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1. Disclaimer: This form is to be filled out by adults only over the age of 21+. If you are under the age of 21, please leave now. By completing the following form, you agree to receive SMS upon completion. You understand and accept responsibility for your own actions, thus releasing the website owner, the website builder software, its staff, affiliates and advertisers from all legal liability. This form is not intended to be viewed/completed by minors. NO sexual activities are implied or condoned by the creator(s) of this form. This form does not promote prostitution nor is this advertisement or any content therein an offer for prostitution. Money exchanged is for companionship only and anything beyond that is a choice made between two consenting adults and not contracted for by the site or its creator(s). Under no circumstances does the website owner, the website builder software, its staff or affiliates consent to or has knowledge of any illegal activity committed by anyone associated with this website.
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3
Name*
Please provide First and Last Name
First Name
Last Name
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Are you affiliated with the police or any undercover law enforcement agencies? Or are you involved in any undercover sting operations or any PI related activities? * This field is required babe! This field is required babe!
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Yes
No
Military Affiliation
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Please Select
Yes
No
Military Affiliation
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How old are you? * This field is required babe! You must be 21+ years of age or older.
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What is your phone number?* This field is required babe! BURNER/VOIP numbers or iCloud emails — I will automatically discard your booking form!
Please enter a number
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7
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Which platform did you find me on?
Instagram
Twitter
Snapchat
Fansly
Onlyfans
Tik Tok
X (Formerly known as twitter)
Tryst
Mega
Discord
Referral
Other
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8
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If you found me on one of my many social media platforms, what is your username/handle?* This field is required babe!
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9
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Are you just traveling into town? I love building long lasting connections!
YES
NO
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10
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What is the city and state you are seeking to book in? * This field is required babe! Looks like we missed something. Take a look at your form and correct any potential errors/mistakes💕
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11
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Are you seeking for me to travel to you? * This field is required babe! A $50-100 deposit is required if I travel to you and for all pre-bookings. Deposit is subject to change based upon distance (No Exceptions - Failure to submit deposit when dates are confirmed will result in cancellation/blocking). If you are seeking a “FMTY” — a 30% deposit is required!
You will 🚗 to me (Deposit Required)
I will 🚗 to you
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12
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What is the duration of time you would like to spend together? Please note: Rates listed are only “BASE RATES” — rates are subject to change based on distance and location.
Please Select
10 minutes (Donation $100 +$ 50 Deposit if I travel to you ! - No Deposit Required If you Travel to me)
20 Minutes (Donation $120 + $50 Deposit if I travel to you! - No Deposit Required If you Travel to me)
30 Minutes (Donation $200 +$100 Deposit if I Travel to you !- No Deposit Required If you Travel to Me)
45 Minutes (Donation $220 + $100 Deposit if I travel to you! - No Deposit Required If you Travel to Me)
1 Hour ( Donation $400 + $100 Deposit If I have to travel you! - No Deposit Required If you Travel to Me )
2 Hours ( Donatiion $800 + $100 Deposit If I have to travel to you! - No Deposit Required If you Travel To me )
3 hours or more ( Donation $1200 + $100 Deposit Required If I have to Travel to you! -No Deposit
Required If I Travel to You! - No Deposit Required If you Travel to me)
12 hours or more ( Please Inquire)
Please Select
Please Select
10 minutes (Donation $100 +$ 50 Deposit if I travel to you ! - No Deposit Required If you Travel to me)
20 Minutes (Donation $120 + $50 Deposit if I travel to you! - No Deposit Required If you Travel to me)
30 Minutes (Donation $200 +$100 Deposit if I Travel to you !- No Deposit Required If you Travel to Me)
45 Minutes (Donation $220 + $100 Deposit if I travel to you! - No Deposit Required If you Travel to Me)
1 Hour ( Donation $400 + $100 Deposit If I have to travel you! - No Deposit Required If you Travel to Me )
2 Hours ( Donatiion $800 + $100 Deposit If I have to travel to you! - No Deposit Required If you Travel To me )
3 hours or more ( Donation $1200 + $100 Deposit Required If I have to Travel to you! -No Deposit
Required If I Travel to You! - No Deposit Required If you Travel to me)
12 hours or more ( Please Inquire)
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13
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What is the industry you currently work in? *please type what industry you work in and career if so
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14
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Please Note: If I travel to you — a $50-$100 deposit is required if I have to travel to you. If this is a “pre-booking” for a later date - a deposit is required to secure the date(s) you are seeking If you are unable to send a deposit prior to our session, you will be blacklisted.All deposits apply towards total session. Deposits can be paid via Cashapp, Apple Pay, PayPal,, and Venmo.
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I understand 😃
I do not understand 😣
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15
Date
What is the date you are interested in booking for? * This field is required babe!
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Date
Year
Month
Day
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16
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What time are you interested in meeting? If you are unsure, please list a time frame. Example: 7:00PM-9:00PM
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17
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As I accomadate to all races and ethnicities, regardless of their physical abilities, and disabilities. Is there anything you would like to share to help me better prepare for our time together? I appreciate your honesty and for sharing anything sensitive with me. This is a 100% judgement free zone.
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18
Type a question
Video verification is required for any and all bookings. Which platform would better work for you to meet via video?* This field is required babe! Live video verification gives us the chance to say a quick hello!This field is required babe!
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FaceTime
Google Meets (Duo)
Snapchat
Instagram
Telegram
Discord
Other —A link for video chat can be shared via FaceTime or Google Meets (Duo). If this option is selected , I will share a link with you to complete video verification.
Please Select
Please Select
FaceTime
Google Meets (Duo)
Snapchat
Instagram
Telegram
Discord
Other —A link for video chat can be shared via FaceTime or Google Meets (Duo). If this option is selected , I will share a link with you to complete video verification.
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