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		<input type="hidden" id="num_questions" name="num_questions" value="8">
		<input type="hidden" name="form_id" value="445">
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	$(function () {
		// reset payment token in case user clicked Back button in browser
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		//$('#business_radio').trigger('change');
		
		
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	}

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	var sent = 0;
	
	// Thibault 2/11/06 added init function called at page load, plus validation that required fields are completed before submit.  should help with problems with the back button and credit cards,  issue 30102
	function init() {
		frm = document.iform;

		
	}

	window.onload = new Function("init()"); //set init function to run at page load

	function lcase(mystring)  {
		return mystring.toLowerCase()
	}

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		if(!delimiters){var delimiters=','}
		_TempListSplitArray = list.split(delimiters)
		FoundIdx = 0;
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			if(_TempListSplitArray[i]==value){
				FoundIdx= i+1;
				break
			}
		}
		return FoundIdx;
	}

	function startValidate() {
		// this will kick off validation, but since we need to validate the captcha
		// we have to wait for that to finish first...
		var iForm = document.getElementById('iform');
		var fld_ss_form_testid = document.getElementById('fld_ss_form_testid');
		var mainV = validateFrm();
		fld_ss_form_testid.value = 1;
		if (mainV) {
			
				iForm.submit();
			
		}
	}

	function validateFrm() {
		if(!sent) sent = 0;  //make sure we have this!
		if (!validForm) validForm = false;
		arrReqMissing = new Array();
		
			
			var jsDesc = "\n\n\r\n\r\n\r\nRelease-Based Cleanup Regulations Breakfast Registration\r\n\r\n\n\nDate Friday, September 18, 2026\r\nLocation Kay&#39;s Pier South, Aqua Turf Club, Plantsville, CT\r\nRegistration &amp; Breakfast 700 am\r\nProgram 800 am\r\nAdjournment Noon\r\n\r\nAgenda\r\n\r\n\r\n\tOverview of Transition to Release-Based Cleanup Program and Release-Based Cleanup Regulations\r\n\tDiscovery of Releases at Construction Sites and Next Steps\r\n\t\r\n\t\tExisting Pollution\r\n\t\tNew Spills\r\n\t\r\n\t\r\n\tSpill Cleanup Contractor Permits\r\n\t\r\n\t\tIndividual permits\r\n\t\tGeneral Permits\r\n\t\r\n\t\r\n\tImporting/Exporting Materials\r\n\r\n\r\n\r\n\r\nPresentations by\r\n\r\n\r\n\r\n\r\n\n\nView the Flyer\r\n";
			
			
			var jsDesc = "Company";
			
				obj = document.iform.response_2;
				val = "";
				
				val = obj.value;
				if (obj.value == "") {
					arrReqMissing[arrReqMissing.length] = jsDesc;
				}
				
			
			var jsDesc = "Registration Contact";
			
				obj = document.iform.response_3;
				val = "";
				
				val = obj.value;
				if (obj.value == "") {
					arrReqMissing[arrReqMissing.length] = jsDesc;
				}
				
			
			var jsDesc = "Confirmation Email";
			
				obj = document.iform.response_4;
				val = "";
				
				val = obj.value;
				if (obj.value == "") {
					arrReqMissing[arrReqMissing.length] = jsDesc;
				}
				
			
			var jsDesc = "\n\nPlease let us know how many attendees you are registering and their names below.";
			
			
			var jsDesc = "Count";
			
				obj = document.iform.response_6;
				val = "";
				
				val = obj.value;
				if (obj.value == "") {
					arrReqMissing[arrReqMissing.length] = jsDesc;
				}
				
			
			var jsDesc = "Attendee Name";
			
				obj = document.iform.response_7;
				val = "";
				
				val = obj.value;
				if (obj.value == "") {
					arrReqMissing[arrReqMissing.length] = jsDesc;
				}
				
			
			var jsDesc = "Additional Attendees";
			
			
		if(arrReqMissing.length > 0) {
			//errStr = "We're sorry, but the following fields are required before you can submit this form. Please click OK, then correct these entries.<br>";
			errStr = "";
			for(i=0; i<arrReqMissing.length; i++) {
				errStr += arrReqMissing[i] + "<br>";
			}
			swal({
	  			title: 'Missing required fields',
	  			html: true,
	  			text: errStr,
	  			animation: 'slide-from-top',
	  			type: 'info',
	  			confirmButtonText: 'Ok',
	  			confirmButtonColor: '#337ab7'
	  		});
			return false;
		}

		for(i=0; i<document.iform.elements.length; i++) {
		 	if (document.iform.elements[i].type == 'textarea' || document.iform.elements[i].type == 'text') {
		 		if (document.iform.elements[i].value.length > 2147483647) {
		 			swal({
			  			title: 'Maximum allowable length',
			  			html: true,
			  			text: "One or more field responses exceeds the maximum allowable length of 2147483647 characters. Please adjust your responses and re-submit.",
			  			animation: 'slide-from-top',
			  			type: 'info',
			  			confirmButtonText: 'Ok',
			  			confirmButtonColor: '#337ab7'
			  		});
		 			return false;
		 		}
		 	}
		}

		if (sent == 1) {
	          swal({
	  			title: 'Processing..',
	  			html: true,
	  			text: "Your request is processing. Please do not click Submit more than once.",
	  			animation: 'slide-from-top',
	  			type: 'info',
	  			confirmButtonText: 'Ok',
	  			confirmButtonColor: '#337ab7'
	  		  });
	          return false;
	    }
		
			bOK = true;
		
		if (bOK) {
			var btn = $('#submitBtn');
			btn.button('loading');
			btn.prop('disabled', true);
			sent = 1;
			validForm = true;
			return true;
		}
		else {
			return false;
		}
	}

	function IsNumeric(sText) {
	   var ValidChars = "0123456789.";
	   var IsNumber=true;
	   var Char;

	   for (i = 0; i < sText.length && IsNumber == true; i++) {
	      Char = sText.charAt(i);
	      if (ValidChars.indexOf(Char) == -1) {
	         IsNumber = false;
	      }
	   }
	   return IsNumber;
	}

	function setButtonVal(el, itemID, price) {
		// first set the price attribute on the element
		el.price = price;
		// now set the value of a hidden field for the associated radio button
		document.getElementById(itemID).price = price;
		document.getElementById(itemID).value = 1;
		// now call the calcTotalFix function to recaculate the total amount due
		calcTotalFix();
	}

	function getRadioButtonValForTotal(radioName){
		var rads = document.getElementsByName(radioName);
		var selectedPrice = 0;
		for(i=0; i < rads.length; i++) {
		  if(rads[i].checked == true){
		    selectedPrice = rads[i].getAttribute('price');
		  }
		}

		selectedPrice = parseFloat(selectedPrice);
		return selectedPrice;
	}

	function calcTotalFix() {
		var priceFields = $(".calculateTotal");
		// console.log('priceFields length: ' + priceFields.length);
		var updateTotal = 0; // initialize total before looping over array
		var processedRadioButtons = [];	/// reset array every time this function is called
		for (var i=0; i < priceFields.length; i++) {
			myFieldObj = priceFields[i];
			if (myFieldObj.value == '') { myFieldObj.value = 0; }
			fieldName = myFieldObj.name;
			value = myFieldObj.value;
			fieldID = myFieldObj.getAttribute('id');
			price = myFieldObj.getAttribute('price');

			// check to see if this is a radioVal by the item id
			if(fieldID != undefined){
				var nRadioVal = fieldID.indexOf("radioVal");
				if(nRadioVal > -1){
					fieldtype = 'radioval';
				} else {
					fieldtype = 'notradioval';
				}
			} else {
				fieldtype = 'nofieldid';
			}

			// if this is just an open price field, there is no notion of quantity times price, so the price to the value of the field
			if(fieldtype === 'radioval'){
				// radio price field - use "price" attribute since we have funky stuff in the "value" attribute that we can't parse easily
				arrNum = $.inArray(fieldName, processedRadioButtons);
				if(arrNum > -1) {
					// set price and calcualted value to zero for the rest of the checkboxes in this array because don't want to keep adding to price
					price = 0;
					calculatedValue = parseFloat(0);
				} else {
					price = getRadioButtonValForTotal(fieldName);
					calculatedValue = parseFloat(price);
					// add radio button field name to array of radio fields processed so we don't check again
					processedRadioButtons.push(fieldName);
				}
				// console.log('fieldName: ' + fieldName + ' / value: ' + value + ' fieldID: ' + fieldID + ' / price: ' + price + ' / calculatedValue: ' + calculatedValue);
			} else {
				if (price === undefined || price === null) {
				// check to see if it's a radio price field first
					// open price field - use "value" attribute
					if (!IsNumeric(value)) {
						//alert("Open Prices must be numbers only, no formatting is allowed.");
						swal({
				  			title: 'Numbers only',
				  			html: true,
				  			text: "Open Prices must be numbers only, no formatting is allowed.",
				  			animation: 'slide-from-top',
				  			type: 'info',
				  			confirmButtonText: 'Ok',
				  			confirmButtonColor: '#337ab7'
				  		});
						myFieldObj.value = 0;
						return;
					}
					calculatedValue = parseFloat(value);
					// console.log('fieldName: ' + fieldName + ' / value: ' + value + ' fieldID: ' + fieldID + ' / price: ' + price + ' / calculatedValue: ' + calculatedValue);
				} else {
					if (!IsNumeric(value)) {
						//alert("Price fields only allow numbers.");
						swal({
				  			title: 'Price fields',
				  			html: true,
				  			text: "Price fields only allow numbers.",
				  			animation: 'slide-from-top',
				  			type: 'info',
				  			confirmButtonText: 'Ok',
				  			confirmButtonColor: '#337ab7'
				  		});
						myFieldObj.value = 0;
						return;
					}
					myVal = parseFloat(value);
					// console.log('in parseint with 10 - fieldName: ' + fieldName + ' / value: ' + value + ' fieldID: ' + fieldID + ' / price: ' + price + ' / myVal: ' + myVal);
					calculatedValue = myVal * parseFloat(price);

				}
			}


			// console.log('Field id: ' + fieldID + ' / Fieldtype: ' + fieldtype + ' / Field name: ' + fieldName + ' / value: ' + value + ' / Price: ' + price + ' / Calculated Field Total: ' + calculatedValue);
			updateTotal = updateTotal + calculatedValue;
		}

		// update hidden total amount
		if (document.iform.hiddentotal) { document.iform.hiddentotal.value = updateTotal; }
		// console.log('The updateTotal is now: ' + updateTotal);
		
		
		// update total value with formatted amount
		if (typeof(formatCurrency) == "function") { document.iform.total.value = formatCurrency(updateTotal); }
		
		if ($('#ordertotal_work').length > 0) {
            $('#ordertotal_work').val(updateTotal.toFixed(2));
        }
        
        if ($('#pmt_method').length > 0) {
        	$('#pmt_method').val('');
        }
        $('.paymentProfileRadio').prop('checked', false);
        $('.card').removeClass('active');
        
		// need to update the cc_info tag fields...
		if (typeof(checkTotal) == "function") { checkTotal(); }
	}

	/* remove after confirming ok without it - 8/8/13 CJV */
	function calcTotal(myField){
		thisVal = myField.value;
		// alert(thisVal);
		if (thisVal == '') {
			thisVal = 0;
			myField.value = 0;
			}
			if (!IsNumeric(myField.value)) {
				//alert('Please enter only numbers or decimal points in a price field');
				swal({
		  			title: 'Price field',
		  			html: true,
		  			text: "Please enter only numbers or decimal points in a price field.",
		  			animation: 'slide-from-top',
		  			type: 'info',
		  			confirmButtonText: 'Ok',
		  			confirmButtonColor: '#337ab7'
		  		});
				myField.value = 0;
				thisVal = 0;
				}
				// get the current total
				var origTotal = document.iform.hiddentotal.value;
				// now backout the prior value from the total
				var priorTotal = origTotal - myField.priorval;
				if(priorTotal == ''){
					priorTotal = 0;
					}
				// add the open price to the total
				updateTotal = parseFloat(eval(priorTotal)) + parseFloat(eval(thisVal));
				// update hidden total amount
				document.iform.hiddentotal.value = updateTotal;
				
					
				// update total value with formatted amount
				document.iform.total.value = formatCurrency(updateTotal);
		checkTotal(); // need to update the cc_info tag fields...
	}
	/* */

	function setOpenPriceInput(thisField,thisPrice){
		if(thisPrice == ''){
			thisField.priorval = 0;
		} else {
			thisField.priorval = thisPrice;
		}
	}

	
		var div_bottom_moved = false;

		function addLoadEvent(func) {
 			var oldonload = window.onload;
  			if (typeof window.onload != 'function') {
    			window.onload = func;
  			}
  			else {
    			window.onload = function() {
      				if (oldonload) {
        				oldonload();
      				}
      				func();
    			}
  			}
 		}

		addLoadEvent(calcTotalFix);
	
