Membership by Mail® Form - Check or Money Order
Print and mail this form with your payment to the address below.
Name:
Street:
City / State / Zip:
Email Address:
Birth date:
Username:
Password:
Signature:
Membership Plan: Good Deal! Membership
$29.95 for 1 Month
Great Deal! Membership
$74.95 for 6 Months
The Backroom - Model Showcase

I certify by my signature above that all of the following is true: I understand that I am an adult who is legally ordering materials which show sexually explicit conduct. I will never let these materials be shown to minors or to persons who do not wish to view sexually explicit materials. I understand the materials are not to be duplicated or commercially displayed. I understand that all of the models in these materials are eighteen years old or older. I declare under penalty of perjury that the foregoing is true and correct.

Please make your Check or Money Order payable to Adult Media Concepts, Inc. and mail to:

Adult Media Concepts, Inc.
EbonyMale.com
Attn: New Membership Processing
P.O. Box 161656
Atlanta, GA 30321-1656