DocLancaster Kinktober Application

DocLancaster's Kinktober Application

Boobtober, Jocktober, & Locktober
Name*

First NameLast Name
Preferred Name (what would you like the doctor to call you?)

What is your handle / username on social media apps?*

	Handle
Instagram
FetLife
Recon
Kik
X / Twitter
Telegram
Skype
Snapchat
Other

Email
example@example.com
Gender

MaleFemaleNon-BinaryFM-> MM->FMOther
Cell Number (Used only in case of emergency or texting for non-response after 72 hrs during an active program)
Location (City/State/Country)
Date of Birth (DocLancaster will manage individuals over the age of majority in your region)*

MonthDayYear
Date
Program Information
What programs are you requesting to be enrolled in? (check all that apply - bonus points for participating in multiple programs)*

Locktober (chastity cage/belt)Jocktober (wearing a jock strap at all times)BoobtoberOther
Do you have another key holder/manager that should be consulted and collaborated with?*

No - just DocLancasterYes - I have others (Please list details below)

If you have others that you would like DocLancaster to collaborate with, please provide details…

	Collaborator 1	Collaborator 2	Collaborator 3
Instagram
FetLife
Recon
Kik
X / Twitter
Telegram
Skype
Snapchat
Other

Are you open to random tasks being assigned as part of the management?*

YesNo
If yes, what kinds of additional kinks are you open to incorporating?

ABDLExhibition/VoyeurismMedical Fetish RelatedRectal PlugsCBTNipple PlayOther
Please include any pictures of yourself that you are willing to share. Suggested images include: Unclothed Full Body, Torso, Genitalia, In Chastity for Locktober participants and Jocked for Jocktober participants. You may include up to 5 images below.
All the legal stuff
Photographs & Video Media - during the program you will be asked to share pictures and videos with DocLancaster. Please indicate below your willingness to allow that media to be shared on social media sites (i.e. FetLife, etc). (Please check all that apply.)

I elect to allow photos, videos, and/or screencaptures, to be shared anonymously (all faces removed) on social media sites by DocLancaster.I elect to post photos, videos and screenshots on social media on social media and will tag DocLancaster.I elect to NOT allow photos, videos, and/or screencaptures, to be shared anonymously (all faces removed) on social media sites by DocLancaster.I elect to have DocLancaster tag me in posts on social media.I am not willing to share any pictures or videos with DocLancaster.
During the program the following rules will be in place:
1. DocLancaster will do random checks, via the agreed upon platform. The participant is expected to respond with evidence of their compliance as reqeusted within 60 minutes.
2. DocLancaster will assign tasks to be completed throughout the program. Participant agrees to complete the assigned tasks within the agreed upon timeframe, but not less than 120 minutes from task assignment.
3. If a participant is going to be out of communication, they must notify DocLancaster at least 4 hours in advance.
4. Failure to complete assigned task within the agreed upon timeframe will result in "penalties" of additional tasks. Progressive failure of completing assigned task may result in the participant being removed from the program.
5. Any effort to defame, insult or otherwise make accusatory remarks about DocLancaster will result in immediate removal from the program.
6. The intent is for both parties to have fun through the program. If at any time, either party feels that it is no longer appropriate to continue, the initiating party shall inform the other party that they would like to end the program. That decision will be respected by the other party and will not be challenged.
Do you agree to abide by the above rules?

YesNo
Are there any other considerations or concerns that you would like to share with DocLancaster concerning your participation? (i.e. certain work schedule that needs to be navigated, family dynamic, etc)
By electronically signing and typing my name below, I agree and request to have DocLancaster manage my compliance with the selected program above. I acknowledge that I am of legal age within my state/country to participate as an adult in this play program. I agree to hold harmless DocLancaster from liability and claim for damages due to bodily injury, including mental and physical, sickness, or disease, including but not limited to death. During the program it is acknowledged and agreed that no sexual acts will occur, including but not limited to intercourse, oral sex, and rimming. In addition, no payment for any services will be received or provided in exchange for the management of the program with DocLancaster. I acknowledge and attest that my electronically signed and typed name below shall be binding just as my physical signature would be.
Signature*

Clear
Typed Name*
Should be Empty:

DocLancaster's Kinktober Application

Program Information

All the legal stuff