Reservations with Mistress Velvet
Email address *
Full Legal Name *
Your answer
Age *
Your answer
City & State of Residence *
Your answer
Phone Number *
Your answer
Name of Employer *
Your answer
Job Position // Title *
Your answer
Humble Introduction *
Your answer
Interests // Desires // Fetishes *
Your answer
Experience Level *
Preferred Play Date(s)
Select All That Apply
NiteFlirt // Skype
Dungeon Session
Double Domme Play
Overnight and/or Extended Submission
Dinner Date
GFE
Home Servitude
Date of Session *
MM
/
DD
/
YYYY
Duration of Session *
hours
hours
Hard Limits *
Your answer
Medical Conditions (latex allergy, claustrophobia, bad knees, etc.) *
Your answer
Character Reference #1 *
Your answer
Character Reference #1 's email *
Your answer
Character Reference #2 *
Your answer
Character Reference #2 's email *
Your answer
How did you find me? *
Your answer
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