Hedgebuilders A+ Filtering Mail-in Registration Form

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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: _______________________@________________________

Choose a password (4 or more characters):________________________________

If you have Windows what version do you use? _________________

 

Please check one for the following:

o Premium Filtering - Enclose a check for $46 (U.S.) ($6 a month for 6 months plus a $10 setup fee).
o Homeschool Filtering - Enclose a check for $29 (U.S.) ($4 a month for 6 months plus a $5 setup fee).
o Filtering for Macintosh - Enclose a check for $46 (U.S.) ($6 a month for 6 months plus a $10 setup fee).

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

o Check here to sign up for a full year, and make your check out for the following:
Premium Filtering - $72.00 (U.S.)
Homeschool Filtering - $48.00 (U.S.)
Filtering for Macintosh - $72.00 (U.S.)

**If this is for a Ministry account circle Yes, and list how many computers you will be filtering _______.

The special minstry rates are posted at www.hedge.org/ministry.html

Your check will not be deposited until after your two week free trial period concludes.

If you have any questions about this form or our subscription rates call us toll free at 866-441-7835.

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 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. 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. If I should inadvertantly discover a site that, in my 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.

How did you hear about HEDGEBUILDERS?______________________________________
The Internet(where?), Hedgebuilders Rep, 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