                           Bad Toys 3D Order Form
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Fill out this order form and fax it to: 1-800-442-3172 or 1-952-646-5604
or mail it to:
  RegNow/Digital River
  9625 West 76th Street, Suite 150
  Eden Prairie, MN 55344
  United States of America
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First Name      ....................... Last Name ............................

Billing Address ..............................................................

                ..............................................................

City            ..............................................................

State/Province  ....................... Zip/Postal Code ......................

Country         ..............................................................

E-mail Address  ..............................................................


Order Details
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[ ] Bad Toys 3D (ID: 2478-21) .......................................... $18.00
    You will receive the registration code via e-mail within 24 hours.
[ ] Original Bad Toys t-shirt (ID: 2478-23) ............................ $13.00
    You will receive it via air mail within 10 days.
    


[ ] Jigs@w Puzzle Entry (ID: 2478-20) .................................. $ 9.95
    You will receive the registration code via e-mail within 24 hours.

[ ] Rolling Marbles (ID: 2478-1) ....................................... $14.95
    You will receive the registration code via e-mail in minutes.


All prices are in US Dollars, postage fee included.
                                                          TOTAL ORDER: $ ______

Payment Details
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[ ] Check / Money Order attached (made out to "Register Now!"), or

[ ] Credit Card:

    Name on Card .............................................

    Type of Credit Card
       [ ] VISA  [ ] Mastercard  [ ] American Express
       [ ] Discover (Novus)  [ ] Eurocard

    Credit card number .......................................

    Expiration Date (MM/YYYY)    ...../..........


    Signature ..................................
