Esquire Adult Films Limited

Adult Entertainment Professional Release Form

Revision 7 (01/2009)

SECTION A - CONTACT / IDENTITY INFORMATION

Actor’s Name

Actor’s
Address

Telephone Fax Email

Date of Birth Age Last Current

Birthday Date

Sex Height Weight

Colour of Colour of Colour

eyes hair of skin

Length of Breast size Shoe

penis (men) (women) size

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SECTION B – Adult Actor Suitability Checklist

(i) Suitability
# Question YES or NO
1 Are you physically fit?
2 Do you suffer from any disabilities?
3 Do you suffer from any illnesses?
4 Are you taking medication prescribed by a physician or apothecary?
5 Have you ever been sectioned under the mental health act?
6 Have you ever received a diagnosis of mental illness?
7 Are you entering the adult entertainment profession of your own free will?
8 Will you be paid as a result of this work?
9 Are you at liberty to leave the adult entertainment profession at any time?
10 Are you happy to be photographed/videotaped?

(ii) Constraints
# Question YES or NO
1 Would you perform with members of the opposite sex?
2 Would you perform with members of the same sex?
3 Would you perform with inanimate objects
4 Would you perform with animate objects
5 Would you participate in the following sexual activities?
YES / NO YES / NO
A Group sex AE Dirty Sanchez
B Anal Sex AF Dry humping
C Cunnilingus AG Loose shunting
D Fellatio AH Deja moo
E Fisting AJ Mudsharking
F Deep throat AK Skylarking
G Water sports AL Bashing The Hoon
H Golden showers AM Sleeping
I Brown showers AN Wolfbagging
J April showers AO Teabagging
K Helicoptering AP Shrooming
L Dogging AQ Polishing the dragon
M Dildogging AR Hiding the meerkat
N Bog-Trotting AS Riding shotgun
O Pony Play AT Jacking
P Bondage AU Phlomping
Q Domination AW Doggy style
R Sado-Masochism AX Googling
S Tickling AY Hamstering
T Transvestism AZ Cleveland steamers
U Hiding-the-sausage BA Wanking
V Petanque BC Sponking
W Reverse Polish Notation BD Bog snorkelling
X Thighjobs BE Spiderpig
Y Scissoring BF Spoon bending
Z Rimjobs BG Spongmonkey
AA Rimshots BH BadgerBadgerBadger
AB Paradiddles BI Kansas
AC Tribbling (with peanuts) BJ Mathematics
AD Tribbling (without peanuts) BK Tony Blair

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(iii) Applicant Statement

QUESTION ANSW ER

1) Why do you want to enter the adult

entertainment industry?

2) How long are you expecting to work in

the adult entertainment industry?

3) What are your favourite sexual

pastimes?

4) What sexual activities will you

absolutely not perform?

5) How do you feel when you are

engaging in sexual activity?

6) When did you start having sexual

activity?

7) How many partners have you

engaged in sexual activity with and
what have you done?

(Answer in detail, use a separate sheet if

necessary)

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SECTION C – Declaration

I/We declare that the information given on this form is true and correct to the best of
my/our knowledge or belief and that I understand that legal penalties may result if any
information I have given is materially incorrect,

In signing this form I absolve Esquire Adult Films Limited from any and all legal action
should injury, trauma (mental or physical), dismemberment, disembowelling, goring,
swelling or death result during any performance in discharge of my duties as an adult
entertainment professional.

Signed Print Name Date

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