You Must Read The Following Before Continuing

By checking this box, I solemnly declare and affirm, under penalty of perjury, the following is true:

• I am at least 21 years of age;
• I am requesting your materials for my own personal use in my private residence;
• I am not accessing this material to use against the site operator or any person whomsoever in any conceivable manner;
• I will not exhibit any material you send me to a minor and will carefully ensure that no minor has access to it; or any other person who might find such material personally offensive;
• I personally warrant that the materials I am requesting, to the best of my knowledge and belief, contain only descriptions or depictions of sexual activity which are acceptable for adults in my community, based on the average adult person applying current community standards;
• I subscribe to the principles of the First Amendment which holds that free adult Americans have the right to decide for themselves what they will read and view without governmental interference;
• I authorize RAD Video to bill my credit card for this and future purchases that I may submit by phone, fax, online, e-mail or mail.
• I understand that RAD Video only ships to certain locations.
• I understand and agree that adult access fees are non-refundable but will be deducted from my first purchase.

Billing Information

Enter billing information As it appears on your credit card, unverified addresses will not be processed.

First name:

Last name:

Telephone:

(Used only if problems occur with your credit card.)

Street:

 

Apt/Ste #:

(leave blank if not applicable)

City:

State: Please select... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington D.C. West Virginia Wisconsin Wyoming ---- Puerto Rico ---- Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Ontario Prince Edward Island Quebec Saskatchewan Yukon

Non US/CAN State:

Zip:

Country: United States Canada Aruba Australia Austria Bahamas Barbados Belgium Brazil Denmark Finland France Germany Great Britain Hong Kong Ireland (Eire) Italy Jamaica Japan Liechtenstein Luxembourg Netherlands Netherlands Antilies New Zealand Norway Poland Portugal Saint Lucia Spain Sweden Switzerland Thailand Scotland American Samoa "France, Metropolitan" French Southern Territorie Guam Puerto Rico Virgin Islands (U.S.)

Enter your email address and choose your password!

Important: Your E-mail address is required for all transactions. Your email address will be used to access your RAD account.

Note: Please note that our website is case-sensitive. Please be sure to enter your correct email address.

• America Online email address are like this: yourscreenname@aol.com
• Prodigy user email address will be userid@prodigy.com
• CompuServe email address will be xxxx.yyyyy@compuserve.com. (Remember to change the comma to a period.)
• If you enter an incorrect email address, you will never receive your validation instructions.

E-mail:

Password:

Re-enter Password:

Password must be at least 6 characters long with no spaces or special characters.

My particular interests are (select one): Gay, Bi-Sexual

Please keep me informed by email of RAD Video specials and updates.
Send me RAD Video's monthly Print Catalog

Credit Card Information

If you'd like to gain Adult Acess but don't have a credit card, are uncomfortable putting your credit card online, or would rather pay with a check or money order; you may do so with the printable Adult Access form Text or PDF. Fill it out and mail it to us along with your payment.

If you are already a member of RAD Video's Adult Access, you must fill in all the previous information and check the 'Existing Customer' button; however you do not need to enter credit card information. Your credit card statements will be billed as "RAD Video, Inc." If you are a new customer a one time Adult Access Fee of $10 will be charged to your credit card. This will be refunded on your first order.

Credit Card Number:

Type: Select One Visa MasterCard
American Express Discover

Expiration Date: Month 01 January 02 February 03 March 04 April 05 May 06 June 07 July 08 August 09 September 10 October 11 November 12 December Year 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Date of Birth:

(mm/dd/yyyy)

Existing Customer