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I, _______________________________________________ (full name), hereby confirm and swear that I am the actual authorized user of the following ScreenName(s) that I use in RussianWomanCam.com, operated by CC Network, Inc.:
- ScreenName: ________________________________________________
- ScreenName: ________________________________________________
- ScreenName: ________________________________________________
I also hereby confirm and swear that I am the actual authorized user of the following credit card(s):
- Credit card number: ______________________________ Expires: _____________
Name on credit card: ____________________________
- Credit card number: ______________________________ Expires: _____________
Name on credit card: _____________________________
- Credit card number: ______________________________ Expires: _____________
Name on credit card: _____________________________
The address where my credit card(s) statements are mailed to is:
Street: _____________________________________________________________
City/State/Zip (Post Code)/Country: ________________________________________
___________________________________________________________________
If the above address is a P.O. Box or is not your permanent residence, then please write your permanent address here:
Street: _____________________________________________________________
City/State/Zip (Post Code)/Country: ________________________________________
___________________________________________________________________
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PAYMENT LIABILITY: By signing this agreement, I confirm that I am an active user of the site and may make frequent use of the 'premium' services which attract a charge, for which I will be fully liable and responsible. I also confirm that I shall regularly view my session details as displayed in 'Viewer Services' and if I disagree with any charges to inform CC Network, Inc. before contacting my credit card company. This commitment shall continue until I cancel my account by notifying CC Network, Inc. using the form on the Contact Us page. I also confirm that I understand that CC Network, Inc. operates a no refunds policy, but may, at its discretion, credit me with free time in the event that I experience technical difficulties which I genuinely tried to overcome, or am purposely deceived by one of the Chathosts.
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CONFIRMATION OF MY IDENTITY
My date of birth is: ___________________________________________________________
My phone number is: _________________________________________________________
My email address is: _________________________________________________________
Signature:______________________________________________
Name (print): ___________________________________________
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