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                    var matchingCheckboxes = $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']");\
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            function encode(myString) {\
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                /* Fixes issues with single quote and backtick encoding */\
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                for (i = 0; i < entities.length; i++) {\
                    myString = String(myString).replace(new RegExp(entities[i][0], \'g\'), entities[i][1]);\
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                return myString;\
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            function showHideSection(showSection) {\
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                    $(\'#FormField23_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16\').show();\
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                        if (obj.checked) {\
                            $(\'#\' + obj.id).change();\
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                    } else {\
                        $(\'#\' + obj.id).change();\
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fbRequireJSScript.addEventListener("load", conditionalSectionJs);var conditionalSectionJs = function () {\
    requirejs([window.formHost + \'/Scripts/require/fbRequire.config.js\'], function (fbRequireConfig) {\
        var fbRequire = fbRequireConfig.fbRequire;\
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        fbRequire([\'jquery\', \'he\'], function ($, he) {\
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            sectionConditions.forEach(function (sectionCondition) {\
                $("select[id=" + sectionCondition.ElementName + "]").addClass(\'conditionalSectionListSelection\');\
                $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']").addClass(\'conditionalSectionListSelection\');\
                $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']").addClass(\'conditionalSectionListSelection\');\
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                    checkShowHide();\
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                $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']").on(\'change\', function () {\
                    checkShowHide();\
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                    checkShowHide();\
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                var shouldShowSection = conditionOperator === \'and\'; /* set default to true for AND operation and false for OR operation */\
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                sectionConditions.forEach(function (sectionCondition) {\
                    checkSelect(sectionCondition);                \
                    checkCheckbox(sectionCondition);                \
                    checkRadio(sectionCondition);                    \
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                showHideSection(shouldShowSection);\
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                        shouldShowSection = mergeCondition(shouldShowSection, hasOneMatchingValue, matchingSelect);\
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                function checkCheckbox(sectionCondition) {\
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                    return overallResult && newResult;\
                } else {\
                    return overallResult || newResult;\
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            function isParentVisible(element) {\
                var parentSectionDiv = $(\'#\' + element.id).closest(".fb-section");\
                return parentSectionDiv && !parentSectionDiv.is(":hidden");\
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            function encode(myString) {\
                myString = he.encode(he.escape(myString));\
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                /* Fixes issues with single quote and backtick encoding */\
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                        [\'&#x60;\', \'`\']\
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                for (i = 0; i < entities.length; i++) {\
                    myString = String(myString).replace(new RegExp(entities[i][0], \'g\'), entities[i][1]);\
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                return myString;\
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            function showHideSection(showSection) {\
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                    $(\'#FormField19_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16\').show();\
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                $("#FormField19_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16 .conditionalSectionListSelection").each(function (i, obj) {\
                    if (obj.type === \'radio\' || obj.type === \'checkbox\') {\
                        if (obj.checked) {\
                            $(\'#\' + obj.id).change();\
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                    } else {\
                        $(\'#\' + obj.id).change();\
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};\
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fbRequireJSScript.addEventListener("load", conditionalSectionJs);var conditionalSectionJs = function () {\
    requirejs([window.formHost + \'/Scripts/require/fbRequire.config.js\'], function (fbRequireConfig) {\
        var fbRequire = fbRequireConfig.fbRequire;\
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        fbRequire([\'jquery\', \'he\'], function ($, he) {\
            he.encode.options.decimal = true;\
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            sectionConditions.forEach(function (sectionCondition) {\
                $("select[id=" + sectionCondition.ElementName + "]").addClass(\'conditionalSectionListSelection\');\
                $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']").addClass(\'conditionalSectionListSelection\');\
                $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']").addClass(\'conditionalSectionListSelection\');\
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                $("select[id=" + sectionCondition.ElementName + "]").on(\'change\', function () {\
                    checkShowHide();\
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            function checkShowHide() {\
                var shouldShowSection = conditionOperator === \'and\'; /* set default to true for AND operation and false for OR operation */\
\
                sectionConditions.forEach(function (sectionCondition) {\
                    checkSelect(sectionCondition);                \
                    checkCheckbox(sectionCondition);                \
                    checkRadio(sectionCondition);                    \
                });\
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                showHideSection(shouldShowSection);\
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                function checkSelect(sectionCondition) {\
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                    if (!matchingSelect) {\
                        return;\
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                    if (matchingSelect.type === \'select-multiple\') {\
