Registration

INSTRUCTIONS: To register for a Butchmanns Experience event, enter this form and review the following:

  • Participants must be a minimum of 18 years old to participate. Legal ID will be verified upon arrival.
  • This event includes physical movement and exertion, including SM activities. You are solely responsible for the health, safety and care of your own person. Signed waiver forms are required.
  • All information provided on this form and throughout the weekend is held in the highest confidence.
  • Write legibly and verify email address. Confirmation of registration will be sent via email. 
PERSONAL INFORMATION
EMERGENCY CONTACT
(someone who is not attending the same event)
HEALTH INFORMATION
Contact your health care provider with any questions about your health status.

* We will do our best to provide for your dietary needs, however we can not guarantee that special diets will be accommodated. You are welcome to bring any specialty foods for your own use.

ADDITIONAL INFORMATION
We recognize the potentially diverse nature of these answers.
We would appreciate knowing how you heard about us.
EXPERIENCE LEVEL / INTEREST LEVEL
Select your level of experience and your level of interest in the following activities using a scale of 1 to 3. (1 = no experience or interest, 2 = some experience or interest, 3 = a lot of experience or interest)
123
Sensory limitation (sight, hearing)
Flogging
Restraints (not immobilized)
Immobile bondage
Mummification
Piercing / Needles
Mastery / slavery (part-time)
Mastery / slavery (full-time)
123
Sensory limitation (sight, hearing)
Flogging
Restraints (not immobilized)
Immobile bondage
Mummification
Piercing / Needles
Mastery / slavery (part-time)
Mastery / slavery (full-time)
EVENT INFORMATION: Which event do you wish to attend? (visit our Schedule page for event details)
Which event do you wish to attend? (visit our Schedule page for event details)
First Choice
Alternate
EVENT FEES
To be paid in advance and enclosed with the printed application. (select appropriate fee)
REFUND POLICY
Participant is eligible for full reimbursement if weekend event is cancelled.

Cancellation up to 4 weeks prior to event 

100% reimbursement of event fee 

Cancellation between 2 and 4 weeks of event 

50% reimbursement of event fee 

Cancellation within 2 weeks of event or no-show 

0% reimbursement of event fee 

 

AUTHORIZATION
I certify that I am of legal age to attend this event and my payment is enclosed.
$
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