Prospective submissive Application

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Terms and Conditions: INFORMED CONSENT STATEMENT* This field is required.INFORMED CONSENT STATEMENT; I am requesting and at my own risk participating in a BDSM session. I understand activities within the Session will be conducted by mutual consent. I accept sole responsibility to; (a) decide what activities I wish to participate in during the Session and decide what my boundaries are. (b) communicate these decisions clearly before the start of the Session. (c) agree to an appropriate safe word or other signal to request an activity stop. (d) signal immediately, any unexpected fatigue, shortness of breath, chest discomfort, nausea, pain or discomfort. I understand I can discontinue participation at any time during the Session, without prejudice against me, beyond fees or tribute for the Session. LIMITS OF LIABILITY; I understand that any activity undertaken during the Session are voluntary and are at my own risk. I agree to indemnify and hold harmless all participants in the Session from all claims of liability, injury, death, property loss or damage, attorney’s fees and costs and I agree to reimburse them for any such claims; of same, they may have. Agreement 1 * By submitting this session application, you understand that domination does not involve sex or any unlawful act. I will not guarantee any specific plays, but will take your interests into consideration. Agreement 2 * You have read and will not ask for any activities listed on my off limits list. Agreement 3 * You have read and understand my late, deposit and cancelation policy. Tribute must be presented in an unsealed envelope at the beginning of our engagement. Agreement 4* A non-refundable 50% deposit is required for all engagements, at the time of booking. AGREEMENT; by submitting this session application, I acknowledge I have read, understood and agree to the contents of this form and I confirm that all information given by me, is correct to the best of my knowledge. I understand there is no sex or any unlawful acts involved in Domina Ara Lee's sessions, I am a consenting adult over the age of 21 and I am not a law enforcement officer or federal law enforcement agent.

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Legal Name* This field is required.No aliases or nicknames (will verify)

First Name

Last Name

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Email* This field is required.

example@example.com

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Phone Number* This field is required.No burners or fake (will verify)

Area Code

Phone Number

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Age* This field is required.

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Why do you want to see a Dominatrix?* This field is required.

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What is it about Me in particular that has inspired you to contact Me? * This field is required.

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How do you plan on making yourself useful to Me?* This field is required.

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What do you identify as?Check all that apply

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What specific feelings do you hope to experience during Our time together?* This field is required.

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What would you like to explore with Me? * This field is required.

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What activities have you enjoyed in the past? * This field is required.

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Desired Experience Length* This field is required.

Devil Dance (2 hours)

Queen’s Kiss (3 hours)

Divine Devotion (4 hours)

Dinner & Domination (4 Hours)

Full Evening Date (Dinner to Midnight)

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Describe your best and worst session, and indicate why for both.* This field is required.

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Conditions, Limits, and boundaries.* This field is required.Participating in sessions involving BDSM activities can put stress on the body. Please disclose any and all health Issues/medical conditions/Mobility Limitations so that I may determine what activities should be modified or avoided. The more thorough you are on this, the happier we will both be in the session! Hard limits include specific phrases, activities, places I should not touch, etc. * It is your responsibility to disclose any of the above or anything else that may not be listed. *

All Hard Limits/Boundaries

Current Medications

Health issues/Medical Conditions/Mobility Limitations

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How do you feel about pain?

I don’t enjoy pain

I want to please you through my suffering

Some light pain is erotic

I am a masochist

I would like my limits pushed

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Can you take bodily marks?This means bruising, broken skin, cutting, etc.

Yes

None

Temporary OK

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