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time Number (ie
Companion
Enter Date requesting (ie dd/mm/yyyyy)
Enter time start (ie 9:30pm)
Your First Name
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Your Email
*
Your Contact Ph Number
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Length of Stay
*
15mins (Massage Only)
30mins
45mins
60mins
90mins
120mins
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Requested
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Me & one Companion
Me & more than one Companion
My Friend & I with Companion/s
Massage
Have you been with this companion before
*
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No
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