DommyMommyK's Application 
This application is for adults aged 21+. Any reference to babies, littles, or diapers is expressly within the context of role-play between consenting adults. 

I do not, in any way, condone the involvement of minors in any related activity. I do NOT offer sexual activities in any way, shape or form.

After I receive your responses, I will contact you via your preferred method to discuss setting up a session. Filling out the application does not guarantee a session. I reserve the right to refuse service for any reason.

A session is not booked on my calendar until the 20% deposit has been paid.
Sign in to Google to save your progress. Learn more
Email *
Name (first & last) *
Age *
Location (city & state) *
Phone number: *
Preferred Pronouns (He/She/They/Other) *
Fetlife/Twitter/Instagram (if applicable)
Length of desired session: *
Desired end date *
MM
/
DD
/
YYYY
Desired start date *
MM
/
DD
/
YYYY
Have you had prior sessions with a professional Mommy/Domme? *
If yes, with whom and when? Please provide their name and contact information for a reference.
Why do you want to see a professional Mommy? *
How do you want to feel after we've had our session? Any particular emotions or goals you'd like to achieve? *
What do you identify as? *
Required
What size diaper do you wear? *
What is your height?
What is your weight?
What size T-shirt or onesie do you wear?
Preferred Caregiver Role: *
What would you like my demeanor to be? *
Required
Session Interests: *
Do you have words or actions that put you into a little or submissive headspace? *
What are your hard limits? If you answer "No hard limits" we are NOT compatible.  *
What is your pain tolerance? (for punishment scenes)
Clear selection
Do you enjoy messing your diaper?
Clear selection
If you answered "Yes" or "Maybe" to the above, how do you prefer to mess?
I use Red and Yellow as safe words during play, do you know what this means and do you agree to use these as safe words? *
Are you interested in another Top during our session? (Babysitter, Nanny, older sister in diapers, Auntie, etc.)

I am currently offering double sessions here in Akron with Momica or at her nursery in Tampa.
Clear selection
What is your preferred method for me to contact you? *
Where did you find me? *
Do you have any medical conditions or allergies I should be aware of? (Note: This is a kitty friendly residence. I take extra care in cleaning for those who are allergic.  If you require a “deep clean” beyond my already high standards, there is a $200 deep cleaning fee). *
In case of an emergency:  *
Required
Do I have permission to take photos or short videos of our playtime for my social media? Faces and distinguishing features will be obscured and you may revoke this after viewing the content. I will not post without your prior approval. *
Is there anything else you'd like me to know?
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy