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SESSION REQUEST FORM ~
DALLAS, TEXAS

A submission of this form is required to formally request a session with Goddess Khiya while She is on

TOUR / TRAVELING.  
All information must be honest and factual.

If the submitted answers change, alert Goddess Khiya prior to the start of the session.

TRIBUTES:        ~ $500 / 1 HOUR (MINIMUM)                ~ $750 / 1.5 HOURS                       ~ $1000 / 2 HOURS                ~ 4+ Hours available, upon request

I have read and voluntarily agree to Goddess Khiya's Session Terms & Conditions. 

www.GoddessKhiya.com/SessionInformation.

I understand that a 25% deposit of total session cost is required upon confirmation of a session date & time, with the remainder due at start of session.

WHAT ARE THE KINK/FETISH INTERESTS YOU WOULD LIKE TO EXPLORE?

BONDAGE
IMPACT PLAY
IMPACT PLAY TYPES
SENSATION PLAY / SENSORY DEPRIVATION
OTHER SESSION ACTIVITIES

SESSION REQUEST DETAILS   

(GENERAL HOURS OF AVAILABILITY: Monday - Sunday (12pm - 12am) 

PICTURES / VIDEO : Do you consent to pictures and/or videos being taken during the session? These pictures may be utilized for marketing or promotional purposes.

Session Request Received. Goddess Khiya will contact you within the next 24 hours.

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