Check     Money Order     Cash (US Dollars)     M4M Credit
Credit Card #:____________________  Visa    MC    AE    DC
Bank Name on Card:_________________________ Exp._______
Customer #:___________________________________________
Name:_______________________________________________
Street Address:________________________________________
City:__________________________ State:_____ Zip:_________
Country:__________________ Email: ____________________
Phone #:_______________________ Fax #:_________________
Format: = DVD    Blu-Ray    Adult Sex Toys
   HOLD UNTIL COMPLETE: To wait until the entire order is complete before shipping (to minimize shipping costs).

   SHIP AS SOON AS POSSIBLE: To ship the movies as they become available (extra shipping costs will apply)
Please list TITLES, STOCK NUMBERS and PRICES below:
  1.)_____________________________ #__________ $________
  2.)_____________________________ #__________ $________
  3.)_____________________________ #__________ $________
  4.)_____________________________ #__________ $________
  5.)_____________________________ #__________ $________
  6.)_____________________________ #__________ $________
  7.)_____________________________ #__________ $________
  8.)_____________________________ #__________ $________
  9.)_____________________________ #__________ $________
10.)_____________________________ #__________ $________
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12.)_____________________________ #__________ $________
13.)_____________________________ #__________ $________
14.)_____________________________ #__________ $________
15.)_____________________________ #__________ $________
Total Amount Enclosed: $__________

AGE VERIFICATION

___________________________________________________
I certify by my signature that I am an adult, 18 years of age or older, and that I wish to receive this merchandise for my personal use.

Adult DVD and Blu-ray Shipping:

Regular shipping Costs: $3.49 per shipment, plus $0.99 per DVD. Foreign Shipping Charges: International Rates.

Adult Sex Toys:

Regular shipping costs: Adult sex toys shipping costs will vary by package weight and delivery destination. Most adult toys are eligible for free shipping and free movies. Click here for details. Sex Toys shipping costs: USPS, UPS or FedEx.

All movie orders and eligible toy orders shipping to customers within the continental United States have the option of including free shipping with every $50.00 in purchases. Orders shipped to international locations, Hawaii, Alaska, and U.S. Territories also qualify for free shipping starting at $250.00 in purchases.



Please printout this form, fill in the blanks, and MAIL it to:

Excalibur Films
2487 E. Orangethorpe Ave Fullerton, CA 92831-5304, U.S.A.

To order by Phone: 800-289-6684

Fax: 714-525-6616    Email: CustomerService@ExcaliburFilms.com

Thank you for your order! All information will be held in the strictest confidence.