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Email * Name * Address * Contact/Cell Phone Number * Date of Birth * - month - Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec - day - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 - year - 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 If under 18 please provide name of Legal Guardian. Legal Guardian phone number. Driver's License Number Have you ever been convicted of a crime? * No Yes If you have been convicted of a crime, please provide details. Emergency Contact * Emergency Contact Number * Emergency Contact #2 * Emergency Contact Number #2 * Position Desired -- Please choose no more than 2 * Actor     Parking     Circle Ticket Taker     Make-up Artist     Maintenance     Zombie Shootout Gallery     Haunted Trail Usher     If you are applying as an actor, please check the two (2) attractions you prefer to work in. We will try to accommodate as much as possible. Haunted Forest     Dark Trail     Hayride     Killers in the Corn -- Haunted Corn Maze     Carney Crypt     To the best of your knowledge, please indicate the nights you know you CAN'T work. Sept 23rd - Saturday     Sept 29th - Friday     Sept 30th - Saturday     Oct 6th - Friday     Oct 7th - Saturday     Oct 13th - Friday     Oct 14th - Saturday     Oct 19th - Thursday (Adult Only Night)     Oct 20th - Friday     Oct 21st - Saturday     Oct 22nd - Sunday     Oct 26th - Thursday     Oct 27th - Friday     Oct 28th - Saturday     Oct 29th - Sunday     Oct 30tt - Monday     Oct 31st - Tuesday     Nov 4th - Saturday     Applicant/Guardian Waiver and Signature Please click to read the document I have read and agree to these terms*  (enter your name) Are you under 18 years old?*   yes   no Parent's signature

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