PRINTABLE ORDER FORM

TERMS AND CONDITIONS OF SALE:

1. Ecstacy Melrose (P.O. Box 461836., Los Angeles, CA 90046 accepts no liability, of any kind, for damages resulting from unapproved or prohibited use/abuse of products sold by Ecstacy Melrose.

2. This disclaimer states that the customer does here by except all responsibility for any consequences incurred from unapproved, prohibited, and/or illegal use/abuse of said products.

3. Some of Ecstacy Melrose products are not intended for human consumption, also, it is proven fact that ingestion of some of the products may cause harmful side effects or death! 
   Do not ingest internally or externally in any way. 

4. They are experimental raw material, for use in/with/for incense, potpourri, ornament/décor, arts & crafts, religious sacrament/ritual, science, and/or collecting.

5. All “Ecstacy Melrose” products must be kept out of the reach of children.

6. You must be 18 years of age or older to purchase our products. 
   
   If you are under 18-years-old and you purchase products from Ecstacy Melrose you are committing fraud and will be prosecuted! 

7. Ecstacy Melrose will not sell any product to any individual or group that we believe is using our products for any illegitimate and/or illegal purpose. 

8. Submitting an order to Ecstacy Melrose constitutes agreement with and acceptance of the above terms and conditions. 

Name_______________________________________________ Age______

Ship-To Address______________________________________________

City_______________________________ State________ Zip________

E-mail____________________________ Phone(_____)_____-________

Signature:________________________________  Date:_________________

Shipping and handling:    Priority:     $ 10.99                     Express:  Add $25.00 to Priority                       Outside US Please ask by Email or call (323)658-1922.

                                                    ORDER TOTAL $______

Send cashier check or money order PAYABLE TO "Ecstacy Melrose" to:   P.O. Box 461836,  Los Angeles, CA 90046

Special Notes or Instructions: