······THIS CERTIFIES, that the undersigned female about to enjoy 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 or 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 give a damn; I am not asleep or drunk, and am entering into this relationship 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 for an early return engagement. Furthermore, I agree never to appear as a witness against him or prosecute under Mann White Slave Act.