You create the account with a fake email (if you want one this is) then when they say a email has been sent, select the change email option and enter a valid one you have access to. Confirm the account and your up and running however your login is the fake email. So it is still possible to create an account with a fake email.
No, because you need to go on that particular email and confirm it. If you really don't want to use your email, make a Gmail or something. Those are really fast to register up. I believe Yahoo Mail has quick registration too.