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_________________________________________________ Begin at:__________ Length:________________________ Beginning signal:_______________________________________________________ Ending signal:_________________________________________________________ Who will keep track of time?

______________________________________________ Does everybody involved understand that there is some risk of accident, miscommunication, misperception, and/or unintentional injury?

Yes_____ No_____ Has any participant tested positive?

Yes_____ No_____ Explanation:___________________________________________________________ The Dominant can use (only) the following intoxicants during the session: ___________________________________________________________________ Acceptable quantity:____________________________________________________ The submissive can use (only) the following intoxicants during the session: ____________________________________________________________________ Acceptable quantity:____________________________________________________ Anything either party would especially like to try or explore?

Yes_____ No_____ Explanation:___________________________________________________________ Is it acceptable to the submissive if the play draws small amounts of blood?

Yes____ No____ Explanation:___________________________________________________________ How easy or difficult has it been to mark the submissive in the past?

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[] Cross-dressing/gender play [] Animal play [] Other_________________________ Any chance of switching roles?

I will strive to maintain discipline, consistency, and creativity in our lives.