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                        for (var i = 0; i < matchingSelect.selectedOptions.length; i++) {\
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                        shouldShowSection = mergeCondition(shouldShowSection, hasOneMatchingValue, matchingSelect);\
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\
                function checkCheckbox(sectionCondition) {\
                    var matchingCheckboxes = $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']");\
                    \
                    for (var i = 0; i < matchingCheckboxes.length; i++) {\
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                            shouldShowSection = mergeCondition(shouldShowSection, matchingCheckboxes[i].checked, matchingCheckboxes[i]);\
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\
                function checkRadio(sectionCondition) {\
                    var matchingRadios = $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']");\
                    \
                    for (var i = 0; i < matchingRadios.length; i++) {\
                        if (encode(matchingRadios[i].value) === sectionCondition.Value) {\
                            shouldShowSection = mergeCondition(shouldShowSection, matchingRadios[i].checked, matchingRadios[i]);\
                        }\
                    }\
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\
            function mergeCondition(overallResult, newResult, element) {\
                newResult = newResult && isParentVisible(element);\
\
                if (conditionOperator === \'and\') {\
                    return overallResult && newResult;\
                } else {\
                    return overallResult || newResult;\
                }\
            }\
\
            function isParentVisible(element) {\
                var parentSectionDiv = $(\'#\' + element.id).closest(".fb-section");\
                return parentSectionDiv && !parentSectionDiv.is(":hidden");\
            }\
\
            function encode(myString) {\
                myString = he.encode(he.escape(myString));\
\
                /* Fixes issues with single quote and backtick encoding */\
                var i,\
                    entities = [\
                        [\'&#x27;\', \'&#39;\'],\
                        [\'&#x60;\', \'`\']\
                    ];\
\
                for (i = 0; i < entities.length; i++) {\
                    myString = String(myString).replace(new RegExp(entities[i][0], \'g\'), entities[i][1]);\
                }\
\
                return myString;\
            }\
\
            function showHideSection(showSection) {\
                if (showSection) {\
                    $(\'#FormField31_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16\').show();\
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                $("#FormField31_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16 .conditionalSectionListSelection").each(function (i, obj) {\
                    if (obj.type === \'radio\' || obj.type === \'checkbox\') {\
                        if (obj.checked) {\
                            $(\'#\' + obj.id).change();\
                        }\
                    } else {\
                        $(\'#\' + obj.id).change();\
                    }\
                });\
            }\
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    });\
};\
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fbRequireJSScript.addEventListener("load", conditionalSectionJs);var conditionalSectionJs = function () {\
    requirejs([window.formHost + \'/Scripts/require/fbRequire.config.js\'], function (fbRequireConfig) {\
        var fbRequire = fbRequireConfig.fbRequire;\
\
        fbRequire([\'jquery\', \'he\'], function ($, he) {\
            he.encode.options.decimal = true;\
            he.encode.options.allowUnsafeSymbols = true;\
\
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            var conditionOperator = \'and\';\
\
            sectionConditions.forEach(function (sectionCondition) {\
                $("select[id=" + sectionCondition.ElementName + "]").addClass(\'conditionalSectionListSelection\');\
                $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']").addClass(\'conditionalSectionListSelection\');\
                $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']").addClass(\'conditionalSectionListSelection\');\
                \
                $("select[id=" + sectionCondition.ElementName + "]").on(\'change\', function () {\
                    checkShowHide();\
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                $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']").on(\'change\', function () {\
                    checkShowHide();\
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                $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']").on(\'change\', function () {\
                    checkShowHide();\
                });\
            });\
            \
            function checkShowHide() {\
                var shouldShowSection = conditionOperator === \'and\'; /* set default to true for AND operation and false for OR operation */\
\
                sectionConditions.forEach(function (sectionCondition) {\
                    checkSelect(sectionCondition);                \
                    checkCheckbox(sectionCondition);                \
                    checkRadio(sectionCondition);                    \
                });\
\
                showHideSection(shouldShowSection);\
\
                function checkSelect(sectionCondition) {\
                    var matchingSelect = $("select[id=" + sectionCondition.ElementName + "]")[0];\
\
                    if (!matchingSelect) {\
                        return;\
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\
                    if (matchingSelect.type === \'select-multiple\') {\
                        var hasOneMatchingValue = false;\
\
                        for (var i = 0; i < matchingSelect.selectedOptions.length; i++) {\
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\
                        shouldShowSection = mergeCondition(shouldShowSection, hasOneMatchingValue, matchingSelect);\
                    } else {\
                        shouldShowSection = mergeCondition(shouldShowSection, encode(matchingSelect.value) === sectionCondition.Value, matchingSelect);\
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\
                function checkCheckbox(sectionCondition) {\
                    var matchingCheckboxes = $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']");\
                    \
                    for (var i = 0; i < matchingCheckboxes.length; i++) {\
                        if (encode(matchingCheckboxes[i].value) === sectionCondition.Value) {\
                            shouldShowSection = mergeCondition(shouldShowSection, matchingCheckboxes[i].checked, matchingCheckboxes[i]);\
                        }\
                    }\
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\
                function checkRadio(sectionCondition) {\
                    var matchingRadios = $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']");\
                    \
                    for (var i = 0; i < matchingRadios.length; i++) {\
                        if (encode(matchingRadios[i].value) === sectionCondition.Value) {\
                            shouldShowSection = mergeCondition(shouldShowSection, matchingRadios[i].checked, matchingRadios[i]);\
                        }\
                    }\
                }\