</script>

	
<style>
.has-error {
	color: #f70404 !important;
}
.has-error input {
	border: 1px solid #f70404 !important;
}
</style>


<script>
	function checkInvalidCharacter(objName){
		var obj = document.iform[objName];
		var strFileName = obj.value.replace('C:\\fakepath\\','');
		iTemp = strFileName.indexOf(":");
		
		if (iTemp > -1) {
			swal({
	  			title: 'Invalid character',
	  			html: true,
	  			text: "Invalid character ':' found in file name. Please change the file name before attempting to upload this file.",
	  			animation: 'slide-from-top',
	  			type: 'info',
	  			confirmButtonText: 'Ok',
	  			confirmButtonColor: '#337ab7'
	  		});
			obj.value = '';
			return false;
		}
		else {
			iTemp = obj.value.indexOf(",");
			if (iTemp > -1) {
				swal({
		  			title: 'Invalid character',
		  			html: true,
		  			text: "Invalid character ',' found in file name. Please change the file name before attempting to upload this file.",
		  			animation: 'slide-from-top',
		  			type: 'info',
		  			confirmButtonText: 'Ok',
		  			confirmButtonColor: '#337ab7'
		  		});
				obj.value = '';
				return false;
			}
		}
	}
	function clearRadio(rd) {
		if (document.iform) {
			var v;
			var ln;
			var ev;
			submitted = 0;
			v = "document.iform." + rd + ".length";
			ln = eval(v);
			// This will ensure we uncheck if there is only 1 radio button..
			v = "document.iform." + rd + ".checked = false;";
			ev = eval(v);
			// Now loop through the list of radio buttons and uncheck them all
			for (i=0;i<ln;i++) {
				v = "document.iform." + rd + "[" + i + "].checked = false;";
				//console.log(v);
				ev = eval(v);
			}
			calcTotalFix();
		}
	}
</script>


<div class="form_layout_wrapper" style="max-width:940px;" >

	
			<!-- The inner div, for the sake of IE -->
			<div id="layout_form_item" style="clear:both;border:0px solid orange;margin:0 0 0px 0;padding:0;min-height:0px;">
		

		<div id="form-item-13097" class="layout form item outer row-1 item-13097 row_num-20 row_pos-16384 rowlength-1 type-None" style="clear:both;width:100%;position:relative;">

			<div class="inner">

				
						<p><img alt="" src="/images/RBCR_brkfst_web_header.png" style="width: 900px; height: 217px;" /></p>

<div class="i4a_ck_halfleft">
<h2><strong>Release-Based Cleanup Regulations Breakfast Registration</strong></h2>

<p>Date: Friday, September 18, 2026<br />
Location: Kay&#39;s Pier South, Aqua Turf Club, Plantsville, CT<br />
Registration &amp; Breakfast: 7:00 am<br />
Program: 8:00 am<br />
Adjournment: Noon</p>

<h2>Agenda</h2>

<ul>
	<li>Overview of Transition to Release-Based Cleanup Program and Release-Based Cleanup Regulations</li>
	<li>Discovery of Releases at Construction Sites and Next Steps
	<ul>
		<li>Existing Pollution</li>
		<li>New Spills</li>
	</ul>
	</li>
	<li>Spill Cleanup Contractor Permits
	<ul>
		<li>Individual permits</li>
		<li>General Permits</li>
	</ul>
	</li>
	<li>Importing/Exporting Materials</li>
</ul>
</div>

<div class="i4a_ck_halfright">
<h2>Presentations by:</h2>

<h2><br />
<img alt="" src="/images/headshot_combo.png" style="width: 300px; height: 293px;" /></h2>

<p><a href="/files/RBCR_Flyer.pdf"><strong>View the Flyer</strong></a></p>
</div>
					

				<input type="hidden" name="question_1" value="&lt;p&gt;&lt;img alt=&quot;&quot; src=&quot;/images/RBCR_brkfst_web_header.png&quot; style=&quot;width: 900px; height: 217px;&quot; /&gt;&lt;/p&gt;

