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EXCALIBUR
PRE-SCENE NEGOTIATION QUESTIONNAIRE
Personal
Information
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Corporal |
Humiliation/Exhibition |
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Torture & Sensory Depravation |
Bondage |
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Stretching
Limitations
| Part
of the Body |
Bondage |
Control |
Torture |
| back_shoulders |
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| bottom |
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| breasts_chest |
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| genitals |
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| thighs |
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| tummy |
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| feet |
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| wrists |
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| ankles |
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General Information
| BD/SM
scene experience |
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| Sexual
Orientation |
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| Gender
Orientation |
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| Dominant |
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| Submissive |
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| Masochist |
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| Sadistic |
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Fetishes
Perceived
Needs:
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Medical,
physical, psychological, restrictions:
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Limits:
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Brief
description of selective fantasies:
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*NOTE:
WE DO NOT CONDONE PEDOPHILIA, BESTIALITY, NECROPHILIA OR NON-CONSENSUAL
ACTS OF VIOLENCE. ASSAULT AND RAPE ARE PUNISHABLE OFFENSES.
THIS SURVEY IS USED AS A RESOURCE TOOL TO GAIN MORE KNOWLEDGE
AS TO YOUR EXPERIENCE, AS WELL AS YOUR LIMITATIONS. ALL INFORMATION
IS KEPT PRIVATE AND CONFIDENTIAL.
**NOTE: THESE ITEMS ARE NOTED AS PERSONAL ACTIVITIES.
DISCLAIMER
I, HEREBY CERTIFY THAT I AM A SANE AND CONSENTING INDIVIDUAL
TWENTY-ONE (21) YEARS OF AGE AND OLDER.
I, DO UNDERSTAND THAT THIS IS A PSYCHODRAMA AND ROLE-PLAY
SERVICE DEALING IN REALISM AND CREATIVE EXPRESSION ONLY; THAT
THERE IS NO NUDITY ON THE PART OF THE DOMINANTS AND/OR ACTS
OF PROSTITUTION AND/OR ACTS OF PEDOPHILIA, NECROPHILIA, BESTIALITY
CONDONED OR PRACTICED ON THE PREMISES.
I PARTAKE IN ANY AND ALL ACTIVITIES AT MY OWN RISK AND THAT
I WILL NOT HOLD ANY OF THE STAFF OR THE EXCALIBUR ORGANIZATION
RESPONSIBLE FOR ANY ACCIDENTAL INJURY THAT I MAY RECEIVE DURING
ANY ACTIVITIES OR EVENTS.
I AM NOT WORKING ON BEHALF OF ANY GOVERNMENT AGENCY; STATE,
LOCAL OR FEDERAL, DURING MY TIME AT EXCALIBUR. IF I AM, I
WILL DISCLOSE THIS INFORMATION SO THAT THAT THE REPRESENTATIVE
MAY DIRECT ME TO THE PERSON WHO CAN BETTER ANSWER MY INQUIRIES.
I ALSO AGREE NOT TO DISCLOSE ANY WRITTEN, AUDIO OR VISUAL
INFORMATION REGARDING EXCALIBUR AND THE EXCALIBUR ORGANIZATION
OR ITS MEMBERS.
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