERIFICATION
CLICK TO PRINT THIS FORM AS A WORD.doc DOCUMENT
SHADOWPLAY IMAGING Please use this form if you wish to pay by cash, check, or money order. Print and complete this form, then mail it to the above address with your payment. Orders are shipped within 48 business hours. If
payment is made by check orders are held until the funds in your account clear. We do NOT accept credit cards for mail orders! Make checks or money orders payable to GEORGE RICHARDS.
PMB 328
4676 COMMERCIAL ST, SE
SALEM, OREGON 97302-1902
PLEASE PRINT CLEARLY, AND PRINT YOUR ADDRESS EXACTLY AS IT MUST APPEAR IN ORDER FOR MAIL TO REACH YOU. IF YOUR INFORMATION CANNOT BE READ WE WILL NOT SHIP YOUR ORDER.
First Name:______________________________________________________
Last Name:______________________________________________________ Street Address:
City:___________________________________State:____________________ Country (for NON-US Customers)_____________________________________
Zip or Postal Code:________________________________________________ Email Address: ___________________________________________________ Signature (REQUIRED FOR ALL ORDERS):
X
_____________________________________________________________ With my signature I certify that I am at least 21 years old, and that the laws of my state or country do not prohibit the purchase or receipt of adult
oriented entertainment or products. I am aware that by ordering this material I will receive sexually oriented material from Shadowplay Imaging, and that this material is for my private and personal use. I understand that
this material will not be resold or in any way be distributed -- especially to minors.
REFUND POLICY
ALL SALES ARE FINAL - REFUNDS ARE NOT ALLOWED
Defective materials will be replaced with the same item and sent to the same address as originally ordered. Shadowplay Imaging IS NOT responsible for Foreign orders
that are seized by customs. There are no refunds for orders seized by Customs.
PLEASE PRINT CLEARLY! IF YOUR INFORMATION CANNOT BE READ WE WILL NOT SHIP YOUR ORDER.
USE BACK OF PAGE TO WRITE IN ADDITIONAL ITEMS BY SPI-000 NUMBER
Item (SPI-000): _________________________________ Price _____________ Item (SPI-000): _________________________________ Price _____________
Item (SPI-000): _________________________________ Price _____________ Item (SPI-000): _________________________________ Price _____________
Item (SPI-000): _________________________________ Price _____________ Item (SPI-000): _________________________________ Price _____________
Item (SPI-000): _________________________________ Price _____________ Item (SPI-000): _________________________________ Price _____________
Item (SPI-000): _________________________________ Price _____________
____________________ Sub-Total Before Shipping: ______________
Postage and Handling fee (SEE SHIPPING COSTS BELOW): ______________ US ORDERS - $7.50 PER ORDER
OVERSEAS ORDERS - $15.00 PER ORDER
Total Cost of Order (PAYMENT ENCLOSED FOR THIS AMOUNT): _____________
REFUND POLICY
ALL SALES ARE FINAL - REFUNDS ARE NOT ALLOWED
Defective materials will be replaced with the same item and sent to the
same address as originally ordered. Shadowplay Imaging IS NOT responsible for Foreign orders that are seized by customs. There are no refunds for orders seized by Customs.
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