Rebecca Edwards
169 Boone Square Street #206
Hillsborough, NC 27278

           
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Shipping Fee:   US - $4.00 per order US
Overseas - $8.00 PER ORDER

TOTAL_________

CREDIT CARDS NOT ACCEPTED VIA SURFACE MAIL
PLEASE USE THE ON-LINE SHOPPING CART FOR CREDIT CARD ORDERS
at CBtheater.com

PAYMENT OPTIONS: check one

    ____Cash    ____Money Order   ____Check   

Checks payable to "Rebecca Edwards".    

I hereby certify that I am 18 years of age or older and aware that you are sending sexually-oriented
material which is for my own individual use and will not be resold, copied, or in any way distributed by me, including to minors. 
I further state and agree that this material complies with my local community standards.

SIGNATURE___________________________________________ Date___________ (Required for ALL orders)