ALS Scan Printable Order Form

For Fax / Mail Payments

Terms and Conditions

  1. I am at least 21 years of age
  2. The sexually explicit material I am buying and/or viewing is for my own personal use and I will never expose minors to said material
  3. I desire and choose to receive the sexually explicit material contained in this website
  4. I do not find sexually explicit material to be obscene or offensive in any way
  5. The viewing, reading, or downloading of the material and images on this website do not violate the laws or standards of my community
  6. I am wholly liable for any false disclosures and solely responsible for any legal ramifications that may arise from viewing, reading, or downloading material and images contained within this website. Furthermore, neither ALS Scan, Inc. nor its affiliates will be held responsible for any legal ramifications that may arise as a result of fraudulent entry into or use of this website and/or material contain herein
  7. I agree that by entering this website, I am subjecting myself, and any business entity of which I have any legal or equitable interest, to the personal jurisdiction of the State of Maryland should any dispute arise at any time between ALS Scan, Inc. and myself and/or such business entity
  8. These terms and conditions shall be governed and construed in accordance with the laws of the State of Maryland (USA) and applicable federal laws without regard to conflicts of law principals. I agree that any and all proceedings relating to this site shall be maintained in the courts of the State of Maryland or the federal district courts sitting in Maryland, which courts shall have exclusive jurisdiction for such purpose
  9. I understand that by entering this site, I have entered into a legal agreement with ALS Scan, Inc. If any portion of this agreement is deemed unenforceable by a court of competent jurisdiction, it shall not affect the enforceability of the other portions of this Agreement
  10. I understand that ALS Scan, Inc. collects statistics on source IP addresses, and that if I share my unique Login name and Password my access will be terminated without reimbursement
  11. Membership sales are final and nonrefundable

* DO NOT PROCEED UNLESS YOU AGREE TO THE ABOVE TERMS *

I have completely read and agree to the above Terms and Conditions for gaining access to the ALS Scan Members Section at www.alsscan.com:

Yes
No

Username and Password must be different, 6 characters or more, and contain letters and numbers only
Password must contain at least 1 uppercase, 1 lowercase, and 1 number

Username:
Password:
Full Name:
Address:
Postal Code:
Country:
Email:
Date of Birth:
Desired Membership Plan (select one):
Recurring Billing Options **
  • $29.95 One (1) Month
    (Rebills at $24.95 every month)
  • $44.95 Two (2) Months
    (Rebills at $39.95 every 2nd month)
  • $59.95 Three (3) Months
    (Rebills at $54.95 every 3rd month)
One Time Only Billing Options
  • $39.95 One (1) Month
  • $54.95 Two (2) Months
    (Just 92¢ a day!)
  • $69.95 Three (3) Months
    (Just 78¢ a day!)
  • $99.95 Six (6) Months
    (Just 55¢ a day!)
  • $149.95 One (1) Year
    (Just 41¢ a day!)

** Recurring Billing Option: Your Credit Card will be automatically recharged
at the lower rate shown and your membership will continue without interruption at
the end of your membership term for your convenience.


US Residents: Must include a photo ID verifying age if not paying by credit card.
Remember to include your payment with this order

Credit Card Type: Visa
MasterCard
American Express
JCB
Credit Card Number:
Expiration Date:
CVV2 Code:
What's This?
 
Signature (I agree to the terms and conditions stated above)

Fax Order Information to: 443-272-7128

Or Mail to:
ALS Scan, Inc.
PO Box 1418
Randallstown, MD, 21133
Please double-check all information before sending