Apply To Serve

Name

First Name

Last Name

Email

Phone number

Session Duration

Minimum of 1 hour

City

Are you looking to book in Chicago, Detroit, or somewhere else?

Date and Time of Appointment

Date and Time desired or your typical availability if you are flexible

References

Please list any references you have, if you have none please attach your ID below (Address can be blacked out)

Medical Conditions

Please be honest. It is very important I understand any relevant medical conditions or allergies you have so we can play as safely as possible.

Desired contact method

Interests

Please be concise, scripts will be discarded

Hard limits

Anything you absolutely do not want to participate in or be called.

I am willing to receive marks

I would like extra aftercare

Typical aftercare is 5-10 minutes to decompress and reflect with some water

Yes

No

If yes please elaborate

How did you find me?

Radio

I understand that I will be required to make a non refundable deposit to lock in my session date and time

Radio

I accept full responsibility for any injury that may occur to my person during our appointment

Apparel request

If possible and within reason

Your personal message

This is your opportunity to introduce yourself and stand out. Make a good first impression and be polite