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For each item, you need to provide two answers:
Experience

Have you had real time experience with the activity? 

Indicate YES or NO next to each item. Write N/A if it does not apply to your gender.

Willingness

Are you willing/open to try an activity?

For each item, indicate the degree to which you are willing to try that particular activity by rating it on a scale of NO or 0-5 (see rating scale below). 

If you write "no", it means you will not do that under any circumstance (a hard limit). There is nothing wrong with indicating 'no' on an item. 

If you do not understand what an activity is, mark that item with a "?".

Mark with an asterisk (*) those items which you are willing to do only with your current sex partner(s), but not with casual play partners

Rating Scale for the Submissive
0 - Utterly no desire to do that activity and donít like doing it (in fact, may loath it) and ordinarily would object to doing it, but you would permit the Dominant to do it if they really wanted it (sometimes called a soft limit)
1 - Donít want to do or like to do this activity, but wouldnít object it if was asked of you
2 Willing to do this activity, but it has no special appeal for you
3 - Usually like doing this activity, at least on an irregular/occasional basis
4 - You like doing this activity and would like to experience it on a regular basis
5 -  Is a wild turn-on for you and you would like it as often as possible

Rating Scale for the Dominant
0 - No experience what so ever in this activity
1 - Have read about this activity and did some research but have yet to experience it.
2 - Have limited hands on experience with this activity
3 - Some experience comfortable performing the activity
4 - Experienced can comfortably perform this activity
5 - A pro have mentored others on this activity

Please use the comment section for anything you feel the Dom/sub should know about. i.e. Health issues, reactions to certain activities ect. 

There is intentionally some overlap between categories.

