PROJECT PEE VIDEO ORDER FORM (revised 09/25/08)

Please circle format wanted:   NTSC       PAL
(NOTE: NTSC is the format used in North American and Japan and
PAL is used in most other countries.  PAL format is no longer
available for VHS tape but it is available for DVD.)

All titles run 60 minutes except as noted.

Please check each item that applies:

DVD VHS
___ ___ The Wet Adventures of Amber & Libby ($50.00) .. $___________
          The video above runs 1 hour, 50 minutes.
___ ___ A Wet Week With Cassandra & Mila ($50.00) ..... $___________
___ ___ Carla & Friends Need To Go ($50.00) ........... $___________
___ ___ Compilation Movie - Vol. 1 ($50.00) ........... $___________
___ ___ Compilation Movie - Vol. 2 ($50.00) ........... $___________
___ ___ Who Dares Pees - Vol. 1 ($50.00) .............. $___________
___ ___ Who Dares Pees - Vol. 2 ($50.00) .............. $___________
___ ___ Who Dares Pees - Vol. 1 and 2 for $80.00 plus
          get a $10.00 voucher toward Vol. 3 .......... $___________
___ ___ Who Dares Pees - Vol. 3 ($50.00) .............. $___________
___ ___ Eve Meets Cassandra ($50.00) .................. $___________
___ ___ Eve & Cassandra's Scottish Pee Tour 1 ($50.00)  $___________
___ ___ Eve & Cassandra's Scottish Pee Tour 2 ($50.00)  $___________
___ ___ Eve & Cassandra's Scottish Pee Tour 1 and 2
          for $80.00 .................................. $___________
___ ___ Kathy & Gina's Mallorcan Pee Break 1 ($50.00) . $___________
___ ___ Kathy & Gina's Mallorcan Pee Break 2 ($50.00) . $___________
___ ___ Kathy & Gina's Mallorcan Pee Break 1 and 2
          for $80.00 .................................. $___________
___ ___ Eve & Natalie In The New Forest ($40.00) ...... $___________
___ ___ Eve & Cassandra's Thames Valley Tour 1 ($50.00) $___________
___ ___ Eve & Cassandra's Thames Valley Tour 2 ($50.00) $___________
          The video above runs 1 hour, 15 minutes.
___ ___ Eve & Cassandra's Thames Valley Tour 1 and 2
          for $100.00 with bonus DVD .................. $___________
___ ___ Ewa Visits Shropshire 1 (70 minutes - $50.00) . $___________
___ ___ Ewa Visits Shropshire 2 (70 minutes - $50.00) . $___________
___ ___ Katharina - Karneval & Beyond (90 min - $50.00) $___________
___ ___ Eve & Genevieve in Paris & Versailles 1 ($50.00)$___________
___ ___ Eve & Genevieve in Paris & Versailles 2 ($50.00)$___________
___ ___ Eve & Genevieve in Paris & Versailles 1 and 2
          for $90.00 .................................. $___________
___ ___ Pee Medley 1 (90 min - $50.00) ................ $___________
___ ___ Pee Medley 2 (65 min - $50.00) ................ $___________
___ ___ Pee Medley 3 (66 min - $50.00) ................ $___________
___ ___ Pee Medley 1, 2 and 3 for $130.00 ............. $___________
___ ___ Eve & Robyn's Yorkshire Travels Parts 1 & 2
          ( 80 min - $60.00) .......................... $___________
___ ___ Eve & Ewa's Tuscan Idyll 1 (79 min - $50.00) .. $___________
___ ___ Eve & Ewa's Tuscan Idyll 2 (65 min - $50.00) .. $___________
___ ___ Eve & Ewa's Tuscan Idyll 3 (77 min - $50.00) .. $___________
___ ___ Tuscan Idyll 1, 2 and 3 for $130.00 ........... $___________
___ ___ Salma & Cindy In Mallorca 1 (76 min - $50.00) . $___________
___ ___ Salma & Cindy In Mallorca 2 (57 min - $50.00) . $___________
___ ___ Mallorca 1 and 2 for $90.00 ................... $___________

Subtract your $10.00 voucher and enclose it with your
order if you are buying Who Dares Pee - Vol. 3 and you
already bought Vol. 1 and Vol. 2 ...................... $___________

Credit Card orders - add $2.00 for a $40 title, $3.00 for
a $50 title, $4.00 for an $80 combo, $6.00 for a $90.00
or $100.00 combo, and $8.00 for a $130.00 combo ....... $___________

Canadian orders add $3.00 per video for
                                     delivery insurance $___________

Australian orders paid by credit card will have a
  10% GST tax added to their total .................... $___________

Shipping is free but overnight delivery by Express Mail
(US Only) add $25.00 for 1 to 4 videos, add $30.00 for 5
to 7 videos, add $35.00 for 8 to 10 videos. (Optional)  $___________

                                                  Total $___________

___I DO NOT want to require a signature to receive my order.
___Do NOT send me information about new products.
___Send future info by ___ e-mail or ___ to my mailing address.

PAYMENT METHOD: ___Check ___Money Order (payable to Patches' Place)
___ Cash ___Visa ___MasterCard ___ Bankcard

Card #_________________________________________  Expires ___________

Security Code ________ (last 3 digits on the back of the Credit Card
above your signature)

Credit card payments will show the name "Clare Gordon" on your card
statement.  Cash payments must be in US dollars.  Personal checks
from outside the US are not acceptable.  International Money Orders
from outside the US must be payable in US dollars and have the name
of the US Bank where the money order can be cleared printed on the
face of the money order.

CERTIFICATION STATEMENT AND SHIPPING ADDRESS:
I certify I am over 21 years of age and am requesting these sexually
oriented materials.  I believe the scenes described in any videos I
order are within the "community standards" where I live.  I certify
I am not a city, state, or federal law enforcement officer for the
United States nor any other country, nor a postal inspector for any
country, nor am I requesting materials as evidence in prosecuting or
harassing any individual or organization.  Any video sent to me is
for my personal use only and will not be shown to minors nor sold,
traded or given to others.  I have not requested anyone to "protect"
me against receiving sexually oriented material nor signed any forms
intended to block the receipt of sexually oriented material.

If I am ordering from outside the United States, I understand all
videos are legal for sale in the USA but that Patches' Place and
other represented video producers cannot predict nor be responsible
for the actions of customs agents in my country nor any intermediate
country.  I release Patches' Place and other video producers from
any responsibility or liability for the acts, omissions or errors of
the government of my country or any intermediate country.  I am
responsible for any import duties that may be required.

Signed ____________________________________  Date __________________

E-Mail address for confirmation or questions________________________

PRINT CLEARLY

Name _______________________________________________________________

Address ____________________________________________________________

City _____________________________ State or Province _______________

Zip _________________  Country (if outside U.S.A.) _________________

Phone number _____________________ (Optional - for use on Express
Mail only in the USA.)  You can phone your order to Patches' Place
by calling 585-218-9928 or send this order to Patches' Place, PO Box
24192, Rochester, NY  14624, USA.