All entries must be in by 5pm on October 28th and the winner
will be picked and notified at 6pm the October 28th.
The limo and dinner party will be held on October 30th starting at 7pm

HALLOWEEN HAUNT ENTRY FORM
 ONE ENTRY PER PERSON/HOUSEHOLD
 Click here for contest rules and regulations.
 Must be 18 to enter.
 MUST BE COMPLETE TO BE ELIGIBLE.

First Name:
Last Name:
Address:
City:
State: Zip:
Telephone Numbers (please include one contact number)
Home: Ex: 408-123-4567
Work:  x Ex: 408-123-4567 x89
Email Address:

Marital Status?
Married
Single
Other
My Age Group?
Under 25
25 - 34
35 - 75
Over 75
Spouse's Age Group?
Under 25
25 - 34
35 - 75
Over 75
Household Income?
Under $35,000
$35,000 - $39,999
$40,000 - $49,999
$50,000 - $59,999
Over $60,000

Home Ownership?
Own Home Buying Home Rent Home

Are you interested in buying or selling your home in the next 6 months?
Yes No


 
 


“WARNING! This exhibit is an authentic stimulation of many grotesque and shocking events.
It is not recommended for people with heart problems, recent surgery, pregnancy, or frequent nausea.
Small children and senior citizens are not encouraged to attend.