Haunted House Insurance Questionnaire

	Yes	No
2. If outdoors, is the area fenced?
3. Are any candles used?
4. Is there any human contact?
5. Is there any use of live animals?
6. Are there any moving floors, walls or steps?
7. Are there any slides?
8. Are bleachers or platforms used?
9. Are smoke effects used?
10. Are extension cords used?
11. Is the haunted house inspected by the fire department prior to use?
12. Are there age restrictions/limits?
13. Is first aid available?

	Enter info below
15. Maximum number of individuals in house at one time:
16. Number of days open:
17. Hours of operations:
18. Anticipated number of people to go through the haunted house:
19. Estimated gross receipts:
20. Price of admission:

	Building Age	Building Construction	Building Limit ($)	Content Limit ($)
Building 1
Building 2