ORDER FORM

STEP ONE: Enter all your shipping information:
Name: Street:
City: State/Prov.:
Zip Code: Country:
STEP TWO: Enter the quanity you want to order & select the shipping.
PRODUCTQUANTITYPRICETOTAL
Bees in a Bottle
bee venom
future product
SUBTOTAL
SHIPPING
GRAND TOTAL
STEP THREE: Press calculate button
RELEASE FORM The undersigned assumes all risks involved in using Bees in a Bottle and/or Dried Bee Venom and holds Greg Ferris harmless. I understand that Greg Ferris makes no claims as to the safety or effectiveness of the product. I further understand that allergic reactions to bee venom can be extremely dangerous and can cause death.

Signed_____________________________
Orders of Beesinabottle will not be shipped without signature
STEP FOUR: Print out this form.


Greg Ferris Make checks payable to: PO Box 143 Greg Ferris Marbury, Md. 20658
STEP FIVE: Sign release & send form with payment to the above address.

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