Sexual Consent Form

(Please turn in to your nearest law enforcement officer or DMV)

This agreement is made this _______ day of the month of _____________ of the year 20__ between

_____________________ (hereinafter the Proposer) and _______________________ (hereinafter the Consenter).  Whereas the Proposer and the Consenter are sexually attracted to each other;

Whereas the Proposer and the Consenter would like to manifest that sexual attraction through participation in one or more sexual acts;

Therefore, the Consenter and the Proposer make their bodies available to each other for the aforesaid purpose from time ___:___ on date ______ (today’s date if left blank) for a period of _______ hours, during which period they consent to participate in the following activities.

Activity (initial all that apply)

_______ Full body touching (external only)

_______ Kissing with/without* the insertion of tongue into mouth

_______ Digital penetration (receiving in ____________________________________ (specify orifice(s)))

_______ Digital penetration (giving in _______________________________________(specify orifice(s)))

_______ Oral sex (receiving)

_______ Oral sex (giving)

_______ Vaginal sex (receiving: females only)

_______ Anal sex (receiving)

_______ Anal sex

_______ Restraint, using the following devices ______________________________ (specify)

_______ Use of following devices in or on the body ___________________________ (specify)

_______ Other activities________________________________ (specify; continue on a separate sheet).

Contraception:_____________________________________________________________________

The party will use the following safe word/phrase for a pause or altogether seizure of sexual activity with the possibility of resuming within the same night.  If resumption is at a later date an additional consent for will be necessary. ____________________________________________________________________________________.

Whereas the Proposer and the Consenter are aware that attraction may escalate during the agreed upon sexual activities, and that both parties may desire to engage in activities that may require additional consent.  Both parties sign below to acknowledge consent.

___________________________________                   _______________________________________