Linked In Profile or Work Website__________
Age_________________(attach Photo ID with redacted number)
References (Name, Website, Ph No.) ___________________________
Have you ever been arrested? Yes____ No________
If Yes, what was the disposition of the charges_____________________
Was the charge a result of Domestic Violence? Yes_____ No________
Please initial each line:
__________ I understand I am only paying for time and companionship.
___________ I agree that I will not summon law enforcement and that if the companion is arrested as a result of my summoning law enforcement absent danger to my life, I agree to reimburse the companion her attorney fees, court costs and fines. Additionally I agree to pay liquidated damages of $20,000.00.
_____________ I agree to pay a non refundable booking fee of 30% of the cost of the consultation to reserve the time. I agree the fee is earned when paid and non refundable.
_____________ I agree that no means no , that the companion is permitted to set her boundaries and if I persist after told no, she may end the session.
_____________ I agree the companion;s fees are non-negotiable.
______________I agree that if I am inebriated when I arrive, I am liable for the whole cost of the session.
_____________ I agree that if I cancel within 24 hours, I will be liable for a cancellation fee of $500.00.
_____________I agree that if the session is terminated due to my behavior, that I will refrain from contacting the companion in the future and if I do, she will be entitled to liquidated damages of $5000.00