{"id":2943,"date":"2020-04-02T09:57:39","date_gmt":"2020-04-02T09:57:39","guid":{"rendered":"https:\/\/littlemedsch.wpengine.com\/egypt\/?page_id=2943"},"modified":"2024-07-09T14:32:04","modified_gmt":"2024-07-09T14:32:04","slug":"class-registration","status":"publish","type":"page","link":"https:\/\/littlemedicalschool.com\/egypt\/class-registration\/","title":{"rendered":"Registration Form"},"content":{"rendered":"<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_16' style='display:none'>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Registration Form<\/h2>\n                            <p class='gform_description'><\/p>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_16'  action='\/egypt\/wp-json\/wp\/v2\/pages\/2943' data-formid='16' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_16' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_16_5\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Parent&#039;s Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_16_5'>\n                            \n                            <span id='input_16_5_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_5.3' id='input_16_5_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_16_5_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_16_5_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_5.6' id='input_16_5_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_16_5_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_16_8\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Child&#039;s Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_16_8'>\n                            \n                            <span id='input_16_8_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_8.3' id='input_16_8_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_16_8_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_16_8_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_8.6' id='input_16_8_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_16_8_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_16_11\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gf_right_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_16_11'>Child&#039;s School Grade<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_16_11' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_16_10\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-full gf_left_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_16_10'>Child&#039;s Birthday<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_10' id='input_16_10' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_16_10_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_16_10_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_16_10' class='gform_hidden' value='https:\/\/littlemedicalschool.com\/egypt\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_16_28\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_16_28'>Mobile Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_28' id='input_16_28' type='number' step='any'   value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_16_29\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_16_29'>WhatsApp Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_29' id='input_16_29' type='number' step='any'   value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_16_16\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gf_left_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_16_16'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_16' id='input_16_16' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><fieldset id=\"field_16_6\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_zip ginput_container_address gform-grid-row' id='input_16_6' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_16_6_1_container' >\n                                        <input type='text' name='input_6.1' id='input_16_6_1' value=''    aria-required='true'    \/>\n                                        <label for='input_16_6_1' id='input_16_6_1_label' class='gform-field-label gform-field-label--type-sub '>Street Name<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_16_6_2_container' >\n                                        <input type='text' name='input_6.2' id='input_16_6_2' value=''     aria-required='false'   \/>\n                                        <label for='input_16_6_2' id='input_16_6_2_label' class='gform-field-label gform-field-label--type-sub '>District<\/label>\n                                    <\/span><input type='hidden' class='gform_hidden' name='input_6.4' id='input_16_6_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_16_6_5_container' >\n                                    <input type='text' name='input_6.5' id='input_16_6_5' value=''    aria-required='true'    \/>\n                                    <label for='input_16_6_5' id='input_16_6_5_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_6.6' id='input_16_6_6' value='Egypt' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_16_13\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_16_13'>What school does your child attend?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_16_13' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_16_26\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Does your child have any allergies?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_16_26'><div class='gchoice gchoice_16_26_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.1' type='checkbox'  value='No'  id='choice_16_26_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_26_1' id='label_16_26_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_26_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.2' type='checkbox'  value='Yes'  id='choice_16_26_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_26_2' id='label_16_26_2' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_16_14\" class=\"gfield gfield--type-textarea gfield--input-type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_16_14'>If yes, please describe what allergies your child has<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_14' id='input_16_14' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_16_15\" class=\"gfield gfield--type-textarea gfield--input-type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_16_15'>Is there anything else you would like us to know about your child?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_15' id='input_16_15' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_16_38\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >What are your Preferred Days and Time during the Week?<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_16_38'><div class='gchoice gchoice_16_38_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.1' type='checkbox'  value='Fridays'  id='choice_16_38_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_38_1' id='label_16_38_1' class='gform-field-label gform-field-label--type-inline'>Fridays<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_38_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.2' type='checkbox'  value='Saturdays'  id='choice_16_38_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_38_2' id='label_16_38_2' class='gform-field-label gform-field-label--type-inline'>Saturdays<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_38_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.3' type='checkbox'  value='Sundays'  id='choice_16_38_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_38_3' id='label_16_38_3' class='gform-field-label gform-field-label--type-inline'>Sundays<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_38_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.4' type='checkbox'  value='Mondays'  id='choice_16_38_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_38_4' id='label_16_38_4' class='gform-field-label gform-field-label--type-inline'>Mondays<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_38_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.5' type='checkbox'  value='Tuesdays'  id='choice_16_38_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_38_5' id='label_16_38_5' class='gform-field-label gform-field-label--type-inline'>Tuesdays<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_38_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.6' type='checkbox'  value='Wednesdays'  id='choice_16_38_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_38_6' id='label_16_38_6' class='gform-field-label gform-field-label--type-inline'>Wednesdays<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_38_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.7' type='checkbox'  value='Thursdays'  