Name *

First Name

Last Name

Phone

(###)

###

####

Requested Date

MM

DD

YYYY

Requested Time

Hour

Minute

Second

AM PM

Select Experience

Submission-Discipline

Service

Sensual-Primal

Rope Bondage

Bondage

Spanking/Paddling

Over the knee

Hair Pulling

Puppy-Kitten Play

Worship

Teacher / Student

Shaving

Master/Slave

Tickling

Whipping with Floggers

Caning

Electrical Play

Ice Cubes

Exhibitionism

Collaring

Foot worship

Hot wax

Humiliation

Interrogation

Kneeling

Nipple Torture

Tease and Denial

Breath Control

Sensory deprivation

Equipment

Rope

Ball Gags Inflatable Gags

Bit Gags

Leather Hoods

Latex Hoods

Canes

Wooden Paddles

Nipple Clamps

Collars

Leashes

Handcuffs

Floggers

Hairbrushes

Crops

TENS Unit (electric play)

Blindfolds

Belts