Pre-Play Form Negotiation and Consent Agreement
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Pre-Play Form Negotiation and Consent Agreement Copyright © 2021 Moonshine’s Garage - ALL RIGHTS RESERVED v3.1 Personal Information Your personal information will be Name Email (optional) Self-identity and Personal Pronouns Man, woman, non-binary, other; They/Them, She/Her, He/Him, etc. 1 What’s Your Kink Experience Would you enjoy pushing some boundaries over your gender or sexuality? If so, what does that sound like to you? Have you practiced any BDSM before? If so, for how long? What kind of Domme are you looking for? What kind of “scene” are you looking for? Do you have any kink goals or interests? . Are you familiar with the color code of Red, Yellow, Green as safe words? (Red meaning “stop immediately,” and Yellow meaning “proceed with caution.”) Do you have a safe word or gesture you would absolutely need me to know otherwise? Do you know how to ask for what you want in general? 2 On a pain scale of 1-10, where do you typically like to be? Where do you want to peak on the scale? I may check in with you and ask where you are. Are you more sting-y or thud-y? Is it ok for me to touch you? Is it ok for me to press/lean my body into yours? If you were to cry how should I handle it? (play on, take a minute, etc) Are there areas of the body where you would like to receive more attention for impact, loving touch, or other sensation play? (Please, indicate feet caning, breast holding, grabbing the back of the neck, etc.) Are there areas of the body where I should avoid? A little or completely? (Such as: don’t touch my hair, pull on my ears, etc.) If you go non-verbal during play, how will I know what you are needing? 3 Identifying Your Kink Role How do you identify? Sub? Dominant? Switch, or other? Do you find pleasure in the idea of giving-over power? If power dynamics are not your primary interest, would you like to feel enraptured, overwhelmed, or as if I am washing over you? Do you like the idea of being equals but worshiping or pleasing me? Do you enjoy service-oriented tasks (bootblacking, foot worship/massage, scrubbing floors)? If so, do you enjoy them more when they are demanded from you or when you can offer them freely? 4 Your Experience Do you have a fantasy you might enjoy telling me about that is your little secret? Do you prefer praise or degradation? If you could dream on this, what might that sound like? Do you enjoy restraints? Would you like to try restraints and be able to change your mind at any time? Do you enjoy sensory deprivation? (blindfolds/headphones/hoods) Do you have any health conditions I should know about before play? Do you have any mobility limitations I should be informed of, such as a shoulder which does not permit you to raise it comfortably, etc? What are your "Hard No's" and are there any other things which might distract you from being in the moment (belts, hair pulling, ear tugging, face pats or face slaps, etc.)? If you are not sure, say, “not sure” and indicate if you have some interests in trying, being sure to stop immediately, calling “Red,” if you become triggered. Or specify the exact nature of what we might, “play through” if something comes up, and what you might need. 5 Your Aftercare Needs What kind of aftercare might you typically require? (cuddles and talking?) Do you have a good support network around you? Are you safe at home? Do you have anything big going on or something which you are trying to work through today? What questions do you have for me? 6 Moonshine’s Garage This Personal Development Agreement (the “Pre-Play Form” or “Agreement” or “Personal Development Agreement”) states the terms and conditions that govern the contractual agreement between Moonshine’s Garage (the “Facilitator”) and the named party (the “Client”) on Page 1 and on the Client Signature line of this document who agrees to be bound by this Agreement. WHEREAS, the Facilitator offers personal development services in the field of BDSM and Domination; and WHEREAS, the Client desires to retain the services of the Facilitator to render personal development services with regard to the scope of services negotiated and agreed in the above covered sections according to the terms and conditions herein. NOW, THEREFORE, In consideration of the mutual covenants and promises made by the parties hereto, the Facilitator and the Client (individually, each a “Party” and collectively, the “Parties”) covenant and agree as follows: 1. Personal Development Services The Facilitator agrees that it shall provide its expertise to the Client for all things pertaining to the scope of services negotiated and agreed in the above covered sections. To protect the confidentiality of any other clients, the Facilitator and its staff, the Client must not visit Facilitator’s designated address (as defined at any time by the Facilitator) outside of the scheduled, paid, and confirmed appointment times. 2. Confidentiality All interactions which take place in the setting of the therapeutic session are considered confidential. This includes requests by telephone, all interactions with this facilitator, any scheduling or appointment notes, all session content records and any progress notes that I take during your sessions. I will not even verify that you are a client. You may choose to give me permission in writing to release any or specific information about you to any person or agency that you designate. 3. Indemnification The Client agrees to indemnify, defend, and protect the Facilitator from and against all lawsuits and costs of every kind pertaining to the Client’s business including reasonable legal fees due to any act or failure to act by the Client based upon the Personal Development Services. 4. No Modification Unless in Writing No modification of this Agreement shall be valid unless in writing and agreed upon by both Parties. 5. Applicable Law This Personal Development Agreement and the interpretation of its terms shall be governed by and construed in accordance with the laws of the State of Georgia and subject to the exclusive jurisdiction of the federal and state courts located in Cobb County, Georgia. IN WITNESS WHEREOF, each of the Parties has executed this Personal Development Agreement, both Parties by its duly authorized officer, as of the day and year set forth below. Moonshine’s Garage ___________________________________________ ___________________________________________ __________________________ Name Signature Date (MM/DD/YYYY) Client ___________________________________________ ___________________________________________ __________________________ Name Signature Date (MM/DD/YYYY) 7 8 .