id='choice_16_38_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_38_7' id='label_16_38_7' class='gform-field-label gform-field-label--type-inline'>Thursdays<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_16_39\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Preferred Friday Times<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_16_39'><div class='gchoice gchoice_16_39_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_39.1' type='checkbox'  value='Morning (10:00am)'  id='choice_16_39_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_39_1' id='label_16_39_1' class='gform-field-label gform-field-label--type-inline'>Morning (10:00am)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_39_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_39.2' type='checkbox'  value='Afternoon (after 1:00pm)'  id='choice_16_39_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_39_2' id='label_16_39_2' class='gform-field-label gform-field-label--type-inline'>Afternoon (after 1:00pm)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_39_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_39.3' type='checkbox'  value='Evening (after 5:00pm)'  id='choice_16_39_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_39_3' id='label_16_39_3' class='gform-field-label gform-field-label--type-inline'>Evening (after 5:00pm)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_16_40\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Preferred Saturday Times<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_16_40'><div class='gchoice gchoice_16_40_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.1' type='checkbox'  value='Morning (10:00am)'  id='choice_16_40_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_40_1' id='label_16_40_1' class='gform-field-label gform-field-label--type-inline'>Morning (10:00am)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_40_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.2' type='checkbox'  value='Afternoon (after 1:00pm)'  id='choice_16_40_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_40_2' id='label_16_40_2' class='gform-field-label gform-field-label--type-inline'>Afternoon (after 1:00pm)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_40_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.3' type='checkbox'  value='Evening (after 5:00pm)'  id='choice_16_40_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_40_3' id='label_16_40_3' class='gform-field-label gform-field-label--type-inline'>Evening (after 5:00pm)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_16_41\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Preferred Sunday Times<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_16_41'><div class='gchoice gchoice_16_41_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.1' type='checkbox'  value='Morning (10:00am)'  id='choice_16_41_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_41_1' id='label_16_41_1' class='gform-field-label gform-field-label--type-inline'>Morning (10:00am)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_41_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.2' type='checkbox'  value='Afternoon (after 1:00pm)'  id='choice_16_41_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_41_2' id='label_16_41_2' class='gform-field-label gform-field-label--type-inline'>Afternoon (after 1:00pm)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_41_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.3' type='checkbox'  value='Evening (after 5:00pm)'  id='choice_16_41_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_41_3' id='label_16_41_3' class='gform-field-label gform-field-label--type-inline'>Evening (after 5:00pm)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_16_42\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Preferred Monday Times<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_16_42'><div class='gchoice gchoice_16_42_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.1' type='checkbox'  value='Morning (10:00am)'  id='choice_16_42_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_42_1' id='label_16_42_1' class='gform-field-label gform-field-label--type-inline'>Morning (10:00am)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_42_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.2' type='checkbox'  value='Afternoon (after 1:00pm)'  id='choice_16_42_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_42_2' id='label_16_42_2' class='gform-field-label gform-field-label--type-inline'>Afternoon (after 1:00pm)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_42_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.3' type='checkbox'  value='Evening (after 5:00pm)'  id='choice_16_42_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_42_3' id='label_16_42_3' class='gform-field-label gform-field-label--type-inline'>Evening (after 5:00pm)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_16_43\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Preferred Tuesday Times<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_16_43'><div class='gchoice gchoice_16_43_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.1' type='checkbox'  value='Morning (10:00am)'  id='choice_16_43_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_43_1' id='label_16_43_1' class='gform-field-label gform-field-label--type-inline'>Morning (10:00am)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_43_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.2' type='checkbox'  value='Afternoon (after 1:00pm)'  id='choice_16_43_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_43_2' id='label_16_43_2' class='gform-field-label gform-field-label--type-inline'>Afternoon (after 1:00pm)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_43_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.3' type='checkbox'  value='Evening (after 5:00pm)'  id='choice_16_43_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_43_3' id='label_16_43_3' class='gform-field-label gform-field-label--type-inline'>Evening (after 5:00pm)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_16_44\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Preferred Wednesday Times<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_16_44'><div class='gchoice gchoice_16_44_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.1' type='checkbox'  value='Morning (10:00am)'  id='choice_16_44_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_44_1' id='label_16_44_1' class='gform-field-label gform-field-label--type-inline'>Morning (10:00am)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_44_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.2' type='checkbox'  value='Afternoon (after 1:00pm)'  id='choice_16_44_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_44_2' id='label_16_44_2' class='gform-field-label gform-field-label--type-inline'>Afternoon (after 1:00pm)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_44_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.3' type='checkbox'  value='Evening (after 5:00pm)'  id='choice_16_44_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_44_3' id='label_16_44_3' class='gform-field-label gform-field-label--type-inline'>Evening (after 5:00pm)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_16_45\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Preferred Thursday Times<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_16_45'><div class='gchoice gchoice_16_45_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.1' type='checkbox'  value='Morning (10:00am)'  id='choice_16_45_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_45_1' id='label_16_45_1' class='gform-field-label gform-field-label--type-inline'>Morning (10:00am)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_45_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.2' type='checkbox'  value='Afternoon (after 1:00pm)'  id='choice_16_45_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_45_2' id='label_16_45_2' class='gform-field-label gform-field-label--type-inline'>Afternoon (after 1:00pm)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_45_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.3' type='checkbox'  value='Evening (after 5:00pm)'  id='choice_16_45_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_45_3' id='label_16_45_3' class='gform-field-label gform-field-label--type-inline'>Evening (after 5:00pm)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_16_17\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Consent<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' 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