18++: 18++ 23 Mar 2006

Form# 69
Version 1.0.2
Sexual Consent Form for two individuals

Whereas _________________, hereafter known as the first party,
and ______________, hereafter known as the second party, being of
consenting age and sound mind, hereby consent to the following
sexual acts, under the conditions and limitations listed below
within the time period between _______ and _______ For more then
two parties, see form 271828, a multi-party version of this form.

Part 1: Sexually transmitted diseases and pregnancy prevention.

This form assumes that both parties are in good health and free
of known sexually transmitted diseases. If either party consents
to any sexual acts while knowingly carrying a STD, that party
agrees to any costs incurred as a result of transmission of that
STD, and to furthermore pay punitive damages amounting to $_____.
Furthermore, each party agrees to acquire and properly use the
following methods of contraception and agrees to be liable for
failure of these contraceptive devices (check the appropriate
forms of contraception)

The first party agrees to obtain and use these forms of
contraception:

__ Condom ( __ with spermicidal lubricant)
__ Female condom (experimental. No liability is assumed for
pregnancy or STD transmission if this device fails).
__ Intrauterine device
__ Cervical Cap (__ with spermicide)
__ Diaphram ( __ with spermicide)
__ Birth control pill (Specify type:________)
__ Contraceptive sponge ( __ with spermicidal lubricant)
__ Spermicidal jelly or foam
__ Surgical sterilization ( __ Vasectomy __ Tubal ligation)
__ Norplant
__ RU 486 (Not legally available in the United States. Only for
use where legal)

The second party agrees to obtain and use these forms of
contraception:

Part 2: Pregnancy clause

If both the party of the first part and the party of the second
part agree that pregnancy is a goal of the sexual acts they wish
to engage in, check here: __. If pregnancy is anatomically
impossible, check here: __. If either of the previous two
conditions don't apply, the following clause applies.

In case of unwanted pregnancy, the parties agree to the following
actions: (Check all that apply)
__ Marriage
__ Abortion. Paid for by ____________
__ Adoption
__ DNA testing of fetus and both parties to insure that both
parties are the parents. Paid for by ____________
__ Single parentood by the following party:_________. In this
case, both parties are still financially responsible for the
offspring.
__ Single parenthood by the following party:________. This party
assumes sole fiscal responsibility.

Part 3: Consent of the first party.

The first party consents to the following sexual acts: (Check all that
the first party consents to. Any contact in the form of XXX-XXX, the
first part refers to the consenting party, and the second part refers to
the other party) Although the first party consents to allow the
following,
this is no way implies that any of the following acts will be carried
out.

__ Fully clothed bodily contact
__ Partially clothed bodily contact
__ Nude bodily contact
__ Hand-torso contact
__ Torso-hand contact
__ Hand-genital contact
__ Genital-hand contact
__ Hand-anal contact
__ Anal-hand contact
__ Oral-oral contact
__ Oral-oral contact involving the tongue
__ Oral-torso contact
__ Oral-torso contact involving the tongue
__ Torso-oral contact
__ Torso-oral contact involving the tongue
__ Oral-genital contact
__ Oral-genital contact involving the tongue
__ genital-oral contact
__ genital-oral contact involving the tongue
__ Oral-anal contact
__ Oral-anal contact involving the tongue
__ Anal-oral contact
__ Anal-oral contact involving the tongue
__ Masturbation in the presence of the other party
__ Sexual intercourse in the missionary position, on top.
__ Sexual intercourse in the missionary position, on the bottom.
__ Sexual intercourse "doggy style"
__ Sexual intercourse in other positions: _____
__ Anal intercourse.
__ Physically binding the other party.
__ Being physically bound by the other party.
__ Using the following devices on the other party: (The party assumes
all liability for malfunction or misuse of these devices):______
__ Having the following devices used upon the party by the other party:
__ Other:

Part 4: Consent of the second party.

The second party consents to the following sexual acts: (Check
all that the second party consents to. Any contact in the form
of XXX-XXX, the first part refers to the consenting party, and
the second part refers to the other party). Although the second
party consents to allow the following, this is no way implies
that any of the following acts will be carried out.

[A reference to Part 4 can be made in this regard.]

Part 5: Termination of consent.

Either party can nullify their consent to any specific act by
saying "_______" to the other party, or otherwise indicating
refusal to consent. Either party can also terminate all consent
to sexual activities by saying "______" to the other party, or by
indicating in the following manner that consent is no longer given:

Part 6: Non-disclosure

__ Check here if both parties agree to the following. If both parties
don't agree, then both parties are free to disclose all that occurs.

Both parties agree to only disclose the following information
concerning their sexual activities to others.

Any party who violates this section is liable for $___ in
punitive damages for each violation of this section.

Signed:
First party: _______________ Second party: _____________
Date: __________ Date: _________
Witnessed by: _______________ Date: _________

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