Blanket Release

This certifies that I, the undersigned female about to give my body voluntarily in a sexual intercourse with __________________________ am above the lawful age of consent, am in my right mind and not under the influence of any drug or narcotic. Neither does he have to use any force, threats nor promises to influence me.

I am in no fear of him whatever, do not expect or want to marry him, don't know whether he is married or not, and don't care. I am not asleep or drunk, and am entering into this relation with him because I love it and want it as much as he does, and if I receive the satisfaction I expect, I am willing to consider an early return engagement.

Furthermore, I agree never to appear as a witness against him or to prosecute him under the Mann White Slave act.

Signed before jumping into bed this _____ day of __________, 19____.

By ________________________________________ Age ____________

Address ________________________________________

Phone Number __________________

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