Unless otherwise stated, the sub is the recipient/target of the activity

       
Activity Dom's Experience Sub's Willingness Comments 
Abrasion      
Age Play      
Anal Sex      
Anal Plugs Small      
Anal Plugs Large      
Anal Plugs Public Underclothes      
Animal Roles      
Arm and Leg Binders      
Aromas      
Asphyxiation      
Auctioned for Charity      
Ball Stretching      
Bathroom Control      
Bestiality      
Beating (soft)      
Beating (Hard)      
Blindfolding      
Being Serviced Sexually      
Being Bitten      
Breast/Chest Bondage      
Breath Control      
Branding      
Boot Worship      
Bondage (Light)      
Bondage (Heavy)      
Bondage (multi-day)      
Bondage (public under clothing)      
Breast Whipping      
Brown Showers/Scat      
Cages (Locked Inside)      
Caning      
Castration Fantasy      
Catheterization      
Cattle Prod       
Cells/Closets (locking inside of)      
Chains      
Chamber Pot Use      
Chastity Belts      
Chauffeuring      
Choking      
Chores (Domestic Service)      
Clothespins      
Cock Rings/Straps      
Cock Worship      
Collars worn in Private      
Collars worn in Public      
Competition with other subs      
Corsets (wearing Casually)      
Corsets  casual wear      
Corsets training      
Cuffs Leather      
Cuffs Metal      
Cutting      
Diapers (Wearing)      
Diapers (Wetting)      
Diapers (soiling)      
Dilation      
Dildos      
Double Penetration      
Electricity      
Enemas (For Cleansing)      
Enemas Retention/Punishment       
Enforced Chastity      
Erotic Dance (For Audience)      
Examinations (Physical)      
Exercise (forced/required)      
Exhibitionism (friends)      
Exhibitionism (strangers)      
Eye Contact Restriction      
Face Slapping      
Fantasy Abandonment      
Fantasy Rape      
Fantasy Gang Rape      
Fear (Being scared)      
Fisting (Anal)      
Fisting (Vaginal)      
Flame Play      
Following Orders      
Foot Worship      
Forced BedWetting      
Forced Dressing      
Forced Eating      
Forced Homosexuality      
Forced Heterosexuality      
Forced Masturbation      
Forced Nudity (Private)      
Forced Nudity (Around others)      
Forced Servitude      
Forced Smoking      
Full Head Hoods      
Gags (cloth)      
Gags (Inflatable)      
Gags (Phallic)      
Gags (Rubber)      
Gags (Tape)      
Gas Mask      
Gates of Hell       
Genital Sex      
Given Away to another Dom (temp)      
Given Away to another Dom (perm)      
Golden Showers      
Gun Play      
Hair Brush Spankings      
Hair Pulling      
Hand Jobs (giving)      
Hand Jobs (Receiving)      
Harems      
Harnessing (leather)      
Harnessing (rope)      
Having Food Chosen for you      
Having Clothing Chosen for you      
Head (giving it)      
Head (receiving it)      
High Heel Wearing      
High Heel Worship      
Homage with Tongue (non sexual)      
Hoods      
Hot oil (on Genitals)      
Hot Waxing      
Housework (doing)      
Human Puppy Dog      
Humiliation (private)      
Humiliation (public)      
Hypnotism      
Ice Cubes      
Immobilization      
Infantilism      
Initiation Rites      
Injections      
Intricate (Japanese) Rope Bondage      
Interrogations      
Kidnapping      
Kneeling      
Knife Play      
Leather Clothing      
Leather Restraints      
Lectures for Misbehavior      
Licking (non sexual)      
Lingerie (wearing)      
Manacles and Irons      
Manicures (giving)      
Massage (giving)      
Massage (Receiving)      
Medical Scenes      
Modeling for Erotic Photos      
Mouth Bits      
Mummifications      
Name Change for scene      
Nipple Clamps      
Nipple rings piercing      
Nipple Weights      
Oral/Anal play (rimming)      
Over the Knee Spanking      
Orgasm Denial      
Orgasms Control      
Outdoor Scenes      
Pain (Severe)      
Pain (Mild)      
Persona Training (in scene)      
Personal Modification (real life)      
Phone Sex (Serving Dom)      
Phone Sex (serving Doms friends)      
Phone Sex (Commercial Provider)      
Piercing Temporary      
Piercing permanent      
Plastic Surgery      
Prison Scenes      
Prostitution (public pretense)      
Prostitution (actual)      
Pony Slave      
public exposure      
Punishment Scene      
Pussy/Cock Whipping      
Pussy Worship      
Riding Crops      
Riding the Horse      
Rituals      
Religious Scenes      
Restrictive rules on Behavior      
Rubber/Latex Clothing      
Rope Body Harness      
Saran Wrap      
Scarification      
Scratching - Getting      
Scratching - Giving      
Sensory Deprivation      
Serving      
Serving as art      
Serving as ashtray      
Serving as Furniture      
Serving as Maid      
Serving as Toilet (urine)      
Serving as Toilet (Feces)      
Serving as waitress/waiter      
Serving Orally (sexually)      
Serving Other Doms (supervised)      
Serving Other Doms (unsupervised)      
Sexual Deprivation (Short term)      
Sexual Deprivation (long term)      
Shaving (Body Hair)      
Skinny Dipping      
Sleep Deprivation      
Sleep Sacks      
Slutty Clothing (Private)      
Slutty Clothing (Public)      
Spandex Clothing      
Spanking      
Speech Restrictions      
Speculums (anal)      
Speculums (Vaginal)      
Spitting      
Spreader Bars      
Standing in Corners      
Stocks      
Straight Jackets      
Strap on Dildos (sucking on)      
Strap on dildos (penetrated by)      
Strap on Dildos (wearing)      
Strapping (Full Body Beating)      
Suspension (Upright)      
Suspension (inverted)      
Supplying New Partners for Dom      
Swallowing Feces      
Swallowing Semen      
Swallowing Urine      
Swapping      
Swinging      
Tampon Training (in ass)      
Tattooing      
Teasing      
TENS      
Thumb Cuffs (Metal)      
Tickling      
Triple Penetration      
Urethral Sounds      
Uniforms      
Vaginal Dildo      
Verbal Humiliation      
Vibrators on Genitals      
Violet Wand      
Voyeurism      
Water Torture      
Waxing (Hair removal)      
Whipping      
Wooden Paddles