&lt;div class=&quot;i4a_ck_halfleft&quot;&gt;
&lt;h2&gt;&lt;strong&gt;Release-Based Cleanup Regulations Breakfast Registration&lt;/strong&gt;&lt;/h2&gt;

&lt;p&gt;Date: Friday, September 18, 2026&lt;br /&gt;
Location: Kay&amp;#39;s Pier South, Aqua Turf Club, Plantsville, CT&lt;br /&gt;
Registration &amp;amp; Breakfast: 7:00 am&lt;br /&gt;
Program: 8:00 am&lt;br /&gt;
Adjournment: Noon&lt;/p&gt;

&lt;h2&gt;Agenda&lt;/h2&gt;

&lt;ul&gt;
	&lt;li&gt;Overview of Transition to Release-Based Cleanup Program and Release-Based Cleanup Regulations&lt;/li&gt;
	&lt;li&gt;Discovery of Releases at Construction Sites and Next Steps
	&lt;ul&gt;
		&lt;li&gt;Existing Pollution&lt;/li&gt;
		&lt;li&gt;New Spills&lt;/li&gt;
	&lt;/ul&gt;
	&lt;/li&gt;
	&lt;li&gt;Spill Cleanup Contractor Permits
	&lt;ul&gt;
		&lt;li&gt;Individual permits&lt;/li&gt;
		&lt;li&gt;General Permits&lt;/li&gt;
	&lt;/ul&gt;
	&lt;/li&gt;
	&lt;li&gt;Importing/Exporting Materials&lt;/li&gt;
&lt;/ul&gt;
&lt;/div&gt;

&lt;div class=&quot;i4a_ck_halfright&quot;&gt;
&lt;h2&gt;Presentations by:&lt;/h2&gt;

&lt;h2&gt;&lt;br /&gt;
&lt;img alt=&quot;&quot; src=&quot;/images/headshot_combo.png&quot; style=&quot;width: 300px; height: 293px;&quot; /&gt;&lt;/h2&gt;

&lt;p&gt;&lt;a href=&quot;/files/RBCR_Flyer.pdf&quot;&gt;&lt;strong&gt;View the Flyer&lt;/strong&gt;&lt;/a&gt;&lt;/p&gt;
&lt;/div&gt;">
				<INPUT TYPE="hidden" NAME="response_1_question_id" VALUE="13097">
				<INPUT TYPE="hidden" NAME="question_type_1" value="None">
				<INPUT TYPE="hidden" NAME="label_1" value="">

				
			</div> <!-- /inner -->

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			<!-- The inner div, for the sake of IE -->
			<div id="layout_form_item" style="clear:both;border:0px solid orange;margin:0 0 0px 0;padding:0;min-height:0px;">
		

		<div id="form-item-13098" class="layout form item outer row-2 item-13098 row_num-40 row_pos-16384 rowlength-2 type-Text" style="clear:both;;position:relative;">

			<div class="inner">

				
							Company:<span class="text-danger"> *</span>
					

							<input type="text"
								
									id="response_2"
									name="response_2"
								
								
								 style="width:300px;"
								
									
                                            value=""
									    
										
								class="form-control type-Text row-2 item-13098"
							><!-- input -->

							
						<INPUT
							TYPE="hidden"
							NAME="response_2_required"
							VALUE="The field Company: is required. Please click your browser's back button and provide this value.">
					

				<input type="hidden" name="question_2" value="Company:">
				<INPUT TYPE="hidden" NAME="response_2_question_id" VALUE="13098">
				<INPUT TYPE="hidden" NAME="question_type_2" value="Text">
				<INPUT TYPE="hidden" NAME="label_2" value="Company:">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
		<div id="form-item-13099" class="layout form item outer row-3 item-13099 row_num-40 row_pos-20480 rowlength-2 type-Text" style=";position:relative;">

			<div class="inner">

				
							Registration Contact:<span class="text-danger"> *</span>
					

							<input type="text"
								
									id="response_3"
									name="response_3"
								
								
								 style="width:300px;"
								
									
                                            value=""
									    
										
								class="form-control type-Text row-3 item-13099"
							><!-- input -->

							
						<INPUT
							TYPE="hidden"
							NAME="response_3_required"
							VALUE="The field Registration Contact: is required. Please click your browser's back button and provide this value.">
					

