Sample BDSM play agreement

I have been working on a form for new play partner intake if you will. It is not a contract even if people call things like this contracts. Instead it is a tool for negotiation. keep in mind that it is not meant to be all inclusive.

BDSM play agreement – Short form The following persons are intending to play: _____________________

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I. Safety precautions Available on hand a. First aid kit b. Safety scissors c. Flashlight d. Fire extinguisher e. Safe words (note here) f. Limit of intoxicant (outline here) g. Barrier protection – Gloves, Condoms, Dental dams Additional Precautions II. Sex The following acts may occur in scene, note if consent is conditional a. Masturbation b. Fellatio c. Cunnilingus d. Vaginal Intercourse e. Vaginal Insertion f. Vaginal fisting g. Anal Intercourse h. Anal Insertion i. Anal Fisting j. Analingus k. Internal Ejaculation l. External Ejaculation m. Biting n. Kissing The following toys may be used, note if conditional o. Dildo p. Vibrator q. Butt Plug r. Lubricants (including active) s. Pervertables III. Humiliation and degradation a. Name calling i. Slut shaming ii. Body shamming iii. Belittlement b. Objectification c. Public humiliation d. Forced flattery e. Scolding f. Orgasm Control or Denial g. Other Special Conditions or notes regarding the above may be added here IV. Marks The following marks may be made (note if conditional) a. Abrasions b. Bruises c. Clip marks d. Cuff marks e. Rope marks f. Welts g. Small cuts h. Substantial cuts Special Conditions or notes regarding the above may be added here V. Pain a. Sting b. Thud c. Amount: Small Medium Large d. Typical reaction to pain VI. Bondage The following forms of bondage are acceptable a. Rope b. Chain c. Cuffs d. Other VII. Roles a. The following will be the power exchange roles adopted. b. List any exceptions VIII. Medical History a. List any medical issues below b. List any areas that may be more or less sensitive for medical reasons c. List any diseases, infections or disorders d. Have you ever had any issues with mental health? IX. Recordings and Privacy a. Photos are okay b. Videos are okay c. Posting to Fetlife is okay d. Conditions for photography are listed below X. Consent a. The above listed is implicitly consented to without exception b. The above listed is implicitly consented to at the start of a scene c. The above requires confirmation at the time of the scene XI. Special skills and opportunities a. List any talents or unique abilities that may contribute to the scene Add any additional comments or limits in the space provided below with a note about the section to which they refer.