Natsby Associates
PO Box 515333
St. Louis, MO 63151

Please select a user name and password that is each six or more characters long. Both are case sensitive so be sure to indicate capital and small letters clearly.

Username ___________________

Password ___________________

Read and sign statement:
My signature below certifies that I am an adult, 18 years of age or older, and am lawfully entitled to receive, access and/or view adult materials in the community where I live. I understand that I am requesting material of an adult nature. I believe this material to be within the community standards of the area in which I live. I agree to not duplicate materials I receive or access. I certify that I will not share this material with, or show this material to, any other persons. I certify under penalty of perjury that all of the aforementioned is true and correct to the best of my knowledge.

Signature___________________________________________________________

Print Name_________________________________________________________

E-Mail Address _____________________________________________________

Please provide an e-mail address so we can notify you that your membership is active or in case there is a problem with your username or password selection. If you choose not to provide an e-mail address, we will activate your account, but you will have to communicate with us in the event of any problems.

You can print this form or provide the information any way you wish.

No membership will be activated until the signed statement above has been received.