Event Registration Form Step 1 of 2 50% Contact DetailsName(Required) First Last Email(Required) Enter Email Confirm Email PhoneAddress(Required) City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Payment DetailsSelect Your Date(s)Select the date(s) you wish to attend Haunted House 2025 Friday October 3, 2025 5pm - 11pm Saturday October 4, 2025 5pm - 11pm Sunday October 5, 2025 5pm - 11pm Friday October 10, 2025 5pm - 11pm Saturday October 11, 2025 5pm - 11pm Sunday October 12, 2025 5pm - 11pm Select Your Date(s)Select the date(s) you wish to attend Haunted House 2025 Friday October 17, 2025 5pm - 11pm Saturday October 18, 2025 5pm - 11pm Sunday October 19, 2025 5pm - 11pm Friday October 24, 2025 5pm - 11pm Saturday October 25, 2025 5pm - 11pm Sunday October 26, 2025 5pm - 11pm Friday October 31, 2025 5pm - 11pm Saturday November 1, 2025 5pm - 11pm How Many Will Be AttendingPlease select the appropriate age group and number of guests in your party. The total due will then be calculated automatically. Under 18 Years of Age Quantity Price: $5.00 Quantity Over 18 Years of Age Quantity Price: $10.00 Quantity 55+ Seniors Quantity Price: $8.00 Quantity Amount Due: Photographs may be taken at the eventAs a guest you may take photographs in the public access areas of the event. We welcome event guests to submit their photos to us, that will be posted on our web site's gallery. In addition, Belly Rub N Grub may be taking photos for marketing purposes. If you wish to not be photographed, please express this at the time of entering the event. You will then receive a wrist band that will indicate to our photographers that you do not wish to be photographed. All children under the age of 18, MUST be accompanied by an adult, AT ALL TIMES. Strobe Light Warning and Release of LiabilityPlease be aware that strobe lights MAY be used during this event. Strobe lights may trigger or exacerbate certain medical conditions, including epilepsy, seizure disorders, or other vision-related problems. By entering and participating in this event, you acknowledge that you are aware of the potential risks associated with strobe lights and therefore, release Belly Rub N Grub, its personnel, and its affiliates from any liability, and any adverse effects or injuries that may result while on the property during this event. If you have any pre-existing condition that may be of concern to you, please contact Belly Rub N Grub for assistance. I understand the above, and release Belly Rub n' Grub of any liabilities. I release Belly Rub n' Grub of any liabilities.Date MM slash DD slash YYYY PhoneThis field is for validation purposes and should be left unchanged. Δ