            }\
\
            function mergeCondition(overallResult, newResult, element) {\
                newResult = newResult && isParentVisible(element);\
\
                if (conditionOperator === \'and\') {\
                    return overallResult && newResult;\
                } else {\
                    return overallResult || newResult;\
                }\
            }\
\
            function isParentVisible(element) {\
                var parentSectionDiv = $(\'#\' + element.id).closest(".fb-section");\
                return parentSectionDiv && !parentSectionDiv.is(":hidden");\
            }\
\
            function encode(myString) {\
                myString = he.encode(he.escape(myString));\
\
                /* Fixes issues with single quote and backtick encoding */\
                var i,\
                    entities = [\
                        [\'&#x27;\', \'&#39;\'],\
                        [\'&#x60;\', \'`\']\
                    ];\
\
                for (i = 0; i < entities.length; i++) {\
                    myString = String(myString).replace(new RegExp(entities[i][0], \'g\'), entities[i][1]);\
                }\
\
                return myString;\
            }\
\
            function showHideSection(showSection) {\
                if (showSection) {\
                    $(\'#FormField34_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16\').show();\
                } else {\
                    $(\'#FormField34_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16\').hide();\
                }\
\
                $("#FormField34_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16 .conditionalSectionListSelection").each(function (i, obj) {\
                    if (obj.type === \'radio\' || obj.type === \'checkbox\') {\
                        if (obj.checked) {\
                            $(\'#\' + obj.id).change();\
                        }\
                    } else {\
                        $(\'#\' + obj.id).change();\
                    }\
                });\
            }\
        });\
    });\
};\
\
fbRequireJSScript.addEventListener("load", conditionalSectionJs);var conditionalSectionJs = function () {\
    requirejs([window.formHost + \'/Scripts/require/fbRequire.config.js\'], function (fbRequireConfig) {\
        var fbRequire = fbRequireConfig.fbRequire;\
\
        fbRequire([\'jquery\', \'he\'], function ($, he) {\
            he.encode.options.decimal = true;\
            he.encode.options.allowUnsafeSymbols = true;\
\
            var sectionConditions = JSON.parse(\'[{"ElementName":"FormField18_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16","Value":"Masters Package: $1,200"}]\');\
            var conditionOperator = \'and\';\
\
            sectionConditions.forEach(function (sectionCondition) {\
                $("select[id=" + sectionCondition.ElementName + "]").addClass(\'conditionalSectionListSelection\');\
                $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']").addClass(\'conditionalSectionListSelection\');\
                $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']").addClass(\'conditionalSectionListSelection\');\
                \
                $("select[id=" + sectionCondition.ElementName + "]").on(\'change\', function () {\
                    checkShowHide();\
                });\
                \
                $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']").on(\'change\', function () {\
                    checkShowHide();\
                });\
                \
                $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']").on(\'change\', function () {\
                    checkShowHide();\
                });\
            });\
            \
            function checkShowHide() {\
                var shouldShowSection = conditionOperator === \'and\'; /* set default to true for AND operation and false for OR operation */\
\
                sectionConditions.forEach(function (sectionCondition) {\
                    checkSelect(sectionCondition);                \
                    checkCheckbox(sectionCondition);                \
                    checkRadio(sectionCondition);                    \
                });\
\
                showHideSection(shouldShowSection);\
\
                function checkSelect(sectionCondition) {\
                    var matchingSelect = $("select[id=" + sectionCondition.ElementName + "]")[0];\
\
                    if (!matchingSelect) {\
                        return;\
                    }\
\
                    if (matchingSelect.type === \'select-multiple\') {\
                        var hasOneMatchingValue = false;\
\
                        for (var i = 0; i < matchingSelect.selectedOptions.length; i++) {\
                            if (encode(matchingSelect.selectedOptions[i].value) === sectionCondition.Value) {\
                                hasOneMatchingValue = true;\
                            }\
                        }\
\
                        shouldShowSection = mergeCondition(shouldShowSection, hasOneMatchingValue, matchingSelect);\
                    } else {\
                        shouldShowSection = mergeCondition(shouldShowSection, encode(matchingSelect.value) === sectionCondition.Value, matchingSelect);\
                    }\
                }\
\
                function checkCheckbox(sectionCondition) {\
                    var matchingCheckboxes = $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'checkbox\']");\
                    \
                    for (var i = 0; i < matchingCheckboxes.length; i++) {\
                        if (encode(matchingCheckboxes[i].value) === sectionCondition.Value) {\
                            shouldShowSection = mergeCondition(shouldShowSection, matchingCheckboxes[i].checked, matchingCheckboxes[i]);\
                        }\
                    }\
                }\
\
                function checkRadio(sectionCondition) {\
                    var matchingRadios = $("input[id^=\'" + sectionCondition.ElementName + "\'][type=\'radio\']");\
                    \
                    for (var i = 0; i < matchingRadios.length; i++) {\
                        if (encode(matchingRadios[i].value) === sectionCondition.Value) {\
                            shouldShowSection = mergeCondition(shouldShowSection, matchingRadios[i].checked, matchingRadios[i]);\
                        }\
                    }\
                }\
            }\
\
            function mergeCondition(overallResult, newResult, element) {\
                newResult = newResult && isParentVisible(element);\
\
                if (conditionOperator === \'and\') {\
                    return overallResult && newResult;\
                } else {\
                    return overallResult || newResult;\
                }\
            }\
\
            function isParentVisible(element) {\
                var parentSectionDiv = $(\'#\' + element.id).closest(".fb-section");\
                return parentSectionDiv && !parentSectionDiv.is(":hidden");\
            }\
\
            function encode(myString) {\
                myString = he.encode(he.escape(myString));\
\
                /* Fixes issues with single quote and backtick encoding */\
                var i,\
                    entities = [\
                        [\'&#x27;\', \'&#39;\'],\
                        [\'&#x60;\', \'`\']\
                    ];\
\
                for (i = 0; i < entities.length; i++) {\
                    myString = String(myString).replace(new RegExp(entities[i][0], \'g\'), entities[i][1]);\
                }\
\
