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The Surrender Process

Name

Name (real or chosen)

*

Age

*

What is your email?

*

What is your phone number?

(Optional, leave blank if you do not wish to be contacted by text)

What drew you to The Surrender Process?

*

Have you explored any of the following before? (Select all that apply.)

*

Have you explored any of the following before? (Select all that apply.)

A

Meditation

B

Energy Work

C

BDSM/ kink/ power exchange

D

Somatic Work

E

None of the above

If shame wasn't part of the equation, what would you be curious to explore?

*

Is there anything you definitely do not wish to experience?

*

Is there anything I should know to help create a safe experience for you?

*

What feels more uncomfortable to you right now?

*

What feels more uncomfortable to you right now?

Being seen.

Not being chosen.

Receiving.

Surrendering control.

Letting another person witness my vulnerability.

I don't know.

Is there anything you would like me to know before we meet?

*

In order to participate you must accept these agreements

*

In order to participate you must accept these agreements

I understand this is not therapy or medical treatment.

I understand that I am responsible for communicating my own boundaries.

I agree to respect the confidentiality of everyone attending the session.

I agree not to judge or shame other participants for their desires, emotions or experiences.

I agree to arrive sober and not under the influence of recreational drugs or alcohol.

I understand that my requests or desires may or may not be included in the session.

I agree to follow the facilitator's instructions where they relate to the safety and flow of the group.

I am willing to approach this experience with curiosity rather than expectation.