RELEASE STATEMENT: I certify that I am 21 years old or older, that I am neither a member of law enforcement or a postal inspector, that I am aware the material I am purchasing is sexual in nature, and not to be viewed by minors, that the materials purchased are to be viewed by me for my own personal use, that I will not show any of this material to children, minors, or persons under the age of 21, that none of this material will be duplicated for commercial purposes of any kind, and that none of this material will be distributed for commercial use without the expressed written consent of Samantha Slopes.

Signed: _______________________________________

Printed name: __________________________________

Mailing address: ________________________________

Please print out this form and sign release form also. Send check or money order to:

Samantha Slopes c/o Poulsen MAKE PAYABLE TO CASH

PO Box 221531

Newhall, Ca 91322