                return myString;\
            }\
\
            function showHideSection(showSection) {\
                if (showSection) {\
                    $(\'#FormField36_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16\').show();\
                } else {\
                    $(\'#FormField36_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16\').hide();\
                }\
\
                $("#FormField36_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16 .conditionalSectionListSelection").each(function (i, obj) {\
                    if (obj.type === \'radio\' || obj.type === \'checkbox\') {\
                        if (obj.checked) {\
                            $(\'#\' + obj.id).change();\
                        }\
                    } else {\
                        $(\'#\' + obj.id).change();\
                    }\
                });\
            }\
        });\
    });\
};\
\
fbRequireJSScript.addEventListener("load", conditionalSectionJs);var totalCostElementJs = function () {\
    requirejs([window.formHost + \'/Scripts/require/fbRequire.config.js\'], function (fbRequireConfig) {\
        var fbRequire = fbRequireConfig.fbRequire;\
\
        fbRequire([\'jquery\'], function ($) {\
\
            $(\'.paymentTotalCost\').hide();\
\
        });\
    });\
};\
\
fbRequireJSScript.addEventListener("load", totalCostElementJs);var overridePaymentJS = function () {\
    requirejs([window.formHost + \'/Scripts/require/fbRequire.config.js\'], function (fbRequireConfig) {\
        var fbRequire = fbRequireConfig.fbRequire;\
\
        fbRequire([\'jquery\'], function ($) {\
            var formId = \'e0ec63f1-019d-49c8-b3be-fd8bb9d08e16\',\
                $formElementsContainer = $(\'.fbFormContainer_\' + formId);\
            \
            $(\'#OverridePaymentCheckbox\').click(function() {\
                if ($(this).prop(\'checked\') === true) {\
                    $formElementsContainer.find(\'div.stripePaymentElement\').hide();\
                    $formElementsContainer.find(\'div.convergePaymentElement\').hide();\
                    $formElementsContainer.find(\'div.braintreePaymentElement\').hide();\
                    $formElementsContainer.find(\'div.braintreePaymentElement\').addClass(\'no-charge\');\
                    $formElementsContainer.find(\'div.instaMedPaymentElement\').hide();\
                    $formElementsContainer.find(\'div.authorizeDotNetPaymentElement\').hide();\
                }\
                else {\
                    $formElementsContainer.find(\'div.stripePaymentElement\').show();\
                    $formElementsContainer.find(\'div.convergePaymentElement\').show();\
                    $formElementsContainer.find(\'div.braintreePaymentElement\').show();\
                    $formElementsContainer.find(\'div.braintreePaymentElement\').removeClass(\'no-charge\');\
                    $formElementsContainer.find(\'div.instaMedPaymentElement\').show();\
                    $formElementsContainer.find(\'div.authorizeDotNetPaymentElement\').show();\
                }\
            });\
            \
            /* Hack until some way more concrete to detect whether to show the override payment checkbox. \
            * Maybe update renderer? */\
            if (window.location.href.indexOf(\'iframe-components/clean/form-renderer.html\') === -1\
                && window.location.href.indexOf(\'submittableFormTest\') === -1\
                && window.location.href.indexOf(\'registrations/add\') === -1) {\
                $(\'.fbFormContainer_\' + formId + \' div.overridePayment\').remove();\
            }\
        });\
    });\
};\
\
fbRequireJSScript.addEventListener(\'load\', overridePaymentJS);var processStripePaymentJs = function () {\
    requirejs([window.formHost + \'/Scripts/require/fbRequire.config.js\'], function (fbRequireConfig) {\
        var fbRequire = fbRequireConfig.fbRequire;\
\
        fbRequire([\'jquery\'], function ($) {\
            $(function () {\
                var jsElm = document.createElement(\'script\');\
                jsElm.type = \'text/javascript\';\
                jsElm.src = \'https://js.authorize.net/v1/Accept.js\';\
                jsElm.charset = \'utf-8\';\
                document.body.appendChild(jsElm);\
            });\
\
            window.getAuthorizeDotNetToken = function (container, successCallBack, failureCallBack) {\
\
                var authData = {\
                    clientKey: \'4f4Vm8t69ef5gEpN53sPDtcchPQ49D28N8xt46hApBX5jU2FZ7t2qX34A8WnzuUv\',\
                    apiLoginID: \'4FwBt4vpT74\'\
                };\
\
                var cardExpiration = container.find(\'.cardExpiration\').val().split("/");\
                if (cardExpiration.length !== 2) {\
                    cardExpiration = [\'\', \'\'];\
                }\
\
                var cardData = {\
                    cardNumber: container.find(\'.cardNumber\').val().replace(/ /g, \'\'),\
                    month: cardExpiration[0].trim(),\
                    year: cardExpiration[1].trim(),\
                    cardCode: container.find(\'.cardCvc\').val(),\
                    zip: container.find(\'.billingZip\').val(),\
                    fullName: container.find(\'.firstNameCard\').val() + \' \' + container.find(\'.lastNameCard\').val()\
                };\
\
                var secureData = {\
                    authData: authData,\
                    cardData: cardData\
                };\
\
                Accept.dispatchData(secureData, responseHandler);\
\
                function responseHandler(response) {\
\
                    if (response.messages.resultCode === \'Error\') {\
                        var errorMessages = [];\
\
                        for (var i = 0; i < response.messages.message.length; i++) {\
                            errorMessages.push(response.messages.message[i].text);\
                        }\
\
                        failureCallBack(container, errorMessages);\
                    } else {\
                        var token = response.opaqueData.dataValue;\
\
                        var customer = {\
                            firstName: container.find(\'.firstNameCard\').val(),\
                            lastName: container.find(\'.lastNameCard\').val(),\
                            id: container.find(\'.customerId\').val()\
                        };\
\
                        var address = {\
                            streetAddress: container.find(\'.billingStreetAddress\').val(),\
                            city: container.find(\'.billingCity\').val(),\
                            state: container.find(\'.billingState\').val(),\
                            zip: container.find(\'.billingZip\').val()\
                        };\
\
                        successCallBack(token, customer, address);\
                    }\
                }\
            };\
        });\
    });\
};\
\
fbRequireJSScript.addEventListener("load", processStripePaymentJs);';

if(fbScriptTag.length === 0) {
    fbScriptTag = document.querySelector("script[src*='e0ec63f1-019d-49c8-b3be-fd8bb9d08e16']");
} else {
    fbScriptTag = fbScriptTag[0];
}

fbRenderContainer.id = "formRenderContainer";
fbRenderContainer.className = " fbRenderContainer fbRenderContainer_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16";
fbRenderedCssContainer.id = "fbRenderedCssContainer";

fbConfigScript.type = "text/javascript";
fbRequireJSScript.type = "text/javascript";
fbInstaMedJSScript.type = "text/javascript";
fbGeoCaptchaCallback.type = "text/javascript";
fbGeoReCaptchaCallback.type = "text/javascript";
