WARNING THIS SITE CONTAINS ADULT-ORIENTED and AGE RESTRICTED MATERIALS.
YOU MUST BE AT LEAST 18 YEARS OLD (21 YEARS IN SOME JURISDICTIONS) TO
ENTER THIS WEB SITE.


By entering this website and/or submitting the information below, you agree to all of this
site's Terms & Conditions. You further agree that the laws of the United States of America
shall govern this transaction.

To enter this site, you must certify and affirm, under the penalties of perjury, your actual
date of birth.


ELECTRONIC AFFIDAVIT
I hereby affirm, under the penalties of perjury pursuant to Title 28 U.S.C. §1746, that I was
born on the following date:


MONTH
DAY
YEAR

"I also agree that this transaction is governed by the Electronic Signatures in Global
and National Commerce Act (E-Sign Act), 15 U.S.C. §7000, et seq"

Note: This information is provided in an effort to comply with the Child Online Protection Act (COPA)
and related state laws. Providing a false declaration under the penalties of perjury is a criminal offense.
This document constitutes an un-sworn declaration under federal law. You may print this form for your
own personal records. You have the right to withdraw your consent to use the E-Sign Act by emailing us. Your consent to use the E-Sign Act is limited to providing the information on this form. You adopt the mark typed in the form below as your electronic signature.


Date XX / XX / 2005 Time XX:XX IP ADDRESS: xxx.xxx.xxx.xxx
Signed:
© BRH Media, LLC – Warning: All rights reserved. Unauthorized duplication, transmission of, copying, mechanical or electronic, is a violation of US Copyright laws. This product and the individual images contained within are protected under the laws of the United States and other countries. Unauthorized duplication, distribution, transmission, or exhibition of the whole or of any part therein may result in civil liability and criminal prosecution.