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                           ADULT VERIFICATION FORM

A complete and accurate verification form along with a copy of a valid
DRIVER'S LICENSE or other form of valid proof of age as approved by the
Commonwealth of Virginia* MUST be received in order to gain adult access to
The Castle's Dungeon BBS. Only validated members may qualify to win any
prizes, credits or other awards as may be offered from time to time.

Name:  ........................................................

Address:  .....................................................

City:     ...................     State: .....   Zip: .........

USERID:  ........................    Date of Birth: ..../..../....

DAY PHONE: (...)....-......... EVENING PHONE: (...)....-....

By signing here, I confirm that I have requested ADULT access to The
Castle's Dungeon BBS, that I am solely responsible for any use of my
account to access this system, and I hereby hold Computerized Services By
Sacks and Chung, its: officers, employees, and other staff members harmless
for any access to this system made by any caller using my account and for
any effects whatsoever any such access could have.  I further agree that
the information is complete and accurate.  I understand that supplying
false or misleading information for access may be a crime under state
and/or federal law.  I further certify that I am over the age of 18. I
further attest that I fully understand that Adult access to The Castle's
Dungeon BBS will expose me to materials of an adult nature that may be
considered offensive by some people and agree to hold Computerized Services
By Sacks and Chung, its: officers, employees, and other staff members totally
harmless and non-liable for anything that I may find offensive.


SIGNATURE: _________________________    Date:  ___/___/___

Send this completed form to:    The Castle's Dungeon BBS
                                c/o Computerized Services By Sacks & Chung
                                13415 Fitzgerald Land
                                Glade Spring, VA 24340

Alternatively, this form may be emailed to: csbsc@comcast.net
 (if you email this in, your scanned copy of your state issued identification
  must be attached in gif, bmp, or jpg format and must be legible.)

Get your form in today, so you can start downloading those HOT PICS and
engage in ADULT entertainment TODAY!!!

Why don't you send a check in with this form while you're thinking about it?

*The Commonwealth of Virginia has approved the following forms of
identification as valid proof of age: Birth Certificate, Valid Driver's
License, goverment issued identification with age/birthdate listed,
accredited school identification with age/birthdate listed, or Passport
identification page.

Please bear in mind that regardless of the form that any payment made to
us may take, it can not replace this form and the required ID for our files
so that adult access may be granted.

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