fbFormulateRenderer.type = "text/javascript";
fbRenderedIntegrations.type = "text/javascript";
fbRenderedScripts.type = "text/javascript";
fbAutoPopulateFromQueryString.type = "text/javascript";

fbRequireJSScript.src = "https://formulate.geonetric.com/Scripts/require.min.js";
fbInstaMedJSScript.src = "https://formulate.geonetric.com/Scripts/vendor/instamed/token.js";
fbInstaMedJSScript.id = "instamed-sdk";
fbGeoCaptchaCallback.src = "https://formulate.geonetric.com/Scripts/geo-captcha-callback.js";
fbGeoReCaptchaCallback.src = "https://www.google.com/recaptcha/api.js?onload=geoFbCaptchaCallback&render=6LdxkTEpAAAAAMKbkhz8-INpQis_mvSaIXnoyC2V";
fbFormulateRenderer.src = "https://formulate.geonetric.com/Scripts/require/formulate-renderer.js?embeddedCssType=0&isTestResponse=False&hasGoogleAnalytics=True";
fbFormulateRenderer.id = "formulateRendererScript";
fbAutoPopulateFromQueryString.src = "https://formulate.geonetric.com/Scripts/auto-populate-from-query-string.js";

if (fbEnableInstaMedScript === 'True') {
    fbInstaMedJSScript.setAttribute("data-displaymode", "embedded");
    fbInstaMedJSScript.setAttribute("data-environment", "UAT");
    fbInstaMedJSScript.setAttribute("data-mobiledisplaymode", "embedded");
}

fbGeoCaptchaCallback.onload = function() {
    if(document.querySelectorAll('.geo-fb-recaptcha').length > 0)
    {
        fbBodyTag.appendChild(fbGeoReCaptchaCallback);
    }
}

fbRequireJSScript.addEventListener("load", function() {
    fbBodyTag.appendChild(fbFormulateRenderer);
    fbBodyTag.appendChild(fbAutoPopulateFromQueryString);
});

fbFormulateRenderer.addEventListener("load", function () {
    initFormBuilderForm();
});

var embeddedCssType = 0
switch (embeddedCssType) {
    case 1:
        fbEmbeddedCss = '<link href=\"https://formulate.geonetric.com/Content/bootstrap.min.css\" rel=\"stylesheet\"><link href=\"https://formulate.geonetric.com/Content/embedded/font-awesome/css/font-awesome.min.css\" rel=\"stylesheet\"><link href=\"https://formulate.geonetric.com/Content/embedded/embedded.css\" rel=\"stylesheet\">';
        break;
    case 2:
        fbEmbeddedCss = '';
        break;
    default:
        fbEmbeddedCss = '<link href=\"https://formulate.geonetric.com/Content/embedded/font-awesome/css/font-awesome.min.css\" rel=\"stylesheet\"><link href=\"https://formulate.geonetric.com/Content/embedded/embedded.css\" rel=\"stylesheet\">';
}

if (fbIsTestResponse === 'True') {
    fbRenderContainer.setAttribute('data-test-mode', 'true');
} else {
    fbRenderContainer.setAttribute('data-test-mode', 'false');
}

fbRenderContainer.innerHTML = "<div id=\'formContainer_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16\' class=\'fbFormContainer fbFormContainer_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16 BlockLabels hidden\'>\
<p>Required fields are marked with <span class=\'fb-required\'>*</span></p>\
<input type=\'hidden\' name=\'formId\' id=\'formId\' value=\'e0ec63f1-019d-49c8-b3be-fd8bb9d08e16\' />\
<input type=\'hidden\' name=\'formName\' id=\'formName\' value=\'Golf Gift Card Purchase Form\' />\
<input type=\'hidden\' name=\'formVersion\' value=\'37\' id=\'formVersion\' />\
<input type=\'hidden\' name=\'organizationId\' id=\'organizationId\' value=\'b1b65ac8-cf8d-4bc5-b46f-eeeda0f28ede\' />\
<input type=\'hidden\' name=\'responseId\' id=\'responseId\' value=\'53d3742f-df76-4da5-b44a-1fb2283ecf03\' />\
<input type=\'hidden\' name=\'formBaseUrl\' id=\'formBaseUrl\' value=\'https://formulate.geonetric.com\' />\
\
<input type=\'hidden\' name=\'totalCost\' id=\'totalCost\' data-export-label=\'total_cost\' value=\'2978\'><input type=\'hidden\' name=\'subTotalCost\' id=\'subTotalCost\' data-export-label=\'subtotal_cost\' value=\'2978\'>\
<div class=\'form-group\'><label for=\'FormField1_e9da2833-2935-4535-8949-0f421ada9bd2\' class=\'control-label  \'>First Name:<span class=\'fb-required\'>*</span></label><div>\
<input type=\'text\' name=\'FormField1_e9da2833-2935-4535-8949-0f421ada9bd2\' id=\'FormField1_e9da2833-2935-4535-8949-0f421ada9bd2\' class=\'form-control input-medium \' value=\'\'  required data-msg-required=\'First Name: is required.\' data-export-label=\'First_Name\'  placeholder=\'\'  />\
</div></div><div class=\'form-group\'><label for=\'FormField2_e9da2833-2935-4535-8949-0f421ada9bd2\' class=\'control-label  \'>Last Name:<span class=\'fb-required\'>*</span></label><div>\
<input type=\'text\' name=\'FormField2_e9da2833-2935-4535-8949-0f421ada9bd2\' id=\'FormField2_e9da2833-2935-4535-8949-0f421ada9bd2\' class=\'form-control input-medium \' value=\'\'  required data-msg-required=\'This field is required.\' data-export-label=\'Last_Name_\'  placeholder=\'\'  />\
</div></div><div class=\'form-group\'><label for=\'FormField3_e9da2833-2935-4535-8949-0f421ada9bd2\' class=\'control-label  \'>Email:<span class=\'fb-required\'>*</span></label><div>\
<input type=\'email\' name=\'FormField3_e9da2833-2935-4535-8949-0f421ada9bd2\' id=\'FormField3_e9da2833-2935-4535-8949-0f421ada9bd2\' class=\'form-control input-medium \' value=\'\'  required data-msg-required=\'This field is required.\' data-export-label=\'Email_\'  placeholder=\'\' data-msg-email=\'This field is invalid.\' />\
</div></div><div class=\'form-group\'><label for=\'FormField5_e9da2833-2935-4535-8949-0f421ada9bd2\' class=\'control-label  \'>Phone Number:</label><div>\
<input type=\'text\' name=\'FormField5_e9da2833-2935-4535-8949-0f421ada9bd2\' id=\'FormField5_e9da2833-2935-4535-8949-0f421ada9bd2\' class=\'form-control input-medium \' value=\'\'   data-export-label=\'Phone_Number_\'  placeholder=\'\' data-rule-phoneUS=\'true\' data-msg-phoneUS=\'This field is invalid.\' />\
</div></div><hr><h3>Mailing Address</h3><p>Please enter the name and address you would like your gift card mailed to:</p>\
                        <fieldset class=\'fb-fieldset \'>\
                            <legend class=\'fb-legend hidden\'>Name:</legend>\
                            \
                            <div class=\'row\'>\
                                <div class=\'col-sm-6\'>\
                                    \
                <div class=\'form-group fb-form-group\'>\
                    <label class=\'control-label  \' for=\'FormField42_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16First\'>First Name:<span class=\'fb-required\'>*</span></label>\
                    <div >\
                        <input class=\'fb-name-field form-control input-medium\' id=\'FormField42_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16First\' name=\'FormField42_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16First\' type=\'text\' data-export-label=\'shipping_name_First_Name\'  integration-export-label=\'\' placeholder=\'\' required data-msg-required=\'First Name: is required.\' />\
                        \
                    </div>\
                </div>\
                                </div>\
                                <div class=\'col-sm-6\'>\
                                    \
                <div class=\'form-group fb-form-group\'>\
                    <label class=\'control-label  \' for=\'FormField42_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16Last\'>Last Name:<span class=\'fb-required\'>*</span></label>\
                    <div >\
                        <input class=\'fb-name-field form-control input-medium\' id=\'FormField42_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16Last\' name=\'FormField42_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16Last\' type=\'text\' data-export-label=\'shipping_name_Last_Name\'  integration-export-label=\'\' placeholder=\'\' required data-msg-required=\'Last Name: is required.\' />\
                        \
                    </div>\
                </div>\
                                </div>\
                            </div>\
                        </fieldset>\
                <fieldset class=\'fb-fieldset \'>\
                    <legend class=\'fb-legend hidden\'>Mailing Address</legend>\
                    \
                <div class=\'form-group fb-form-group\'>\
                    <label class=\'control-label \' for=\'FormField41_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_Line1\'>Line 1<span class=\'fb-required\'>*</span></label>\
                    <div >\
                        <input class=\'form-control\' id=\'FormField41_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_Line1\' name=\'FormField41_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_Line1\' type=\'text\' data-export-label=\'address_line1\'  required data-msg-required=\'Mailing Address Line 1 is required.\' autocomplete=\'street-address\'  />\
                    </div>\
                </div>\
                    \
                <div class=\'form-group fb-form-group\'>\
                    <label class=\'control-label \' for=\'FormField41_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_Line2\'>Line 2</label>\
                    <div >\
                        <input class=\'form-control\' id=\'FormField41_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_Line2\' name=\'FormField41_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_Line2\' type=\'text\' data-export-label=\'Address_Line2\'     />\
                    </div>\
                </div>\
                    <div class=\'row\'>\
                        <div class=\'col-sm-4\'>\
                            \
                <div class=\'form-group fb-form-group\'>\
                    <label class=\'control-label \' for=\'FormField41_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_City\'>City<span class=\'fb-required\'>*</span></label>\
                    <div >\
                        <input class=\'form-control\' id=\'FormField41_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_City\' name=\'FormField41_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_City\' type=\'text\' data-export-label=\'Address_City\'  required data-msg-required=\'Mailing Address City is required.\' autocomplete=\'locality\'  />\
                    </div>\
                </div>\
                        </div>\
                        <div class=\'col-sm-4\'>\
                            \
                <div class=\'form-group fb-form-group\'>\
                    <label class=\'control-label \' for=\'FormField41_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_State\'>State<span class=\'fb-required\'>*</span></label>\
                    <div >\
                        <select class=\'form-control\' name=\'FormField41_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_State\' id=\'FormField41_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_State\' autocomplete=\'region\' required=\'required\' data-msg-required=\'Mailing Address State is required.\' data-export-label=\'Address_State\' >\
                            <option value=\'\'>( Please Select )</option>\
                            <option value=\'AL\'>Alabama</option>\
                            <option value=\'AK\'>Alaska</option>\
                            <option value=\'AZ\'>Arizona</option>\
                            <option value=\'AR\'>Arkansas</option>\
                            <option value=\'CA\'>California</option>\
                            <option value=\'CO\'>Colorado</option>\
                            <option value=\'CT\'>Connecticut</option>\
                            <option value=\'DE\'>Delaware</option>\
                            <option value=\'DC\'>District Of Columbia</option>\
                            <option value=\'FL\'>Florida</option>\
                            <option value=\'GA\'>Georgia</option>\
                            <option value=\'HI\'>Hawaii</option>\
                            <option value=\'ID\'>Idaho</option>\
                            <option value=\'IL\'>Illinois</option>\
                            <option value=\'IN\'>Indiana</option>\
                            <option value=\'IA\'>Iowa</option>\
                            <option value=\'KS\'>Kansas</option>\
                            <option value=\'KY\'>Kentucky</option>\
                            <option value=\'LA\'>Louisiana</option>\
                            <option value=\'ME\'>Maine</option>\
                            <option value=\'MD\'>Maryland</option>\
                            <option value=\'MA\'>Massachusetts</option>\
                            <option value=\'MI\'>Michigan</option>\
                            <option value=\'MN\'>Minnesota</option>\
                            <option value=\'MS\'>Mississippi</option>\
                            <option value=\'MO\'>Missouri</option>\
                            <option value=\'MT\'>Montana</option>\
                            <option value=\'NE\'>Nebraska</option>\
                            <option value=\'NV\'>Nevada</option>\
                            <option value=\'NH\'>New Hampshire</option>\
                            <option value=\'NJ\'>New Jersey</option>\
                            <option value=\'NM\'>New Mexico</option>\
                            <option value=\'NY\'>New York</option>\
                            <option value=\'NC\'>North Carolina</option>\
                            <option value=\'ND\'>North Dakota</option>\
                            <option value=\'OH\'>Ohio</option>\
                            <option value=\'OK\'>Oklahoma</option>\
                            <option value=\'OR\'>Oregon</option>\
                            <option value=\'PA\'>Pennsylvania</option>\
                            <option value=\'RI\'>Rhode Island</option>\
                            <option value=\'SC\'>South Carolina</option>\
                            <option value=\'SD\'>South Dakota</option>\
                            <option value=\'TN\'>Tennessee</option>\
                            <option value=\'TX\'>Texas</option>\
                            <option value=\'UT\'>Utah</option>\
                            <option value=\'VT\'>Vermont</option>\
                            <option value=\'VA\'>Virginia</option>\
                            <option value=\'WA\'>Washington</option>\
                            <option value=\'WV\'>West Virginia</option>\
                            <option value=\'WI\'>Wisconsin</option>\
                            <option value=\'WY\'>Wyoming</option>\
                        </select>\
                    </div>\
                </div>\
                \
                        </div>\
                        <div class=\'col-sm-4\'>\
                            \
                <div class=\'form-group fb-form-group\'>\
                    <label class=\'control-label \' for=\'FormField41_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_Zip\'>Zip<span class=\'fb-required\'>*</span></label>\
                    <div >\
                        <input class=\'form-control\' id=\'FormField41_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_Zip\' name=\'FormField41_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_Zip\' type=\'text\' data-export-label=\'Address_Zip\'  required data-msg-required=\'Mailing Address Zip is required.\' autocomplete=\'postal-code\' data-rule-zipCode=\'true\' />\
                    </div>\
