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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*

On which day would you like to meet your date*

Duration and time of the date*

Which escort model you would like to meet*
—Please choose an option—AmiraAriannaCarolinaClaireClaudiaGiadaLisa

Please also thereby specify a further escort model*
—Please choose an option—AmiraAriannaCarolinaClaireClaudiaGiadaLisa

Name and location of the hotel

Meeting point at the bar / room

Special wishes / preferences

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

Security question: How much is 6 + 7?

I am in agreement with my data being stored for the processing of this inquiry.