Join Our Condom Club

Join the Condom Club!

Thank you for your interest in joining our Condom Club! We collect basic information below to be able to send condoms and/or lube FREE OF CHARGE directly to you. Your information is always kept confidential according to strict HIPAA guidelines. Supply is based on current stock and available funding.
Contact Info
First and Last Name *

First Name Last Name
Preferred Language *

English Spanish
Phone Number *

Area Code Phone Number
E-mail *
Are you able to receive text messages at this phone number? *

Yes No
Mailing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Club Preferences
I would like to receive 25 condoms every other month. *

Yes No
Condom Preference (Select ONE option.): *

Premium condoms XL condoms Combination of Premium and XL condoms Internal (FEMALE) condoms
I would like to receive 25 foil packets of lube every other month. *

Yes No lube desired

Join the Condom Club!