                </div>\
                        </div>\
                    </div>\
                </fieldset><h3>Gift Card Options:</h3><div class=\'form-group\'><label for=\'FormField18_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16\' class=\'control-label  hidden-label\'>Gift Card Options:<span class=\'fb-required\'>*</span></label><div><select  name=\'FormField18_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16\' id=\'FormField18_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16\' class=\'form-control \' style=\'width: auto\' required data-msg-required=\'Please select a gift card.\' data-export-label=\'Gift_Card_Options\' ><option value=\'\' selected>( Please Select )</option><option value=\'Initial Evaluation: $249\'>Initial Evaluation: $249</option><option value=\'Single Visit: $149\'>Single Visit: $149</option><option value=\'Players Package: $500\'>Players Package: $500</option><option value=\'Open Package: $880\'>Open Package: $880</option><option value=\'Masters Package: $1,200\'>Masters Package: $1,200</option></select></div></div><div class=\'fb-section\' style=\'display: none;\' id=\'FormField23_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16\'><div class=\'\'><div class=\'form-group\'><input type=\'hidden\' name=\'FormField33_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_description\' id=\'FormField33_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_description\' data-export-label=\'evaluation_cost_description\' value=\'Evaluation\'><input type=\'hidden\' name=\'FormField33_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_amount\' id=\'FormField33_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_amount\' data-export-label=\'evaluation_cost_amount\' value=\'249\'><input type=\'hidden\' name=\'FormField33_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_item_total\' id=\'FormField33_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_item_total\' data-export-label=\'evaluation_cost_item_total\' value=\'249\'><label class=\'control-label  \' >Initial Evaluation Cost</label><span> ($249.00)</span><p>Approximately 90 minutes</p></div><div class=\'form-group\'><label class=\'control-label  \'>Quantity<span class=\'fb-required\'>*</span></label><input type=\'number\' class=\'quantity form-control\' min=\'1\'  name=\'FormField33_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_quantity\' id=\'FormField33_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_quantity\' data-export-label=\'evaluation_cost_quantity\' value=\'1\' required></div><div class=\'form-group\'><label class=\'control-label  \' >Item Total:</label><span id=\'renderedItemTotal_FormField33_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16\'></span></div></div></div><div class=\'fb-section\' style=\'display: none;\' id=\'FormField19_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16\'><div class=\'\'><div class=\'form-group\'><input type=\'hidden\' name=\'FormField20_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_description\' id=\'FormField20_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_description\' data-export-label=\'single_visit_cost_description\' value=\'Single Visit\'><input type=\'hidden\' name=\'FormField20_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_amount\' id=\'FormField20_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_amount\' data-export-label=\'single_visit_cost_amount\' value=\'149\'><input type=\'hidden\' name=\'FormField20_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_item_total\' id=\'FormField20_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_item_total\' data-export-label=\'single_visit_cost_item_total\' value=\'149\'><label class=\'control-label  \' >Single Visit</label><span> ($149.00)</span><p>Approximately 45 minutes</p></div><div class=\'form-group\'><label class=\'control-label  \'>Quantity<span class=\'fb-required\'>*</span></label><input type=\'number\' class=\'quantity form-control\' min=\'1\'  name=\'FormField20_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_quantity\' id=\'FormField20_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_quantity\' data-export-label=\'single_visit_cost_quantity\' value=\'1\' required></div><div class=\'form-group\'><label class=\'control-label  \' >Item Total:</label><span id=\'renderedItemTotal_FormField20_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16\'></span></div></div></div><div class=\'fb-section\' style=\'display: none;\' id=\'FormField31_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16\'><div class=\'\'><div class=\'form-group\'><input type=\'hidden\' name=\'FormField32_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_description\' id=\'FormField32_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_description\' data-export-label=\'players_package_cost_description\' value=\'Players Package\'><input type=\'hidden\' name=\'FormField32_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_amount\' id=\'FormField32_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_amount\' data-export-label=\'players_package_cost_amount\' value=\'500\'><input type=\'hidden\' name=\'FormField32_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_item_total\' id=\'FormField32_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_item_total\' data-export-label=\'players_package_cost_item_total\' value=\'500\'><label class=\'control-label  \' >Players Package</label><span> ($500.00)</span><p>4-pack of 45 minute sessions</p></div><div class=\'form-group\'><label class=\'control-label  \'>Quantity<span class=\'fb-required\'>*</span></label><input type=\'number\' class=\'quantity form-control\' min=\'1\'  name=\'FormField32_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_quantity\' id=\'FormField32_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_quantity\' data-export-label=\'players_package_cost_quantity\' value=\'1\' required></div><div class=\'form-group\'><label class=\'control-label  \' >Item Total:</label><span id=\'renderedItemTotal_FormField32_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16\'></span></div></div></div><div class=\'fb-section\' style=\'display: none;\' id=\'FormField34_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16\'><div class=\'\'><div class=\'form-group\'><input type=\'hidden\' name=\'FormField35_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_description\' id=\'FormField35_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_description\' data-export-label=\'open_package_cost_description\' value=\'Players Package\'><input type=\'hidden\' name=\'FormField35_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_amount\' id=\'FormField35_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_amount\' data-export-label=\'open_package_cost_amount\' value=\'880\'><input type=\'hidden\' name=\'FormField35_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_item_total\' id=\'FormField35_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_item_total\' data-export-label=\'open_package_cost_item_total\' value=\'880\'><label class=\'control-label  \' >Open Package</label><span> ($880.00)</span><p>8-pack of 45 minute sessions</p></div><div class=\'form-group\'><label class=\'control-label  \'>Quantity<span class=\'fb-required\'>*</span></label><input type=\'number\' class=\'quantity form-control\' min=\'1\'  name=\'FormField35_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_quantity\' id=\'FormField35_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_quantity\' data-export-label=\'open_package_cost_quantity\' value=\'1\' required></div><div class=\'form-group\'><label