Fax-In Membership Instructions

Wasteland & House of Japanese Bondage are Private, Uncensored Adult Entertainment Services providing Thousands of pictures, stories, articles and other sexually explicit content.

Members enjoy UNLIMITED ACCESS to our services.

Simply print out this page and fill out the requested information below and you become a
privileged members of these sites. IT'S THAT EASY!!!

We have several different subscription lengths for your convenience. The best value and most popular is our annual membership. Now that you have had a small sample of our fantastic offerings, we think you'll agree that the annual subscription is the best. You can also select a monthly, quarterly or semi-annual.

Your Credit Card will be discreetly billed to "The Phoenix Group"

International Members Are Welcome!

Please fill in the following information. We will e-mail your membership confirmation,
alias and password shortly after we receive your application.

All Set? Ok, Here We Go......
Print out this form and complete. Please print clearly!
Wasteland Membership Form
The information you provide us is strictly confidential - we do not sell our mailing list.

Please Tell Us....

Your Name:_____________________________________________

Address:____________________________________

City:_______________________________________

State/Prov:_________________________________ (if applicable)

Zip/Postal Code:________________________________ (Required in the USA Only)

Country:__________________________________

Username:________________________

Password:_________________________
 

Membership Length

[_] 1 Month$34.95

[_] 3 Months $74.95

[_] 6 Months $134.95

[_] 1 Year $174.95

Payment Type (please check the appropriate box)

[_] Visa

[_] MasterCard

[_] Novus (Discover)

[_] Personal Check (make checks payable to The Phoenix Group)

[_] Money Order (make money orders payable to The Phoenix Group)

What is your Credit Card Number?________________________________

What is the Expiration Date on your Credit Card?____________________

Signature:_____________________________________________________

What is Your Email Address (Please print clearly)? _____________________________________

That's All There is to it!
Our Fax Number Is:
1-603-465-9095
Your Credit Card will be discreetly billed to "The Phoenix Group".
If you have any questions please call us at 1-603-465-9088 or e-mail

Be sure to read the terms and conditions.
In accepting membership to Wasteland I hereby acknowledge my understanding of the following:
I declare under penalty of perjury that I am at least 18 years old.
I understand that membership subscription fees are non-refundable.
I understand that I must submit by E-Mail if I wish to cancel my subscription.
I understand that subscription fees will be automatically charged to my credit card.
I understand that by becoming a member of Wasteland, I become a subscriber and agree to the Membership Terms and conditions