VIP MEMBER VALIDATION FORM

Why do we require validation?
The purpose of this document is to protect you and us from credit card fraud. All information will be used for validation purposes only. For your protection, everything you submit will stored securely offline in a locked file. It is NOT stored on our Internet servers so it CANNOT be stolen by hackers and used against you. We never sell or share your information with anyone. There is no charge for validation.

Step 1: Scan or photocopy the back of your credit card. Your card number must be visible on the back. If not, scan the front and back of your card.
Step 2: Print this form, complete it and sign it.
Step 3: Submit all documents by email or fax to:
     EMAIL: support@spread4u.com
     FAX (US & Canada toll-free): 1-877-626-0600
     FAX (International): +1-416-913-1867

Upon validation your account will be credited with $50, and all spending limits will be removed.

You will receive an email reply by the next business day, possibly sooner. To expedite the process, submit your documents then call Customer Support at 1-866-611-7157 or +1-716-829-7206 weekdays between 4PM and Midnight ET.

Black Dog Unlimited VIP User Agreement

Under penalty of perjury, I,  _______________________________, hereby attest, affirm, confirm, and swear that I am the actual authorized user of the user name _________________ and password __________________________, and that I am the valid cardholder of the credit card(s) below.

Credit Card Number(s) (Please list every card you will use):
Card 1: __________________________________   Expiry Date: ___ / ___
Card 2: __________________________________   Expiry Date: ___ / ___
Card 3: __________________________________   Expiry Date: ___ / ___

The billing address to which your credit card statements are mailed is as follows:

Name: _________________________________________________________

Street: _________________________________________________________

City: __________________________________________________________

State/Province/Region:____________________________________________

Postal/Zip Code:_________________________________________________

Country: _______________________________________________________

(Note: In most cases, a P.O. Box address will not be accepted)

CREDIT CARD AUTHORIZATION: I hereby authorize Black Dog Unlimited and/or it's partners and/or subsidiary's to charge any of the credit card(s) above for any services that I may choose to purchase on it's website(s). This authorization is retroactive to the date of my first purchase, and will remain in effect for all purchases I make for the term of this agreement.

RESPONSIBILITY: By execution of this Agreement, I understand that I will be responsible for all past, present and future activity conducted on Black Dog Unlimited's Internet services, to the extent consistent with federal and local consumer protections laws. My responsibility continues until I cancel my account via notice by email to support@spread4u.com.

REFUNDS: I understand and agree that while Black Dog Unlimited will attempt to resolve all customer support issues to our mutual satisfaction. All refunds and credits will be subject to our Terms & Conditions, located at http://www.stroke4u.com/terms.html.

DISPUTES: Should I successfully dispute any billings through my credit card issuer; I understand that am still responsible to Black Dog Unlimited for payment and I will be directly billed for my activity (including possible rebilling of my credit card), and that my account maybe turned over to a collection agency for final collection. I understand that my credit report, as maintained with various credit-reporting agencies, maybe adversely impacted by any such disputes culminating in 1) late payment 2) reduced payment 3) no payment. Furthurmore, all outstanding balances shall accrue interest at a rate of 2% per month, compounded monthly, retroactive to the time of purchase.

FRAUDULENT USE: In the event that I am fraudulently using a credit card for which I do not have authorization, I waive all privacy rights such that Black Dog Unlimtied may freely provide to Law Enforcement any router logs, ISP address information, chat logs, telephone records, email records, and all other available information concerning my activity for immediate investigation and prosecution. I personally will remain responsible for any charges related to my Black Dog Unlimited activity, and may be sued for such charges.

CONTROLLING INSTRUMENT: This agreement incorporates, in whole and in part, Black Dog Unlimited “Terms of Service” and the privacy policy as found on its websites. This document is the controlling instrument over the TOS.

TERM: This agreement is retroactive to the date of my first purchase and shall remain in effect until terminated by myself with 24 hours written email notice to Black Dog Unlimited at support@spread4u.com, or terminated immediately by Black Dog Unlimited with email notice to the address below.

CONFIRMATION OF IDENTITY:

Date of Birth: __________________________________________________

E-Mail Address:____________________________________

Signature: ___________________________________

Name (print): _________________________________

Date: __________________________