class=\'control-label  \' >Item Total:</label><span id=\'renderedItemTotal_FormField35_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16\'></span></div></div></div><div class=\'fb-section\' style=\'display: none;\' id=\'FormField36_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16\'><div class=\'\'><div class=\'form-group\'><input type=\'hidden\' name=\'FormField37_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_description\' id=\'FormField37_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_description\' data-export-label=\'masters_package_cost_description\' value=\'Masters Package\'><input type=\'hidden\' name=\'FormField37_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_amount\' id=\'FormField37_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_amount\' data-export-label=\'masters_package_cost_amount\' value=\'1200\'><input type=\'hidden\' name=\'FormField37_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_item_total\' id=\'FormField37_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_item_total\' data-export-label=\'masters_package_cost_item_total\' value=\'1200\'><label class=\'control-label  \' >Masters Package</label><span> ($1,200.00)</span><p>12-pack of 45 minute sessions</p></div><div class=\'form-group\'><label class=\'control-label  \'>Quantity<span class=\'fb-required\'>*</span></label><input type=\'number\' class=\'quantity form-control\' min=\'1\'  name=\'FormField37_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_quantity\' id=\'FormField37_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16_quantity\' data-export-label=\'masters_package_cost_quantity\' value=\'1\' required></div><div class=\'form-group\'><label class=\'control-label  \' >Item Total:</label><span id=\'renderedItemTotal_FormField37_e0ec63f1-019d-49c8-b3be-fd8bb9d08e16\'></span></div></div></div><div class=\'\'><div class=\'form-group\' style=\'display:none\'><label class=\'control-label\'><strong>Subtotal:</strong></label><span class=\'subtotalCostAmount\'></span></div><div class=\'form-group\' style=\'display:none\'><label class=\'control-label\'><strong>Discount:</strong></label><span class=\'promoCodeDiscount\'></span>&nbsp;&#40;<span class=\'appliedPromoCode\'></span>&#41;</div><div class=\'form-group\'><label class=\'control-label  \'><strong>Total Cost:</strong></label><span class=\'totalCostAmount\'></span></div></div><div class=\'overridePayment\'>\
    <div class=\'flow Chkbx\'>\
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        <label class=\'control-label\' for=\'customerId\'><span class=\'fb-required\'>*</span></label>\
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            <input data-msg-required=\' is required\' class=\'form-control input-large customerId no-partials\' type=\'text\' name=\'customerId\' id=\'customerId\' autocorrect=\'off\' spellcheck=\'false\' value=\'\' required=\'required\' maxlength=\'64\' />\
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            <input data-msg-required=\'Card Street Address is required\' class=\'form-control input-large billingStreetAddress no-partials\' type=\'text\' name=\'billingStreetAddress\' id=\'billingStreetAddress\' autocomplete=\'billing street-address\' autocorrect=\'off\' spellcheck=\'false\' value=\'\' required=\'required\' maxlength=\'60\' />\
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    <div class=\'form-group\'>\
        <label class=\'control-label\' for=\'billingCity\'>City<span class=\'fb-required\'>*</span></label>\
        <div class=\'\'>\
            <input data-msg-required=\'Card City is required\' class=\'form-control input-large billingCity no-partials\' type=\'text\' name=\'billingCity\' id=\'billingCity\' autocomplete=\'billing locality\' autocorrect=\'off\' spellcheck=\'false\' value=\'\' required=\'required\' maxlength=\'40\' />\
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            <select data-msg-required=\'Card State is required\' class=\'form-control billingState no-partials\' name=\'billingState\' id=\'billingState\' autocomplete=\'billing region\' required=\'required\'>\
                <option value=\'\'>( Please Select )</option>\
                <option value=\'AL\'>Alabama</option>\
                <option value=\'AK\'>Alaska</option>\
                <option value=\'AZ\'>Arizona</option>\
                <option value=\'AR\'>Arkansas</option>\
                <option value=\'CA\'>California</option>\
                <option value=\'CO\'>Colorado</option>\
                <option value=\'CT\'>Connecticut</option>\
                <option value=\'DE\'>Delaware</option>\
                <option value=\'DC\'>District Of Columbia</option>\
                <option value=\'FL\'>Florida</option>\
                <option value=\'GA\'>Georgia</option>\
                <option value=\'HI\'>Hawaii</option>\
                <option value=\'ID\'>Idaho</option>\
                <option value=\'IL\'>Illinois</option>\
                <option value=\'IN\'>Indiana</option>\
                <option value=\'IA\'>Iowa</option>\
                <option value=\'KS\'>Kansas</option>\
                <option value=\'KY\'>Kentucky</option>\
                <option value=\'LA\'>Louisiana</option>\
                <option value=\'ME\'>Maine</option>\
                <option value=\'MD\'>Maryland</option>\
                <option value=\'MA\'>Massachusetts</option>\
                <option value=\'MI\'>Michigan</option>\
                <option value=\'MN\'>Minnesota</option>\
                <option value=\'MS\'>Mississippi</option>\
                <option value=\'MO\'>Missouri</option>\
                <option value=\'MT\'>Montana</option>\
                <option value=\'NE\'>Nebraska</option>\
                <option value=\'NV\'>Nevada</option>\
                <option value=\'NH\'>New Hampshire</option>\
                <option value=\'NJ\'>New Jersey</option>\
                <option value=\'NM\'>New Mexico</option>\
                <option value=\'NY\'>New York</option>\
                <option value=\'NC\'>North Carolina</option>\
                <option value=\'ND\'>North Dakota</option>\
                <option value=\'OH\'>Ohio</option>\
                <option value=\'OK\'>Oklahoma</option>\
                <option value=\'OR\'>Oregon</option>\
                <option value=\'PA\'>Pennsylvania</option>\
                <option value=\'RI\'>Rhode Island</option>\
                <option value=\'SC\'>South Carolina</option>\
                <option value=\'SD\'>South Dakota</option>\
                <option value=\'TN\'>Tennessee</option>\
                <option value=\'TX\'>Texas</option>\
                <option value=\'UT\'>Utah</option>\
                <option value=\'VT\'>Vermont</option>\
                <option value=\'VA\'>Virginia</option>\
                <option value=\'WA\'>Washington</option>\
                <option value=\'WV\'>West Virginia</option>\
                <option value=\'WI\'>Wisconsin</option>\
                <option value=\'WY\'>Wyoming</option>\
            </select>\
        </div>\
    </div>\
    <div class=\'form-group\'>\
        <label class=\'control-label\' for=\'billingZip\'>Zip<span class=\'fb-required\'>*</span></label>\
        <div class=\'\'>\
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    </div>\
    <input type=\'hidden\' class=\'authorizeCardDataValue\' />\
    <input type=\'hidden\' class=\'authorizeCardDataDescriptor\' />\
    <div class=\'paymentTotalCost\'>\
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</div>\
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