Hedgebuilders Mail-in Sign-Up Sheet

0091

On your browser click File, then click Print.


After you have printed this page, please fill out the following:

 

First Name: _______________________________

Last Name: _______________________________

Home Address: ________________________________________

City: ____________________________________

State: __________

Zip: _________________

Home Phone: _(______)______________________

E-mail Address: _______________________@________________________

Name of Internet Provider:______________________________________

 

 

Please enclose a check for $30 (first six months) plus $10 account setup. Your check will not be deposited until after your two week free trial period

How do you wish to pay for your semi-annual renewals?

o Check. Hedgebuilders will mail you a renewal notice.

o Credit Card. Number:_____________________________ Exp:__________ HB will automatically debit your credit card every six months.


___________________________________________________________________

Every Subscriber Must Sign This Release

I am applying for Filtered Internet through Hedgebuilders. I understand that Hedgebuilders blocks access to certain Internet Sites that I am legally entitled to view under the First Amendment, the Freedom of Information Act, the Computer Decency Act, and other legislation. I choose to voluntarily give up these rights in order to avoid viewing of inappropriate content by myself and my family. I give Hedgebuilders authority to make determinations of appropriate and inappropriate content on my behalf and to select sites for blocking accordingly.

I further understand that the Internet is constantly changing, worldwide, and largely unregulated. Several thousand new sites are added each week. Hedgebuilders will diligently attempt to filter all inappropriate sites according to strict Christian guidelines, but it is possible that a site may exist for a short time before it becomes blocked. Should we ever inadvertantly discover a site that, in our opinion, should be blocked, notification by e-mail or phone to Hedgebuilders will result in that site being immediately reviewed for blocking. Hedgebuilders is unable to provide warranties beyond these.

 Signed: ______________________________ Date: _________________


Mail this completed form with your check to the address below. You will receive e-mail instructions on how to set-up Hedgebuilders on your computer.

Thanks for protecting your family with Hedgebuilders!



How did you hear about HEDGEBUILDERS?______________________________________
The Internet(where?), Hedgebuilders Rep, Focus on the Family web site, Word of mouth, Your church (what's it's name), Other (please be specific)

 

Hedgebuilders, Inc.
P.O. Box 503
Kingston Springs, TN 37082-0503