BDSM Consent form
Consensual Power Exchange Agreement
cinema for sinners wanted a copy of this form posted.
Consensual Power Exchange Agreement.
Participant A Name: ___________________________
Participant B Name: ___________________________
Participate C Name:
__________________________
This agreement confirms that all activities are entered into willingly, knowingly, and with full consent by all parties.
1. Age & Capacity Confirmation
I confirm that I am 18 years or older and legally able to consent.
☐ Yes ☐ No
I confirm that I am entering this agreement of my own free will.
☐ Yes ☐ No
I don’t mind watching my partner having sex with another party
☐ Yes ☐ No
I’m don’t mind taking part in a 3-way
☐ Yes ☐ No
2. Power Exchange Dynamic
Do you consent to participating in a consensual power exchange dynamic?
☐ Yes ☐ No
Do you understand that this dynamic is role play and can be stopped at any time?
☐ Yes ☐ No
Do you consent to the use of titles (e.g., Sir, Ma’am, Master, Mistress, etc.)?
☐ Yes ☐ No
3. Physical Interaction
Do you consent to physical touch
☐ Yes ☐ No
Do you consent to restraint (e.g., cuffs, rope, being held in place)?
☐ Yes ☐ No
Do you consent to impact play (e.g., spanking, paddling)?
☐ Yes ☐ No
Do you consent to sensory play (e.g., blindfolds, temperature play, light sensation play)?
☐ Yes ☐ No
4. Psychological & Verbal Play
Do you consent to verbal dominance (e.g., commands, tone shifts)?
☐ Yes ☐ No
Do you consent to humiliation play
☐ Yes ☐ No
Do you consent to public behavior protocols
☐ Yes ☐ No
5. What are your Limits & Boundaries?
____________________________________________________________________________________________________________________________________________
Triggers or Topics to Avoid:
____________________________________________________________________________________________________________________________________________
6. Safe Word Agreement (insert Safe word)
_________________________________
I understand that I may withdraw consent at any time by using a safe word.
☐ Yes ☐ No
Traffic light system agreed upon?
☐ Yes ☐ No
(Example: Green = Continue, Yellow = Slow/Check in, Red = Stop)
7. Aftercare
Do you require aftercare following a scene?
☐ Yes ☐ No
Preferred Aftercare:
☐ Physical comfort (e.g., cuddling, blanket)
☐ Verbal reassurance
☐ Quiet time
☐ Check-in message later
☐ Other: _______________________________
8. Final Acknowledgment
I acknowledge that Consent can be withdrawn at any time.
No means no.
Safe words will be respected immediately.
Communication is required before, during, and after scenes
☐ Yes ☐ No
All Participant Signatures: ___________________________
___________________________
___________________________
___________________________
Date: ___________________________


Awesome Ambs!
Yes everyone needs to have this! Its such a great example of explicit consent.