				<input type="hidden" name="question_3" value="Registration Contact:">
				<INPUT TYPE="hidden" NAME="response_3_question_id" VALUE="13099">
				<INPUT TYPE="hidden" NAME="question_type_3" value="Text">
				<INPUT TYPE="hidden" NAME="label_3" value="RegistrationContact:">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
				</div> <!-- /The inner div, for the sake of IE -->
			
			<!-- The inner div, for the sake of IE -->
			<div id="layout_form_item" style="clear:both;border:0px solid orange;margin:0 0 0px 0;padding:0;min-height:0px;">
		

		<div id="form-item-13100" class="layout form item outer row-4 item-13100 row_num-60 row_pos-16384 rowlength-1 type-Email" style="clear:both;;position:relative;">

			<div class="inner">

				
							Confirmation Email:<span class="text-danger"> *</span>
					

								<script type="text/javascript" src="/i4a/ams/include/checkemail.js"></script>
							

							<input type="text"
								
									id="response_4"
									name="response_4"
								
								
								 style="width:300px;"
								
									
										onchange="VerifyEmailAddress('iform', this.name,'Confirmation Email:')" value=""
									
								
								class="form-control type-Email row-4 item-13100"
							><!-- input -->

							
						<INPUT
							TYPE="hidden"
							NAME="response_4_required"
							VALUE="The field Confirmation Email: is required. Please click your browser's back button and provide this value.">
					

				<input type="hidden" name="question_4" value="Confirmation Email:">
				<INPUT TYPE="hidden" NAME="response_4_question_id" VALUE="13100">
				<INPUT TYPE="hidden" NAME="question_type_4" value="Email">
				<INPUT TYPE="hidden" NAME="label_4" value="Confirmation Email:">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
				</div> <!-- /The inner div, for the sake of IE -->
			
			<!-- The inner div, for the sake of IE -->
			<div id="layout_form_item" style="clear:both;border:0px solid orange;margin:0 0 0px 0;padding:0;min-height:0px;">
		

		<div id="form-item-13102" class="layout form item outer row-5 item-13102 row_num-80 row_pos-16384 rowlength-1 type-None" style="clear:both;width:100%;position:relative;">

			<div class="inner">

				
						<p>Please let us know how many attendees you are registering and their names below.</p>
					

				<input type="hidden" name="question_5" value="&lt;p&gt;Please let us know how many attendees you are registering and their names below.&lt;/p&gt;">
				<INPUT TYPE="hidden" NAME="response_5_question_id" VALUE="13102">
				<INPUT TYPE="hidden" NAME="question_type_5" value="None">
				<INPUT TYPE="hidden" NAME="label_5" value="">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
				</div> <!-- /The inner div, for the sake of IE -->
			
			<!-- The inner div, for the sake of IE -->
			<div id="layout_form_item" style="clear:both;border:0px solid orange;margin:0 0 0px 0;padding:0;min-height:0px;">
		

		<div id="form-item-13103" class="layout form item outer row-6 item-13103 row_num-100 row_pos-16384 rowlength-2 type-Text" style="clear:both;;position:relative;">

			<div class="inner">

				
							Count:<span class="text-danger"> *</span>
					

							<input type="text"
								
									id="response_6"
									name="response_6"
								
								
								 style="width:80px;"
								
									
                                            value=""
									    
										
								class="form-control type-Text row-6 item-13103"
							><!-- input -->

							
						<INPUT
							TYPE="hidden"
							NAME="response_6_required"
							VALUE="The field Count: is required. Please click your browser's back button and provide this value.">
					

				<input type="hidden" name="question_6" value="Count:">
				<INPUT TYPE="hidden" NAME="response_6_question_id" VALUE="13103">
				<INPUT TYPE="hidden" NAME="question_type_6" value="Text">
				<INPUT TYPE="hidden" NAME="label_6" value="Count:">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
		<div id="form-item-13104" class="layout form item outer row-7 item-13104 row_num-100 row_pos-16388 rowlength-2 type-Text" style=";position:relative;">

			<div class="inner">

				
							Attendee Name:<span class="text-danger"> *</span>
					

							<input type="text"
								
									id="response_7"
									name="response_7"
								
								
								 style="width:300px;"
								
									
                                            value=""
									    
										
								class="form-control type-Text row-7 item-13104"
							><!-- input -->

							
						<INPUT
							TYPE="hidden"
							NAME="response_7_required"
							VALUE="The field Attendee Name: is required. Please click your browser's back button and provide this value.">
					

