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Check list for Bdsm play

This checklist was filled out by _________________ and provided to __________________ This has been designed to provide a quick "head-start" to identifying limits, negotiating and finding common ground for play to get a better handle on specific interests. For each item, you will need to provide two answers: For experience, write YES or NO next to each item to indicate if you have ever DONE that activity. Mark N/A if it does not apply to your gender.

For willingness, indicate for each item how you feel about DOING that activity with The Dominant by rating it on a scale of NO or 1 to 4.
NO means that YOU WILL NOT do that activity under any circumstances (a hard limit). 1 means You are willing to do this activity, but are unsure to what appeal it will have for you. 2 means You usually like doing this activity, at least on an irregular/ occasional basis. 3 means You like doing this activity, and would like to do it on a regular basis. 4 means You find the activity is a wild turn-on for you, and you would like to do it as often as possible. Note any additional information or comments that might be important to be noted in the margin to the right. Experience, Yes/No, Willingness NO or 1-4 Notes & Comments

Unless otherwise stated, you are the recipient/target of the activity. # Any and all activities not marked as a hard limit may or may not be carried out during the particular session or future sessions at all times safe words are encouraged and accepted. Safe words are: Red means stop Amber means slow/softer Please fill in here any medical issues eg asthma, profuse bleeding, Hi/Low blood pressure etc and how this may effect play, information is voluntary and designed for your safety and will remain confidential.

Activity to be performed

Experien

Willingne

Notes & Comments

ce Yes/No Abrasion Age play Anal sex Animal roles Arm & leg sleeves (arm binders) Aromas Asphyxiation on the sub Auctioned for charity Bathroom use control Beating (soft) on the sub Beating (hard) on the sub Blindfolds on the sub Being serviced (sexual) Biting the sub Breast/chest bondage Breath control on the sub Branding on the sub Boot worship by the sub Bondage (light) on the sub Bondage (heavy) on the sub Bondage (public, under clothing) Breast whipping on the sub Cages (locked inside of) Caning on the sub Cattle prod (electrical toy) Cells/Closets (locked inside of) Chains on the sub Chastity belts on the sub Chauffeuring by the sub Choking on the sub Chores (domestic service) Clothespins on the sub Cock worship by the sub Collars (worn in private) on the sub Collars (worn in public) on the sub Competitions (with other Subs) Corsets (wearing casually) by the sub Corsets (trained waist reduction) Cuffs (leather) on the sub Cuffs (metal) on the sub Cutting the sub Dilation vaginal Dildos used on the sub Double penetration on the sub Electricity on the sub Enforced chastity on the sub Examinations (physical) Exhibitionism (friends) Exhibitionism (strangers) Face slapping to the sub Fantasy abandonment

ss No or 0-4 2 4 3 3 4 3 3 2 1

Fantasy rape Fantasy gang-rape Fear (being scared) to the sub Fisting (vaginal) on the sub Flame play on the sub Following orders given The Master Foot worship by the sub Forced dressing on the sub Forced homosexuality Forced heterosexuality Forced masturbation Forced nudity (private) Forced nudity (around others) Forced servitude Forced smoking Full head hoods Gags (cloth) Gags (inflatible) Gags (phallic) Gags (rubber) Gags (tape) Gas masks Genital sex between Master & sub Genital play (fingering) Hairbrush spankings Hair pulling Hand jobs by the sub Harems (serving w/other subs) Harnessing (leather) Harnessing (rope) Having clothing chosen for you Head (give fellatio/cunnilingus) Head (receiving fellatio High heel wearing Hoods Hot oils (on genitals) Hot waxing Housework (doing) Human puppy dog Hypnotism Ice cubes Immobilisation Injections Intricate (Japanese) rope bondage Kidnapping Kneeling Knife play Leather clothing Leather restraints Lectures for misbehaviour Lent to another Dom (temp) Licking (non-sexual) Lingerie (wearing)

Manacles & Irons Manicures (giving) Massage (giving) Medical scenes Modelling for erotic photos Mouth bits Mummification Nipple clamps Nipple rings (bitting) Nipple play (piecing) Nipple play (sucking) Nipple play (torture) Nipple weights Over-the-knee spanking Orgasm denial on the sub Orgasm control by the Dom Outdoor scenes Outdoor sex between Dom & Sub Pain (severe) Pain (mild) Phone sex (serving Dom) Phone sex (serving Dom's friends) Piercing (temporary, play-pierce) Piercing (permanent) Prison scenes Pony slave Public exposure Punishment Scene Pussy whipping Pussy worship Riding crops Restrictive rules on behaviour Role Play (Fantasy) Rope body harness Saran wrapping Scarification Scratching - getting Scratching leaving marks Sensory deprivation (sensual) Sensory deprivation (non sensual) Sub to be Serving Sub to be Serving orally (sexual) Serving other doms (supervised) Sexual deprivation (short term) Sexual deprivation (long term) Shaving (body hair) Shaving (genital hair) Skinny-dipping Sleep deprivation Slutty clothing (private) Slutty clothing (public) Spanking Speech restrictions (when, what)

Speculums (Anal) Speculums (vaginal) Spreader bars Standing in corner Stocks Straight jackets Strap-on-dildos (sucking on) by the sub Strap-on-dildos (penetrated by the Dom to the Sub Strap-on-dildos (wearing) by the sub Strapping (full body beating) Suspension (upright) Suspension (inverted) Suspension (horizontal) Swallowing semen by the sub Sword Play Tattooing Teasing TENS Unit (electrical toy) Thumb cuffs (metal) Tickling Triple penetration by the Dom to the Sub Urethral Sounds (metal rods) Uniforms to be worn by the sub Including others in play Vibrator on genitals Violet Wand (electrical toy) Video (recordings of you) Water torture Waxing (hair removal) Wearing symbolic jewellery Whipping Wooden paddles

Signature____________________________ Permission given by subs Dominant / Partner if required for all activities marked Yes/No______ Dominant /Partners Name_____________________________ # electronic signature will surfice Primum non nocere - First do no Harm Copyright Master NightWing 2010

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