First and last name under which you registered at the hotel*

Phone number*

E-Mail address*

How do you want to be contacted and at what time*

Which escort model you would like to meet*
AdelinaAlessaAlinaAmélieAngelinaAnikaAnjaAnnabelleAnneCelinaClaraClaudiaEmiliaEvaHannaIsabellaIvyJessicaJilJohannaJuliaLaraLauraLeaLenyaLivMayaMiaNaomiRebbecaSamSarahSinaSophiaVivienne

Please also thereby specify a further escort model*
AdelinaAlessaAlinaAmélieAngelinaAnikaAnjaAnnabelleAnneCelinaClaraClaudiaEmiliaEvaHannaIsabellaIvyJessicaJilJohannaJuliaLaraLauraLeaLenyaLivMayaMiaNaomiRebbecaSamSarahSinaSophiaVivienne

On which day would you like to meet your date*

Name and location of the hotel

Meeting point at the bar / room

Duration and time of the date*

Special wishes / preferences

Please provide a brief description of yourself: (looks, height, age, clothing style, nationality, interests, etc.)

I have read the Privacy Policy note. I agree that my details and data will be collected and stored electronically to answer my request.