Please enable JavaScript in your browser to complete this form.DO NOT FILL THIS FORM OUT UNTILL YOU ARE 100% READY TO SELECT A TIME & SUBMIT A DEPOSIT *Sessions are open to any gender, sexual orientation, race or experience level. Most of my sessions are conducted CFNM (Clothed Female Nude Male) You will be expected to strip and provided with a safe space to place your belongings while you are in session. For sessions with couples or multiple submissives, all parties must fill out their own new client form. Your details will not be shared with anyone, these are simply an efficient way to understand what you are looking for to provide the best experience possible. Once we have agreed on the date/time/length of session you will be expected to submit a deposit and a photo of your ID so I can recognize you for the meet-up. Indicate that you have read this by typing above "I Understand. I Consent"Name *FirstLastNickname on Social Media Accounts (ie. ExcitedSubmissive on Instagram) *Real Physical Age (Also Regression or Character Age if Applicable) *Sessions are not always sexual in theme but participants must be at least 21 years of age to participate. There is no upper age limit. Email *Double-check that this is correct.DATE(S) & TIMES you can be available for a Session. (ie every Wednesday in May from 6-8pm) *What area are you coming from? *I am hoping to be added to a mailing list so I can be notified in advance if you are ever planning a trip to my area.I am hoping for a quote for a FMTY (Fly-Me-To-You) session and understand there are extra costs associated with this. WHAT city?I found your Info through... *Internet SearchLeolistDickie VirginTrystLondon SugarTwitterInstagramFetlifeFacebookTumblrCraigslistKijijiLocantoOtherI am looking for a PAID session involving *A Consultation (I want to meet at your location and discuss my interests. Help with shopping. Verbal Instruction on some topic.)A Play SessionA Makeover/Photoshoot/Help with Online ProfilesExtended StayI would like to be Emailed about Upcoming Parties or Events that are Relevant to My InterestsLength of Session *Themes, Scenarios or Role Play that Interest Me...Medical Themes (Doctor, Nurse, Dentist, Proctologist, Plastic Surgeon)Torture or Interrogation ThemesTease & DenialAge Roleplay (Adult Baby or Regression)Student/Teacher ThemesCheerleader/Mean Girl ThemesBoss Employee Themes (CEO, Intern, Introview)Human Slave ThemesAnimal Roleplay: Dog, Cat, Pony, etc.Vampire, Demon, Succubus, Witch ThemesPrisoner Police or Army Officer Role playBeing Treated like an ObjectHigh Protocal Slave (Lots of Specific Directions)HumiliationVerbal AbuseI am Interested in Activities that Involve Physical Domination such as...Rough Body Play (uncomfortable positions, stretching, wrestling holds)Hair PullingHead ScissoringBreath Play (Restricted Breathing/Choking)Face SittingBreast SmotheringBlindfoldsGagsCollarsBondage (Rope, Leather Restraints & Chains, Straps, etc)MummificationChastity Devices (Cock Cage and/or Butt Chastity)I am interested in Activites that involve some level of Physical Pain like...Spanking (Hand, Paddles)PinchingFlogging, Whipping, CaningCBT (Cock & Ball Torture)ScratchingWhartenberg WheelBall KickingHand StrappingFoot CaningNipple Pinching or ClampsTrampling (Stepping or Standing on you)Face SlappingHot Wax PlayElectro Play (Neon Wand & Estim)Level of redness or marking? Areas that are off limits, if any?I am interested in Activities that involve Penetration like...Beginner Anal Training (butt plugs)Prostate or G Spot MassagePegging/Strap onElectric Stimulation for the Prostate/G-SpotFistingSounding (Urethral Insertion)EdgingForced Orgasm (via Vibrators, Estim etc)What types/sizes of anal play have you participated in before? How long ago?I am interested in Activities/Themes that Explore Gender RolesFellatio InstructionForced Feminization"Forced Bi" (Bi-Sexual Activity)Wearing LingerieCross Dressing (Male to Female or Female to Male)Make upWigsPadding or PackingWearing High HeelsI Enjoy...Leather FetishFoot FetishFoot WorshipStocking FetishStocking WorshipHigh Heel FetishHigh Heel WorshipBoot FetishBoot WorshipDiaper FetishI am interested in Play with FluidsSpitGolden Nectar/Champagne (Urine Drinking)Golden Shower (Being Urinated On)Cum EatingForced FeedingSplooshing (Squishing Food)Licking Shoes or BootsLicking toiletsExtra Details about Activities That Interest MeHard Limits - Activities that DO NOT Interest MeHealth ConditionsLimited Mobility: ShouldersLimited Mobility: KneesLimited Mobility: BackHeart IssuesBreathing IssuesAllergies (ie. latex, peanuts, etc)Medication that causes lightheadedness/increased bruising/slow blood clottingIf you have a disability let me know and I will do my best to modify or accommodate where I can. I try to be conscious of these things and some of my play spaces are walker/wheelchair/scooter accessible.)Extra Details about Health ConditionsNameSubmit