				<input type="hidden" name="question_7" value="Attendee Name:">
				<INPUT TYPE="hidden" NAME="response_7_question_id" VALUE="13104">
				<INPUT TYPE="hidden" NAME="question_type_7" value="Text">
				<INPUT TYPE="hidden" NAME="label_7" value="Attendee Name:">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
				</div> <!-- /The inner div, for the sake of IE -->
			
			<!-- The inner div, for the sake of IE -->
			<div id="layout_form_item" style="clear:both;border:0px solid orange;margin:0 0 0px 0;padding:0;min-height:0px;">
		

		<div id="form-item-13105" class="layout form item outer row-8 item-13105 row_num-120 row_pos-16384 rowlength-1 type-Textarea" style="clear:both;;position:relative;">

			<div class="inner">

				
							Additional Attendees
					

							<textarea
								
									onKeyDown="limitText(response_8, countdown_8, 2000);"
									onKeyUp="limitText(response_8, countdown_8, 2000);"
								
								id="response_8"
								name="response_8"
								rows="5"
								class="form-control type-Textarea row-8 item-13105"
								
								
									style="width:200px;"
								

								></textarea>
								
									
										<br />
										<font size="1">(Maximum characters: 2000)
										<br />
										You have <input readonly type="text" name="countdown_8" size="5" value="2000" > characters left.</font>
									
								
				<input type="hidden" name="question_8" value="Additional Attendees">
				<INPUT TYPE="hidden" NAME="response_8_question_id" VALUE="13105">
				<INPUT TYPE="hidden" NAME="question_type_8" value="Textarea">
				<INPUT TYPE="hidden" NAME="label_8" value="Additional Attendees">

				
			</div> <!-- /inner -->

		</div> <!-- /layout_form_item -->

		
	</div><!-- /The inner div, for the sake of IE -->

	
	<input type="hidden" id="hasOpenPriceField" name="hasOpenPriceField" value="0">

	
</div><!-- /form_layout_wrapper -->


		<div id="_ssdiv2" style="display:none">
			<input type="hidden" id="fld_uploadfields" name="UploadFields" value="">
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			<input type="hidden" id="fld_ss_form_testid" name="ss_form_testid" value="0" />
			<div id="_ssdiv">
				<p style="background-color: blue"><input type="text" name="ss_state" value="" /></p>
			</div>
		</div>
		
			<input type="hidden" name="form_isEdit" value="0">
		
	
		<div id="div_bottom" style="clear:both;">
			
			
				<input type="hidden" name="useCaptcha" value="0">
			
			
				<INPUT TYPE="hidden" NAME="send_mail_ind" VALUE="0">
				<INPUT TYPE="hidden" NAME="no_opt_out" VALUE="1">
			
	
			<div id="frm_submit_button">
				<br />
				<button class="btn btn-primary" type="button" data-loading-text="Please wait..." id="submitBtn"
					
						onclick="startValidate();"
					
				>Submit Form</button>
				<br /><br />
			</div>
	
			
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	<!-- display verisign seal if SSL connection -->
	
		
		<img alt="void" src="/i4a/sysimages/blank.gif" width="98" height="102" border="0">
	

			</div>
			
	
				<div id="frm_required_copy_bottom">
					<p>Fields marked with <span class="text-danger">*</span> are required.</p>
				</div>
			
	
				<div id="frm_ssl_copy_bottom"><p>Your form submission WILL be encrypted using SSL to ensure your privacy.</p></div>
			
	
		</div><!-- div_bottom -->
	
		
	</form>
</div>


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	});
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AdButler.ads.push({handler: function(opt){ AdButler.register(178303, 844160, [300,250], 'placement_844160_'+opt.place, opt); }, opt: { place: plc844160++, keywords: abkw, domain: 'servedbyadbutler.com', click: 'CLICK_MACRO_PLACEHOLDER' }});
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var abkw = window.abkw || '';
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AdButler.ads.push({handler: function(opt){ AdButler.register(178303, 844161, [300,250], 'placement_844161_'+opt.place, opt); }, opt: { place: plc844161++, keywords: abkw, domain: 'servedbyadbutler.com', click: 'CLICK_MACRO_PLACEHOLDER' }});
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