| Age Certification | Consent To Release Age-Certification Information | |
| I hereby certify that attached herewith are at
least two forms of identification which state my true date of birth,
indicating that I am at least 18 years of age, or the age of majority in
my legal jurisdiction (whichever is greater). My signature also certifies
that, should I provide WebPower/iFriends with false identification
(including name, image, and/or date of birth), I will not hold
WebPower/iFriends liable for the direct or indirect results of my
fraudulent actions, and I will indemnify WebPower/iFriends to the greatest
extent permitted in law or equity, for any actions or damages that result
from my fraudulent behavior, as I understand that this identification was
accepted in good faith, and that this effort was made to ensure that I am
at least 18 years of age, or the age of majority in my legal jurisdiction
(whichever is greater). I also certify that all decisions related to the content and nature of my videochat sessions/Productions are made at my own discretion, and that these videochat sessions/Productions do not violate the local community standards for “obscenity” in my area, and that my videochat sessions/Productions do not violate any other laws, domestic or foreign. I am completely responsible for my own actions. I hereby indemnify and hold harmless WebPower/iFriends from all related liabilities. I hereby discharge all persons related to WebPower/iFriends of any past, present or future liability. I hereby represent that I am at least 18 years of age or the age of majority in my legal jurisdiction (whichever is greater). I further represent that I have fully read this form prior to its execution and that I have not been induced or coerced to sign this form by any statement made by iFriends, its agents, employees, consultants, or anyone acting on their behalf. My signature below is certification that the identification documents are accurate and valid. |
I hereby knowingly, willfully and voluntarily
consent to allow full and complete access by WebPower/iFriends, or its
agents, representatives or designees (collectively, "WebPower/iFriends"),
to all available records (the “Records”) that support my claim that I am
at least 18 years of age or the age of majority in my legal jurisdiction
(whichever age is greater). The Records include, but are not limited to,
birth certificates, drivers licenses, passports, school records and such
other records that verify or tend to verify my true birth date, age, or
identity, as may be available from any person or governmental, religious or private
agency, organization or other entity.
Further, I hereby expressly authorize any person or governmental, religious or private agency, organization, or other entity, to provide the Records to WebPower/iFriends and I hereby release any such person or entity from any liability for acting in reliance on this Consent. I understand that any information obtained by WebPower/iFriends from the Records is used for WebPower/iFriends' internal purposes and that such information will not be disclosed to any party, other than WebPower/iFriends and its authorized representatives and agents acting on the company’s behalf, unless WebPower/iFriends is compelled by law to do so by a law-enforcement agency, other authorized governmental agency or court of law. |
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| VIDEO CHATHOST INFORMATION
(Blank answers not accepted; use 'N / A' instead) |
| Provide information for each question below. If you do not have any information for a given question, put “N/A” or “Not Applicable” in the space provided. Do not leave any line blank as we will consider the application incomplete if each line does not have either valid information, “N/A” or “Not Applicable” next to it. |
| Name, Stage Names and Aliases
(Blank answers not accepted; use 'N / A' instead) |
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| (U.S. Federal law requires the maintenance of records that prove that you are of legal adult age, and that such records include all names and stage-names/aliases under which you have performed or are now performing. For purposes of this form, a "stage name" is any alias, nickname, handle, screenname, pseudonym or other 'professional name' you have used or are now using, at iFriends or elsewhere.) | |||||||||||||||||||||||||||||||||||||||||||||||
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| Other Required Video Chathost Information
(Blank answers not accepted; use 'N / A' instead) |
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Date of Birth: |
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Current Residential Address: |
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Current City/State/Postal Code: |
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Country: |
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Address where webcam and PC are located |
(provide street address, city, state & country) |
SSN# (if U.S. Citizen): |
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Alien# or Other Govt.-Issued ID# (non-U.S. Citizen): |
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Telephone Number: |
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Email Address: |
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| CHATHOST REPRESENTATIVE INFORMATION
(Blank answers not accepted; use 'N / A' instead) |
| If Video Chathost is working with a Chathost Representative, Chathost Representative must provide the information requested below. |
| Do not leave any line blank as we will consider the application incomplete if each line does not have either valid information, “N/A” or “Not Applicable” next to it. |
Chathost Representative iFriends ID Card Name: |
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Chathost Representative’s Signature: |
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Date: |
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Chathost Representative Legal Name: |
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Chathost Representative Payee Name: |
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Contact Name: |
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Chathost Representative Business Address: |
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Chathost Representative Mailing Address |
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Country: |
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TaxID# (if U.S. Company): |
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Chathost Representative Telephone Number: |
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Chathost Representative Email Address: |
| By signing above Chathost Representative hereby represents and warrants that (i) the information provided by both Video Chathost and Chathost Representative is true and correct and (ii) the identification documents provided by both Video Chathost and Chathost Representative are accurate and valid. |
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