Blind Date Session Name * Name First First Last Last Phone * Email * Age * Select one 1819202122232425262728293031323334353637383940 Gender * Select one MaleFemale Are you single? * Select one YesNo Location * Have you ever been married? * Select one YesNo Are you comfortable with someone that has been divorced? * Select one YesNo Do you have children? * Select one YesNo Are you comfortable being with someone that HAS children? * Select one YesNo Do you want children in the future? * Select one YesNo Are you interested in a male or female? * Select one FemaleMale What do you do for a living? * Do you smoke? * Select one YesNo Do you drink? If yes, how often? * Select one Yes, RarelyYes, Occasionally/SociallyYes, ModeratelyYes, HeavilyNo What personality traits do you like in a partner? * What would make you pass on a partner? * **Please include anything you would NOT be comfortable with a partner doing/having. What things interest you? * What turns you off? * Is weight an issue for you in a partner? Select one YesNo What is your picture perfect date? * Favorite type of music? * How do you spend your nights off? * Do you agree to showing affection through intimate poses, kissing and other public displays of affection during the session? * Select one YesNo Do you agree to the story and all images being shared on social media? * Select oneYesNo Do you agree to 100% commit to this with no cold feet? * Select one YesNoI'm not sure **MUST be dependable. What does your availability look like? * Anything else you would like to share? * Why do you want to participate in a blind date session? * Are you willing to go/have the female shirtless? * Select one YesNoPossibly **A bra or lingerie piece, not fully nude. Are you willing to go/have the male in just his boxers? * Select one YesNoPossibly Agree * Yes reCAPTCHA If you are human, leave this field blank. Submit
