A+ Internet Filtering Sign-Up Form

Hedgebuilders A+ Internet Filtering Sign-up Form

Step 2. Please complete the following quick sign-up form. All fields are required.

First Name:
Last Name:
Email Address:
Home Phone:
Home Address:
City:
State:
Country:
Zip Code:

Please enter a password of your choice.

New Password:

Payment Method:	Visa
	Mastercard
	American Express

If you want to pay by check, please click the Back button on your browser.

Credit Card Number:
Credit Card Expiration:

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).

Subscriber Agreement

I am applying for Internet filtering 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 give Hedgebuilders authority to make determinations of appropriate and inappropriate content and to select sites for blocking accordingly.

I further understand that the Internet is constantly changing, worldwide, and largely unregulated. Thousands of new sites are added each week. Hedgebuilders will diligently attempt to filter all inappropriate sites according to the established blocking criteria, but it is possible that a site may exist for a short time before it becomes blocked. I understand Hedgebuilders is unable to provide warranties beyond these.

I have read and agree with the above.
Type your full legal name in this box:

If you sign up for a full year of A+ Internet filtering, we will waive your set up fee!
Check here to sign up for a full year.

Click the "Submit" button below to create your account
and go on to Step 3:

(IMPORTANT NOTE: After you click on the "Submit" button if you receive the message "Form Was Not Processed" CLICK HERE for more information on how to proceed.)

To clear all entries and fill out the form again click: