{"id":4193,"date":"2024-12-23T13:31:06","date_gmt":"2024-12-23T05:31:06","guid":{"rendered":"https:\/\/p15.projs.ifdemo.com\/viva\/?page_id=4193"},"modified":"2026-10-13T17:13:42","modified_gmt":"2026-10-13T09:13:42","slug":"be-a-viva-friend","status":"publish","type":"page","link":"https:\/\/p15.projs.ifdemo.com\/viva\/join-us\/be-a-viva-friend\/","title":{"rendered":"Be A VIVA Friend"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"4193\" class=\"elementor elementor-4193\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f086cca e-con-full e-flex e-con e-parent\" data-id=\"f086cca\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-ec7fa33 elementor-widget elementor-widget-psg_banner\" data-id=\"ec7fa33\" data-element_type=\"widget\" data-widget_type=\"psg_banner.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"viva-banner-img-wrap\">\n \t<div class=\"viva-banner-img-left\">\n\t\t<h1 class=\"viva-banner-page-title\">Be A VIVA Friend<\/h1> \n\t\t<div class=\"viva-breadcrumbs\"><a href=\"https:\/\/p15.projs.ifdemo.com\/viva\" rel=\"nofollow\"><i class=\"fal fa-home\"><\/i><\/a><span class=\"separator\"><i class=\"fal fa-angle-right\"><\/i><\/span><a href=\"https:\/\/p15.projs.ifdemo.com\/viva\/join-us\/\">Join Us<\/a><span class=\"separator\"><i class=\"fal fa-angle-right\"><\/i><\/span>Be A VIVA Friend<\/div>  \n\t<\/div>\n\t<div class=\"viva-banner-img-right\"><\/div>\n\t<img decoding=\"async\" src=\"https:\/\/p15.projs.ifdemo.com\/viva\/wp-content\/themes\/viva\/assets\/images\/banner-wave.png\" alt=\"Bottom Shape\" class=\"viva-banner-bottom-shape\">\n<\/div>\n\n\n    \t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-7cde961 e-flex e-con-boxed e-con e-parent\" data-id=\"7cde961\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-6ce88ce e-flex e-con-boxed e-con e-child\" data-id=\"6ce88ce\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-ee53ba0 elementor-widget elementor-widget-heading\" data-id=\"ee53ba0\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Be A VIVA Friend<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1b29d06 elementor-widget elementor-widget-text-editor\" data-id=\"1b29d06\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">Join Our Community<\/span><\/p><p><span style=\"font-weight: 400;\">Fill up the form below and we will be in touch with you<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-2bf0af0 e-con-full elementor-hidden-desktop elementor-hidden-laptop elementor-hidden-tablet_extra elementor-hidden-tablet elementor-hidden-mobile e-flex e-con e-child\" data-id=\"2bf0af0\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-46c9cf9 viva-be-a-member-wd-wrp elementor-widget elementor-widget-wp-widget-gform_widget\" data-id=\"46c9cf9\" data-element_type=\"widget\" data-widget_type=\"wp-widget-gform_widget.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<script id=\"wp-dom-ready-js\" src=\"https:\/\/p15.projs.ifdemo.com\/viva\/wp-includes\/js\/dist\/dom-ready.min.js?ver=3fe927cab37bf38d6a23\"><\/script>\n<script id=\"wp-hooks-js\" src=\"https:\/\/p15.projs.ifdemo.com\/viva\/wp-includes\/js\/dist\/hooks.min.js?ver=f0f188028580e8dc1255\"><\/script>\n<script id=\"wp-i18n-js\" src=\"https:\/\/p15.projs.ifdemo.com\/viva\/wp-includes\/js\/dist\/i18n.min.js?ver=1dfe7db3940c23ea9216\"><\/script>\n<script id=\"wp-i18n-js-after\">\nwp.i18n.setLocaleData( { 'text direction\\u0004ltr': [ 'ltr' ] } );\n\/\/# sourceURL=wp-i18n-js-after\n<\/script>\n<script id=\"wp-a11y-js\" src=\"https:\/\/p15.projs.ifdemo.com\/viva\/wp-includes\/js\/dist\/a11y.min.js?ver=31c6cec5a4ff7aff483d\"><\/script>\n<script id=\"jquery-core-js\" src=\"https:\/\/p15.projs.ifdemo.com\/viva\/wp-includes\/js\/jquery\/jquery.min.js?ver=3.7.1\"><\/script>\n<script id=\"jquery-migrate-js\" src=\"https:\/\/p15.projs.ifdemo.com\/viva\/wp-includes\/js\/jquery\/jquery-migrate.min.js?ver=3.4.1\"><\/script>\n<script id=\"gform_json-js\" defer='defer' src=\"https:\/\/p15.projs.ifdemo.com\/viva\/wp-content\/plugins\/gravityforms\/js\/jquery.json.min.js?ver=2.9.24\"><\/script>\n<script id=\"gform_gravityforms-js-extra\">\nvar gf_global = {\"gf_currency_config\":{\"name\":\"Singapore Dollar\",\"symbol_left\":\"$\",\"symbol_right\":\"\",\"symbol_padding\":\" \",\"thousand_separator\":\",\",\"decimal_separator\":\".\",\"decimals\":2,\"code\":\"SGD\"},\"base_url\":\"https:\/\/p15.projs.ifdemo.com\/viva\/wp-content\/plugins\/gravityforms\",\"number_formats\":[],\"spinnerUrl\":\"https:\/\/p15.projs.ifdemo.com\/viva\/wp-content\/plugins\/gravityforms\/images\/spinner.svg\",\"version_hash\":\"89a7b37bf21e360b51b6e604e01116ed\",\"strings\":{\"newRowAdded\":\"New row added.\",\"rowRemoved\":\"Row removed\",\"formSaved\":\"The form has been saved.  The content contains the link to return and complete the form.\"}};\n\/\/# sourceURL=gform_gravityforms-js-extra\n<\/script>\n<script id=\"gform_gravityforms-js\" defer='defer' src=\"https:\/\/p15.projs.ifdemo.com\/viva\/wp-content\/plugins\/gravityforms\/js\/gravityforms.min.js?ver=2.9.24\"><\/script>\n<script id=\"gform_conditional_logic-js-extra\">\nvar gf_legacy = {\"is_legacy\":\"\"};\n\/\/# sourceURL=gform_conditional_logic-js-extra\n<\/script>\n<script id=\"gform_conditional_logic-js\" defer='defer' src=\"https:\/\/p15.projs.ifdemo.com\/viva\/wp-content\/plugins\/gravityforms\/js\/conditional_logic.min.js?ver=2.9.24\"><\/script>\n<script id=\"gform_recaptcha-js\" defer='defer' src=\"https:\/\/www.google.com\/recaptcha\/api.js?hl=en&#038;&#038;ver=7.1.3#038;render=explicit\"><\/script>\n<script id=\"gform_textarea_counter-js\" defer='defer' src=\"https:\/\/p15.projs.ifdemo.com\/viva\/wp-content\/plugins\/gravityforms\/js\/jquery.textareaCounter.plugin.min.js?ver=2.9.24\"><\/script>\n<script id=\"gform_placeholder-js\" defer='defer' src=\"https:\/\/p15.projs.ifdemo.com\/viva\/wp-content\/plugins\/gravityforms\/js\/placeholders.jquery.min.js?ver=2.9.24\"><\/script>\n<script>\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 InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return 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<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework viva-form-wrp_wrapper viva-member-form-wrp_wrapper' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_8' style='display:none'>\n                        <div class='gform_heading'>\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_8' class='viva-form-wrp viva-member-form-wrp' action='\/viva\/wp-json\/wp\/v2\/pages\/4193' data-formid='8' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_8' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_8_1\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio viva-input field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Choose Your Participation Type<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_8_1'>\n\t\t\t<div class='gchoice gchoice_8_1_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_1' type='radio' value='General Public' checked='checked' id='choice_8_1_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_1_0' id='label_8_1_0' class='gform-field-label gform-field-label--type-inline'>General Public<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_1_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_1' type='radio' value='Healthcare Professionals'  id='choice_8_1_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_1_1' id='label_8_1_1' class='gform-field-label gform-field-label--type-inline'>Healthcare Professionals<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_1_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_1' type='radio' value='Patients And Survivors'  id='choice_8_1_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_1_2' id='label_8_1_2' class='gform-field-label gform-field-label--type-inline'>Patients And Survivors<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_8_2\" class=\"gfield gfield--type-section gfield--input-type-section gsection viva-seprator-line field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><div id=\"field_8_3\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input is_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_8_3'>First Name (As per NRIC\/FIN)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_8_3' type='text' value='' class='large'    placeholder='First name' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_4\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input is_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_8_4'>Last Name (As per NRIC\/FIN)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_8_4' type='text' value='' class='large'    placeholder='Last name' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_5\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input is_number 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_8_5'>Contact Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_8_5' type='text' value='' class='large'    placeholder='e.g. 8123 4567' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_6\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half viva-input 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_8_6'>Email Address<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_6' id='input_8_6' type='email' value='' class='large'   placeholder='e.g. example@example.com' aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><fieldset id=\"field_8_9\" class=\"gfield gfield--type-password gfield--input-type-password gfield--width-full viva-input viva-password gfield_contains_required field_sublabel_above gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Password<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container_password gform-grid-row' id='input_8_9_container'>\n\t\t\t\t\t\t<span id='input_8_9_1_container' class='ginput_password ginput_left gform-grid-col gform-grid-col--size-auto'>\n\t\t\t\t\t\t\t<label for='input_8_9' class='gform-field-label gform-field-label--type-sub '>Password<\/label>\n\t\t\t\t\t\t\t<span class='password_input_container'>\n\t\t\t\t\t\t\t<input type='password' name='input_9' id='input_8_9'    value=''  placeholder='Enter Password' aria-required=\"true\" aria-invalid=\"false\" \/>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span id='input_8_9_2_container' class='ginput_password ginput_right gform-grid-col gform-grid-col--size-auto'>\n\t\t\t\t\t\t\t<label for='input_8_9_2' class='gform-field-label gform-field-label--type-sub '>Confirm Password<\/label>\n\t\t\t\t\t\t\t<span class='password_input_container'>\n\t\t\t\t\t\t\t<input type='password' name='input_9_2' id='input_8_9_2'   value=''  placeholder='Re-enter password' aria-required=\"true\" aria-invalid=\"false\" \/>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<div class='gf_clear gf_clear_complex'><\/div>\n\t\t\t\t\t<\/div><\/fieldset><div id=\"field_8_16\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half viva-input 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_8_16'>Title<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_16' id='input_8_16' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select your title (e.g. Mr)<\/option><option value='Mr.' >Mr.<\/option><option value='Mrs.' >Mrs.<\/option><option value='Miss' >Miss<\/option><option value='Ms.' >Ms.<\/option><option value='Dr.' >Dr.<\/option><\/select><\/div><\/div><div id=\"field_8_17\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input is_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_8_17'>Full Name (As per NRIC\/FIN)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_17' id='input_8_17' type='text' value='' class='large'    placeholder='e.g. John Tan Kai Jie' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_18\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half viva-input 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_8_18'>Email Address<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_18' id='input_8_18' type='email' value='' class='large'   placeholder='e.g. example@example.com' aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_8_19\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input 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_8_19'>Date Of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_19' id='input_8_19' type='text' value='' class='large'    placeholder='e.g. 01 Jan 2020' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_20\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input is_number be_member_phone gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_20'>Mobile No.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_20' id='input_8_20' type='text' value='' class='large'  aria-describedby=\"gfield_description_8_20\"  placeholder='e.g. 8123 4567' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_8_20'>Should be 8 characters onwards<\/div><\/div><div id=\"field_8_21\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input is_number be_member_phone field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_21'>Office No. (Main \/ DID)<\/label><div class='ginput_container ginput_container_text'><input name='input_21' id='input_8_21' type='text' value='' class='large'  aria-describedby=\"gfield_description_8_21\"  placeholder='e.g. 6543 1234'  aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_8_21'>Should be 8 characters onwards<\/div><\/div><div id=\"field_8_23\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full viva-input 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_8_23'>Country Of Residence<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_23' id='input_8_23' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select<\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cabo Verde' >Cabo Verde<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' >United Kingdom<\/option><option value='United States' >United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option><\/select><\/div><\/div><fieldset id=\"field_8_25\" class=\"gfield gfield--type-password gfield--input-type-password gfield--width-full viva-input viva-password gfield_contains_required field_sublabel_above gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Password<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container_password gform-grid-row' id='input_8_25_container'>\n\t\t\t\t\t\t<span id='input_8_25_1_container' class='ginput_password ginput_left gform-grid-col gform-grid-col--size-auto'>\n\t\t\t\t\t\t\t<label for='input_8_25' class='gform-field-label gform-field-label--type-sub '>Password<\/label>\n\t\t\t\t\t\t\t<span class='password_input_container'>\n\t\t\t\t\t\t\t<input type='password' name='input_25' id='input_8_25'    value=''  placeholder='Enter Password' aria-required=\"true\" aria-invalid=\"false\" \/>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span id='input_8_25_2_container' class='ginput_password ginput_right gform-grid-col gform-grid-col--size-auto'>\n\t\t\t\t\t\t\t<label for='input_8_25_2' class='gform-field-label gform-field-label--type-sub '>Confirm Password<\/label>\n\t\t\t\t\t\t\t<span class='password_input_container'>\n\t\t\t\t\t\t\t<input type='password' name='input_25_2' id='input_8_25_2'   value=''  placeholder='Re-enter password' aria-required=\"true\" aria-invalid=\"false\" \/>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<div class='gf_clear gf_clear_complex'><\/div>\n\t\t\t\t\t<\/div><\/fieldset><div id=\"field_8_27\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full viva-heading gfield_html gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >If you are a certified medical professional in Singapore, please select the following in the drop down list below and provide your registration number.<\/div><div id=\"field_8_28\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half viva-input mep gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_28'>Professional Registration<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_28' id='input_8_28' class='large gfield_select'  aria-describedby=\"gfield_description_8_28\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select your healthcare profession registered in Singapore:<\/option><option value='[Select your profession]' >[Select your profession]<\/option><option value='Medical Doctor (Registered with Singapore Medical Council)' >Medical Doctor (Registered with Singapore Medical Council)<\/option><option value='Nurse (Registered with Singapore Nursing Board)' >Nurse (Registered with Singapore Nursing Board)<\/option><option value='Pharmacist (Registered with Singapore Pharmacy Council)' >Pharmacist (Registered with Singapore Pharmacy Council)<\/option><option value='Allied Health Professional (Registered with Allied Health Professions Council)' >Allied Health Professional (Registered with Allied Health Professions Council)<\/option><option value='Not Singapore-registered healthcare professional' >Not Singapore-registered healthcare professional<\/option><option value='Not applicable' >Not applicable<\/option><\/select><\/div><div class='gfield_description' id='gfield_description_8_28'>For Singapore delegates, please indicate if you are a CME\/CNE\/CPE applicant. If you are a foreigner, please choose \"NA\".<\/div><\/div><div id=\"field_8_29\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input is_number field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_29'>Certification No.<\/label><div class='ginput_container ginput_container_text'><input name='input_29' id='input_8_29' type='text' value='' class='large'    placeholder='e.g. 2023110200001'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_30\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full viva-input 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_8_30'>Organization Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_30' id='input_8_30' type='text' value='' class='large'    placeholder='Enter organization name' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_31\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input 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_8_31'>Department<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_31' id='input_8_31' type='text' value='' class='large'    placeholder='e.g. A&amp;E' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_32\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input 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_8_32'>Designation<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_32' id='input_8_32' type='text' value='' class='large'    placeholder='e.g. Staff Nurse' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_35\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input is_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_8_35'>First Name (As per NRIC\/FIN)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_35' id='input_8_35' type='text' value='' class='large'    placeholder='First name' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_36\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input is_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_8_36'>Last Name (As per NRIC\/FIN)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_36' id='input_8_36' type='text' value='' class='large'    placeholder='Last name' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_37\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input 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_8_37'>Date Of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_37' id='input_8_37' type='text' value='' class='large'    placeholder='e.g. 01 Jan 2020' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_8_39\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half viva-input 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' >Gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_8_39'>\n\t\t\t<div class='gchoice gchoice_8_39_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_39' type='radio' value='Male' checked='checked' id='choice_8_39_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_39_0' id='label_8_39_0' class='gform-field-label gform-field-label--type-inline'>Male<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_39_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_39' type='radio' value='Female'  id='choice_8_39_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_39_1' id='label_8_39_1' class='gform-field-label gform-field-label--type-inline'>Female<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_8_38\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input is_number gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_8_38'>Age<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_38' id='input_8_38' type='text' value='' class='large'    placeholder='e.g. 3' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_40\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half viva-input field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_8_40'>Religion<\/label><div class='ginput_container ginput_container_select'><select name='input_40' id='input_8_40' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select your religion<\/option><option value='Buddhism' >Buddhism<\/option><option value='Christianity' >Christianity<\/option><option value='Hinduism' >Hinduism<\/option><option value='Islam' >Islam<\/option><option value='Sikhism' >Sikhism<\/option><option value='Taoism' >Taoism<\/option><option value='Judaism' >Judaism<\/option><option value='Zoroastrianism' >Zoroastrianism<\/option><option value='No Religion \/ Atheism' >No Religion \/ Atheism<\/option><option value='Others' >Others<\/option><\/select><\/div><\/div><div id=\"field_8_41\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full viva-input gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_8_41'>Which hospital\/doctor did you get your treatment from?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_41' id='input_8_41' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select hospital<\/option><option value='Hospital 1' >Hospital 1<\/option><option value='Hospital 2' >Hospital 2<\/option><option value='Hospital 3' >Hospital 3<\/option><\/select><\/div><\/div><div id=\"field_8_61\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full viva-input field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_61'>Which hospital\/doctor did you get your treatment from?<\/label><div class='gfield_description' id='gfield_description_8_61'>*To support you better in our programme planning<\/div><div class='ginput_container ginput_container_text'><input name='input_61' id='input_8_61' type='text' value='' class='large'  aria-describedby=\"gfield_description_8_61\"  placeholder='Please Enter Hospital\/Doctor Name'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_42\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full viva-input 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_8_42'>Medical Condition \/ Type Of Cancer<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_42' id='input_8_42' class='textarea small'    placeholder='Notes about your medical condition(s)' aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_8_43\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full viva-input gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_8_43'>Treatment(s)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_43' id='input_8_43' class='textarea small'    placeholder='Notes about your treatment(s)' aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_8_45\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full viva-input gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_8_45'>Food Preference<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_45' id='input_8_45' type='text' value='' class='large'    placeholder='e.g. 01 Jan 2020' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_62\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full viva-input 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_8_62'>Are you a:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_62' id='input_8_62' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please Select From Below<\/option><option value='A survivor in remission' >A survivor in remission<\/option><option value='A patient undergoing treatment in Singapore hospital' >A patient undergoing treatment in Singapore hospital<\/option><option value='A patient undergoing treatment in overseas hospital' >A patient undergoing treatment in overseas hospital<\/option><option value='A patient not undergoing treatment and in palliative care' >A patient not undergoing treatment and in palliative care<\/option><\/select><\/div><\/div><div id=\"field_8_63\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half viva-input 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_8_63'>Dietary Requirements<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_63' id='input_8_63' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please Select Diet<\/option><option value='No pork no lard' >No pork no lard<\/option><option value='Halal' >Halal<\/option><option value='Vegetarian' >Vegetarian<\/option><option value='No restrictions' >No restrictions<\/option><\/select><\/div><\/div><div id=\"field_8_46\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input 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_8_46'>Allergies\/Special Needs<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_46' id='input_8_46' type='text' value='' class='large'    placeholder='e.g. 3' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_47\" class=\"gfield gfield--type-section gfield--input-type-section gsection viva-seprator-line field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><div id=\"field_8_49\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input is_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_8_49'>Parent&#039;s First Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_49' id='input_8_49' type='text' value='' class='large'    placeholder='Parent&#039;s first name' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_50\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input is_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_8_50'>Parent&#039;s Last Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_50' id='input_8_50' type='text' value='' class='large'    placeholder='Parent&#039;s last mame' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_51\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input is_number 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_8_51'>Contact Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_51' id='input_8_51' type='text' value='' class='large' maxlength='8'   placeholder='e.g. 8123 4567' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_53\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half viva-input 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_8_53'>Email Address<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_53' id='input_8_53' type='email' value='' class='large'   placeholder='e.g. example@example.com' aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_8_54\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full viva-input 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_8_54'>Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_54' id='input_8_54' type='text' value='' class='large'    placeholder='Enter your address' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_56\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half viva-input 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_8_56'>Country Of Residence<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_56' id='input_8_56' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select<\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cabo Verde' >Cabo Verde<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' >United Kingdom<\/option><option value='United States' >United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option><\/select><\/div><\/div><div id=\"field_8_57\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input is_number 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_8_57'>Postal Code \/ Zip Code<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_57' id='input_8_57' type='text' value='' class='large'    placeholder='e.g. 520001' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_8_58\" class=\"gfield gfield--type-password gfield--input-type-password gfield--width-full viva-input viva-password gfield_contains_required field_sublabel_above gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Password<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container_password gform-grid-row' id='input_8_58_container'>\n\t\t\t\t\t\t<span id='input_8_58_1_container' class='ginput_password ginput_left gform-grid-col gform-grid-col--size-auto'>\n\t\t\t\t\t\t\t<label for='input_8_58' class='gform-field-label gform-field-label--type-sub '>Password<\/label>\n\t\t\t\t\t\t\t<span class='password_input_container'>\n\t\t\t\t\t\t\t<input type='password' name='input_58' id='input_8_58'    value=''  placeholder='Enter Password' aria-required=\"true\" aria-invalid=\"false\" \/>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span id='input_8_58_2_container' class='ginput_password ginput_right gform-grid-col gform-grid-col--size-auto'>\n\t\t\t\t\t\t\t<label for='input_8_58_2' class='gform-field-label gform-field-label--type-sub '>Confirm Password<\/label>\n\t\t\t\t\t\t\t<span class='password_input_container'>\n\t\t\t\t\t\t\t<input type='password' name='input_58_2' id='input_8_58_2'   value=''  placeholder='Re-enter password' aria-required=\"true\" aria-invalid=\"false\" \/>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<div class='gf_clear gf_clear_complex'><\/div>\n\t\t\t\t\t<\/div><\/fieldset><div id=\"field_8_59\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full viva-input field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_59'>Other Remarks<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_59' id='input_8_59' class='textarea small'    placeholder='Notes about other remarks'  aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_8_60\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full viva-input mb_20 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' >Are you interested to join VIVA\u2019s activities?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_8_60'>\n\t\t\t<div class='gchoice gchoice_8_60_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_60' type='radio' value='Yes' checked='checked' id='choice_8_60_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_60_0' id='label_8_60_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_60_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_60' type='radio' value='No'  id='choice_8_60_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_60_1' id='label_8_60_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_8_10\" class=\"gfield gfield--type-captcha gfield--input-type-captcha gfield--width-full viva-input field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_10'>CAPTCHA<\/label><div id='input_8_10' class='ginput_container ginput_recaptcha' data-sitekey='6LfoM9cZAAAAAD0OMOH3OTGusYu2rLMEQWX-rWi_'  data-theme='light' data-tabindex='0'  data-badge=''><\/div><\/div><fieldset id=\"field_8_12\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full viva-input gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >I have read and agree to the terms and conditions.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_12.1' id='input_8_12_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_8_12_1' >I have read and agree to the <a href=\"https:\/\/p15.projs.ifdemo.com\/viva\/join-us\/be-a-member\/terms-condition\/\">terms and conditions<\/a>.<span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/label><input type='hidden' name='input_12.2' value='I have read and agree to the &lt;a href=&quot;https:\/\/p15.projs.ifdemo.com\/viva\/join-us\/be-a-member\/terms-condition\/&quot;&gt;terms and conditions&lt;\/a&gt;.' class='gform_hidden' \/><input type='hidden' name='input_12.3' value='10' class='gform_hidden' \/><\/div><\/fieldset><fieldset id=\"field_8_33\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full viva-input mtm_10 field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >I would like to receive news, information, updates from and about the VIVA Foundation for Children with Cancer.<\/legend><div class='ginput_container ginput_container_consent'><input name='input_33.1' id='input_8_33_1' type='checkbox' value='1'    aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_8_33_1' >I would like to receive news, information, updates from and about the VIVA Foundation for Children with Cancer.<\/label><input type='hidden' name='input_33.2' value='I would like to receive news, information, updates from and about the VIVA Foundation for Children with Cancer.' class='gform_hidden' \/><input type='hidden' name='input_33.3' value='10' class='gform_hidden' \/><\/div><\/fieldset><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <button class='gform_button' id='gform_submit_button_8'>Sign Up<\/button> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_8' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_8' id='gform_theme_8' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_8' id='gform_style_settings_8' value='' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_8' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='8' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_8' 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Open items with Enter or Space, close with Escape and navigate using the Arrow keys.\">\n\t\t\t<div class=\"e-n-tabs-heading\" role=\"tablist\">\n\t\t\t\t\t<button id=\"e-n-tab-title-825193481\" class=\"e-n-tab-title\" aria-selected=\"true\" data-tab-index=\"1\" role=\"tab\" tabindex=\"0\" aria-controls=\"e-n-tab-content-825193481\" style=\"--n-tabs-title-order: 1;\">\n\t\t\t\t\t\t<span class=\"e-n-tab-title-text\">\n\t\t\t\tGeneral Public\t\t\t<\/span>\n\t\t<\/button>\n\t\t\t\t<button id=\"e-n-tab-title-825193482\" class=\"e-n-tab-title\" aria-selected=\"false\" data-tab-index=\"2\" role=\"tab\" tabindex=\"-1\" aria-controls=\"e-n-tab-content-825193482\" style=\"--n-tabs-title-order: 2;\">\n\t\t\t\t\t\t<span class=\"e-n-tab-title-text\">\n\t\t\t\tHealthcare Professionals\t\t\t<\/span>\n\t\t<\/button>\n\t\t\t\t<button id=\"e-n-tab-title-825193483\" class=\"e-n-tab-title\" aria-selected=\"false\" data-tab-index=\"3\" role=\"tab\" tabindex=\"-1\" aria-controls=\"e-n-tab-content-825193483\" style=\"--n-tabs-title-order: 3;\">\n\t\t\t\t\t\t<span class=\"e-n-tab-title-text\">\n\t\t\t\tPatients and Survivors\t\t\t<\/span>\n\t\t<\/button>\n\t\t\t\t\t<\/div>\n\t\t\t<div class=\"e-n-tabs-content\">\n\t\t\t\t<div id=\"e-n-tab-content-825193481\" role=\"tabpanel\" aria-labelledby=\"e-n-tab-title-825193481\" data-tab-index=\"1\" style=\"--n-tabs-title-order: 1;\" class=\"e-active elementor-element elementor-element-4db8e7c e-con-full e-flex e-con e-child\" data-id=\"4db8e7c\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d93e033 elementor-widget elementor-widget-wp-widget-gform_widget\" data-id=\"d93e033\" data-element_type=\"widget\" data-widget_type=\"wp-widget-gform_widget.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h5>General Public<\/h5><script id=\"jquery-ui-core-js-before\">\njQuery.uiBackCompat = true;\n\/\/# sourceURL=jquery-ui-core-js-before\n<\/script>\n<script id=\"jquery-ui-core-js\" src=\"https:\/\/p15.projs.ifdemo.com\/viva\/wp-includes\/js\/jquery\/ui\/core.min.js?ver=1.14.2\"><\/script>\n<script id=\"jquery-ui-datepicker-js\" src=\"https:\/\/p15.projs.ifdemo.com\/viva\/wp-includes\/js\/jquery\/ui\/datepicker.min.js?ver=1.14.2\"><\/script>\n<script id=\"gform_datepicker_legacy-js\" defer='defer' src=\"https:\/\/p15.projs.ifdemo.com\/viva\/wp-content\/plugins\/gravityforms\/js\/datepicker-legacy.min.js?ver=2.9.24\"><\/script>\n<script id=\"gform_datepicker_init-js\" defer='defer' src=\"https:\/\/p15.projs.ifdemo.com\/viva\/wp-content\/plugins\/gravityforms\/js\/datepicker.min.js?ver=2.9.24\"><\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework viva-form-wrp_wrapper' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_13' style='display:none'><div id='gf_13' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">VIVA General Programme & Event Registration<\/h2>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_13' class='viva-form-wrp' action='\/viva\/wp-json\/wp\/v2\/pages\/4193#gf_13' data-formid='13' novalidate>\n        <div id='gf_progressbar_wrapper_13' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<p class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>5<\/span><span class='gf_step_page_name'> - Participant Information<\/span>\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_20' style='width:20%;'><span>20%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_13_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_13' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_13_3\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p>Thank you for your interest in joining our upcoming activities!<\/p><p>Please complete the form below to register your participation.<\/p><\/div><div id=\"field_13_4\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">1. Participant Information<\/h3><\/div><div id=\"field_13_5\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input 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_13_5'>Full Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_13_5' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_6\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_6'>Preferred Name<\/label><div class='ginput_container ginput_container_text'><input name='input_6' id='input_13_6' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_7\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-third viva-input 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_13_7'>Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_7' id='input_13_7' type='text' value='' class='datepicker gform-datepicker dmy datepicker_with_icon gdatepicker_with_icon'   placeholder='dd\/mm\/yyyy' aria-describedby=\"input_13_7_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_13_7_date_format' class='screen-reader-text'>DD slash MM slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_13_7' class='gform_hidden' value='https:\/\/p15.projs.ifdemo.com\/viva\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_13_8\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third viva-input 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_13_8'>Age<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_8' id='input_13_8' type='number' step='any' min='0'  value='' class='large'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_instruction_13_8\" \/><div class='gfield_description instruction ' id='gfield_instruction_13_8'>Please enter a number greater than or equal to <strong>0<\/strong>.<\/div><\/div><\/div><fieldset id=\"field_13_9\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-third 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' >Gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_9'>\n\t\t\t<div class='gchoice gchoice_13_9_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Male'  id='choice_13_9_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_9_0' id='label_13_9_0' class='gform-field-label gform-field-label--type-inline'>Male<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_9_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Female'  id='choice_13_9_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_9_1' id='label_13_9_1' class='gform-field-label gform-field-label--type-inline'>Female<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_9_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Prefer not to say'  id='choice_13_9_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_9_2' id='label_13_9_2' class='gform-field-label gform-field-label--type-inline'>Prefer not to say<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_9_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Other'  id='choice_13_9_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_9_3' id='label_13_9_3' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_10\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full viva-input 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_13_10'>Please specify your gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_13_10' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_11\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">2. Number of Attendees<\/h3><\/div><div id=\"field_13_12\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><\/div><div id=\"field_13_14\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third viva-input 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_13_14'>Children (Under 18)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_14' id='input_13_14' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='0' >0<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5+' >5+<\/option><\/select><\/div><\/div><div id=\"field_13_13\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third viva-input 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_13_13'>Adults (18+)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_13' id='input_13_13' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='0' >0<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5+' >5+<\/option><\/select><\/div><\/div><div id=\"field_13_15\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third viva-input 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_13_15'>Total Number Attending<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_15' id='input_13_15' type='number' step='any' min='1'  value='' class='large'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_instruction_13_15\" \/><div class='gfield_description instruction ' id='gfield_instruction_13_15'>Please enter a number greater than or equal to <strong>1<\/strong>.<\/div><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_13_1' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_13_2' class='gform_page' data-js='page-field-id-1' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_13_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_13_16\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">3. Contact Information<\/h3><div class='gsection_description' id='gfield_description_13_16'>For participants under 18, please provide parent\/guardian details.<\/div><\/div><div id=\"field_13_17\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input 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_13_17'>Primary Contact Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_17' id='input_13_17' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_18\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_18'>Relationship to Participant (if applicable)<\/label><div class='ginput_container ginput_container_text'><input name='input_18' id='input_13_18' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_19\" class=\"gfield gfield--type-text gfield--width-half viva-input viva-phone-digits 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_13_19'>Contact Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input inputmode=\"numeric\" pattern=\"[0-9]*\" name='input_19' id='input_13_19' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_20\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half viva-input 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_13_20'>Email Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_20' id='input_13_20' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_13_21\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">4. Emergency Contact<\/h3><\/div><div id=\"field_13_22\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input 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_13_22'>Emergency Contact Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_22' id='input_13_22' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_26\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input 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_13_26'>Relationship to Participant<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_26' id='input_13_26' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_24\" class=\"gfield gfield--type-text gfield--width-half viva-input viva-phone-digits 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_13_24'>Primary Phone Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input inputmode=\"numeric\" pattern=\"[0-9]*\" name='input_24' id='input_13_24' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_25\" class=\"gfield gfield--type-text gfield--width-half viva-input viva-phone-digits field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_25'>Alternative Phone Number<\/label><div class='ginput_container ginput_container_text'><input inputmode=\"numeric\" pattern=\"[0-9]*\" name='input_25' id='input_13_25' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_13_27' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_13_27' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_13_3' class='gform_page' data-js='page-field-id-27' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_13_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_13_28\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">5. How Did You Hear About Us?<\/h3><div class='gsection_description' id='gfield_description_13_28'>Please let us know how you learned about this event\/programme:<\/div><\/div><fieldset id=\"field_13_29\" 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' >How Did You Hear About Us?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_13_29'><div class='gchoice gchoice_13_29_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_29.1' type='checkbox'  value='VIVA Website \/ Newsletter'  id='choice_13_29_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_29_1' id='label_13_29_1' class='gform-field-label gform-field-label--type-inline'>VIVA Website \/ Newsletter<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_29_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_29.2' type='checkbox'  value='Social Media (Facebook, Instagram, LinkedIn, etc.)'  id='choice_13_29_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_29_2' id='label_13_29_2' class='gform-field-label gform-field-label--type-inline'>Social Media (Facebook, Instagram, LinkedIn, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_29_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_29.3' type='checkbox'  value='Word of Mouth \/ Friend or Family Referral'  id='choice_13_29_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_29_3' id='label_13_29_3' class='gform-field-label gform-field-label--type-inline'>Word of Mouth \/ Friend or Family Referral<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_29_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_29.4' type='checkbox'  value='Poster \/ Flyer'  id='choice_13_29_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_29_4' id='label_13_29_4' class='gform-field-label gform-field-label--type-inline'>Poster \/ Flyer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_29_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_29.5' type='checkbox'  value='Partner Organization \/ School \/ Community Center'  id='choice_13_29_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_29_5' id='label_13_29_5' class='gform-field-label gform-field-label--type-inline'>Partner Organization \/ School \/ Community Center<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_29_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_29.6' type='checkbox'  value='Other'  id='choice_13_29_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_29_6' id='label_13_29_6' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_30\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full viva-input 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_13_30'>Please specify how you heard about us<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_30' id='input_13_30' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_31\" class=\"gfield gfield--type-textarea gfield--input-type-textarea viva-input field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_31'>Additional Details<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_31' id='input_13_31' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_13_35\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">6. Dietary Requirements &amp; Allergies<\/h3><\/div><fieldset id=\"field_13_36\" 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' >Dietary Preferences<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_13_36'><div class='gchoice gchoice_13_36_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.1' type='checkbox'  value='No restrictions'  id='choice_13_36_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_36_1' id='label_13_36_1' class='gform-field-label gform-field-label--type-inline'>No restrictions<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_36_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.2' type='checkbox'  value='Vegetarian'  id='choice_13_36_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_36_2' id='label_13_36_2' class='gform-field-label gform-field-label--type-inline'>Vegetarian<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_36_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.3' type='checkbox'  value='Vegan'  id='choice_13_36_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_36_3' id='label_13_36_3' class='gform-field-label gform-field-label--type-inline'>Vegan<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_36_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.4' type='checkbox'  value='Halal'  id='choice_13_36_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_36_4' id='label_13_36_4' class='gform-field-label gform-field-label--type-inline'>Halal<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_36_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.5' type='checkbox'  value='Other'  id='choice_13_36_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_36_5' id='label_13_36_5' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_37\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full viva-input 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_13_37'>Please specify other dietary requirements<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_37' id='input_13_37' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_13_40' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_13_40' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_13_4' class='gform_page' data-js='page-field-id-40' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_13_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_13_41\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">7. Event Terms &amp; Participation Agreement<\/h3><\/div><div id=\"field_13_42\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p>By registering, I\/we understand that:<\/p><ol><li>Participation in VIVA Life Programme activities is voluntary.<\/li><li>Participants are responsible for informing event organizers of any medical, accessibility, or dietary requirements.<\/li><li>Event availability is on a first-come, first-served basis where capacity is limited.<\/li><li>VIVA reserves the right to modify, postpone, or cancel activities due to unforeseen circumstances.<\/li><\/ol><\/div><fieldset id=\"field_13_43\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio 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' >Do you agree to the terms above?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_43'>\n\t\t\t<div class='gchoice gchoice_13_43_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='Yes'  id='choice_13_43_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_43_0' id='label_13_43_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_43_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='No'  id='choice_13_43_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_43_1' id='label_13_43_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_44\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">8. Photo &amp; Media Consent<\/h3><\/div><div id=\"field_13_45\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p>During events, photographs or video footage may be captured for community updates, reports, or promotional materials.<\/p><\/div><fieldset id=\"field_13_46\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox 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' >Photo &amp; Media Consent<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_13_46'><div class='gchoice gchoice_13_46_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_46.1' type='checkbox'  value='I CONSENT to media capture and use on official websites, social media, and printed materials.'  id='choice_13_46_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_46_1' id='label_13_46_1' class='gform-field-label gform-field-label--type-inline'>I CONSENT to media capture and use on official websites, social media, and printed materials.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_13_47' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_13_47' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_13_5' class='gform_page' data-js='page-field-id-47' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_13_5' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_13_48\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">10. Declaration<\/h3><\/div><div id=\"field_13_49\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p>I confirm that the information provided in this form is accurate and complete.<\/p><\/div><fieldset id=\"field_13_50\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox 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' >Declaration<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_13_50'><div class='gchoice gchoice_13_50_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.1' type='checkbox'  value='Yes'  id='choice_13_50_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_50_1' id='label_13_50_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><\/div><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><input type='submit' id='gform_previous_button_13' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <button class='gform_button' id='gform_submit_button_13'>Submit Registration<\/button> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_13' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_13' id='gform_theme_13' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_13' id='gform_style_settings_13' value='' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_13' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='13' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_13' 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data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_10' >\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Education Programme Registration<\/h2>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_10' class='viva-form-wrp' action='\/viva\/wp-json\/wp\/v2\/pages\/4193' data-formid='10' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_10' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_10_1\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third viva-input field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_10_1'>Prefix<\/label><div class='ginput_container ginput_container_select'><select name='input_1' id='input_10_1' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select<\/option><option value='Dr.' >Dr.<\/option><option value='Prof' >Prof<\/option><option value='A\/Prof' >A\/Prof<\/option><option value='Mr.' >Mr.<\/option><option value='Mrs.' >Mrs.<\/option><option value='Ms' >Ms<\/option><\/select><\/div><\/div><div id=\"field_10_3\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third viva-input gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_10_3'>First Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_10_3' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_10_4\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third viva-input gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_10_4'>Last Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_10_4' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_10_5\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half viva-input gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_10_5'>Email Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_5' id='input_10_5' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_10_6\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half viva-input gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_10_6'>Country\/Region<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_6' id='input_10_6' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select your country\/region<\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cabo Verde' >Cabo Verde<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' >United Kingdom<\/option><option value='United States' >United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option><\/select><\/div><\/div><div id=\"field_10_7\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_10_7'>Organization<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_7' id='input_10_7' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_10_8\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_10_8'>Job Title<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_10_8' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_10_9\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do You Require a Certificate of Attendance?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_10_9'>Only for healthcare professionals present for at least 75% of the duration of the webinar.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_10_9'>\n\t\t\t<div class='gchoice gchoice_10_9_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Yes'  id='choice_10_9_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_10_9\"   \/>\n\t\t\t\t\t<label for='choice_10_9_0' id='label_10_9_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_10_9_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='No'  id='choice_10_9_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_10_9_1' id='label_10_9_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_10_10\" class=\"gfield gfield--type-text gfield--input-type-text viva-input field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_10_10'>Professional Registration Number<\/label><div class='gfield_description' id='gfield_description_10_10'>Applicable to Singapore healthcare professionals for accreditation purposes (CME\/CNE\/CPE), subject to approval.<\/div><div class='ginput_container ginput_container_text'><input name='input_10' id='input_10_10' type='text' value='' class='large'  aria-describedby=\"gfield_description_10_10\"    aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_10_11\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you a?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_10_11'>\n\t\t\t<div class='gchoice gchoice_10_11_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='Physician'  id='choice_10_11_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_10_11_0' id='label_10_11_0' class='gform-field-label gform-field-label--type-inline'>Physician<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_10_11_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='Pharmacist'  id='choice_10_11_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_10_11_1' id='label_10_11_1' class='gform-field-label gform-field-label--type-inline'>Pharmacist<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_10_11_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='Nurse'  id='choice_10_11_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_10_11_2' id='label_10_11_2' class='gform-field-label gform-field-label--type-inline'>Nurse<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_10_11_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='Researcher'  id='choice_10_11_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_10_11_3' id='label_10_11_3' class='gform-field-label gform-field-label--type-inline'>Researcher<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_10_11_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='Scientist'  id='choice_10_11_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_10_11_4' id='label_10_11_4' class='gform-field-label gform-field-label--type-inline'>Scientist<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_10_11_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='Surgeon'  id='choice_10_11_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_10_11_5' id='label_10_11_5' class='gform-field-label gform-field-label--type-inline'>Surgeon<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_10_11_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='Oncologist'  id='choice_10_11_6' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_10_11_6' id='label_10_11_6' class='gform-field-label gform-field-label--type-inline'>Oncologist<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_10_11_7'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='Other healthcare professional'  id='choice_10_11_7' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_10_11_7' id='label_10_11_7' class='gform-field-label gform-field-label--type-inline'>Other healthcare professional<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_10_12\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-two-thirds viva-input field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_10_12'>What are your sub-specialties?<\/label><div class='ginput_container ginput_container_text'><input name='input_12' id='input_10_12' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_10_16\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-third viva-practice-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you in private or public practice?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_10_16'>\n\t\t\t<div class='gchoice gchoice_10_16_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='Private'  id='choice_10_16_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_10_16_0' id='label_10_16_0' class='gform-field-label gform-field-label--type-inline'>Private<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_10_16_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='Public'  id='choice_10_16_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_10_16_1' id='label_10_16_1' class='gform-field-label gform-field-label--type-inline'>Public<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_10_13\" class=\"gfield gfield--type-text gfield--input-type-text viva-input field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_10_13'>Do you have another profession? What is it?<\/label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_10_13' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_10_15\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Age<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_10_15'>\n\t\t\t<div class='gchoice gchoice_10_15_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='21\u201334'  id='choice_10_15_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_10_15_0' id='label_10_15_0' class='gform-field-label gform-field-label--type-inline'>21\u201334<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_10_15_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='35\u201344'  id='choice_10_15_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_10_15_1' id='label_10_15_1' class='gform-field-label gform-field-label--type-inline'>35\u201344<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_10_15_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='45\u201354'  id='choice_10_15_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_10_15_2' id='label_10_15_2' class='gform-field-label gform-field-label--type-inline'>45\u201354<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_10_15_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='55\u201364'  id='choice_10_15_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_10_15_3' id='label_10_15_3' class='gform-field-label gform-field-label--type-inline'>55\u201364<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_10_15_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='65 and above'  id='choice_10_15_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_10_15_4' id='label_10_15_4' class='gform-field-label gform-field-label--type-inline'>65 and above<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_10_17\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Would you like to join VIVA&#039;s Mailing List?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_10_17'>\n\t\t\t<div class='gchoice gchoice_10_17_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='Yes'  id='choice_10_17_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_10_17_0' id='label_10_17_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_10_17_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='No'  id='choice_10_17_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_10_17_1' id='label_10_17_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_10_18\" class=\"gfield gfield--type-textarea gfield--input-type-textarea viva-input field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_10_18'>Questions &amp; Comments<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_18' id='input_10_18' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <button class='gform_button' id='gform_submit_button_10'>Submit<\/button> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_10' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_10' id='gform_theme_10' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_10' id='gform_style_settings_10' value='' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_10' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='10' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_10' 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} );} );\n<\/script>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div id=\"e-n-tab-content-825193483\" role=\"tabpanel\" aria-labelledby=\"e-n-tab-title-825193483\" data-tab-index=\"3\" style=\"--n-tabs-title-order: 3;\" class=\" elementor-element elementor-element-2a6de88 e-con-full e-flex e-con e-child\" data-id=\"2a6de88\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4303006 elementor-widget elementor-widget-wp-widget-gform_widget\" data-id=\"4303006\" data-element_type=\"widget\" data-widget_type=\"wp-widget-gform_widget.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h5>Patient and survivors<\/h5>\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework viva-form-wrp_wrapper' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_11' style='display:none'><div id='gf_11' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data'  id='gform_11' class='viva-form-wrp' action='\/viva\/wp-json\/wp\/v2\/pages\/4193#gf_11' data-formid='11' novalidate>\n        <div id='gf_progressbar_wrapper_11' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<p class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>5<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_20' style='width:20%;'><span>20%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_11_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_11' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_11_3\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p>Thank you for your interest in participating in the VIVA Life Programme.<\/p>\n\n<p>The VIVA Life Programme organises activities, events, and bonding opportunities for children and young people affected by cancer, including patients and survivors. These activities provide opportunities for friendship, confidence-building, enjoyment, and meaningful experiences beyond treatment.<\/p>\n\n<p>Please complete this form to register your interest in participating in VIVA Life Programme activities and events.<\/p><\/div><div id=\"field_11_4\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">1. Participant Information<\/h3><\/div><div id=\"field_11_5\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input 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_11_5'>Full Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_11_5' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_6\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_6'>Preferred Name<\/label><div class='ginput_container ginput_container_text'><input name='input_6' id='input_11_6' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_7\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-third viva-input 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_11_7'>Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_7' id='input_11_7' type='text' value='' class='datepicker gform-datepicker dmy datepicker_with_icon gdatepicker_with_icon'   placeholder='dd\/mm\/yyyy' aria-describedby=\"input_11_7_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_11_7_date_format' class='screen-reader-text'>DD slash MM slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_11_7' class='gform_hidden' value='https:\/\/p15.projs.ifdemo.com\/viva\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_11_8\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third viva-input 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_11_8'>Age<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_8' id='input_11_8' type='number' step='any' min='0' max='100' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_instruction_11_8\" \/><div class='gfield_description instruction ' id='gfield_instruction_11_8'>Please enter a number from <strong>0<\/strong> to <strong>100<\/strong>.<\/div><\/div><\/div><fieldset id=\"field_11_9\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-third 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' >Gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_11_9'>\n\t\t\t<div class='gchoice gchoice_11_9_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Male'  id='choice_11_9_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_9_0' id='label_11_9_0' class='gform-field-label gform-field-label--type-inline'>Male<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_9_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Female'  id='choice_11_9_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_9_1' id='label_11_9_1' class='gform-field-label gform-field-label--type-inline'>Female<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_9_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Prefer not to say'  id='choice_11_9_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_9_2' id='label_11_9_2' class='gform-field-label gform-field-label--type-inline'>Prefer not to say<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_9_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Other'  id='choice_11_9_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_9_3' id='label_11_9_3' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_11_10\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full viva-input 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_11_10'>Please specify your gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_11_10' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_11\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">2. Number of Attendees<\/h3><\/div><div id=\"field_11_12\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p>Please indicate the total number of people attending the event.<\/p><\/div><div id=\"field_11_14\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third viva-input 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_11_14'>Number of Children<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_14' id='input_11_14' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='0' >0<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><\/select><\/div><\/div><div id=\"field_11_13\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third viva-input 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_11_13'>Number of Adults<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_13' id='input_11_13' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='0' >0<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><\/select><\/div><\/div><div id=\"field_11_15\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third viva-input gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_15'>Total Number Attending<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_15' id='input_11_15' type='number' step='any' min='1'  value='' class='large'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_instruction_11_15 gfield_description_11_15\" \/><div class='gfield_description instruction ' id='gfield_instruction_11_15'>Please enter a number greater than or equal to <strong>1<\/strong>.<\/div><\/div><div class='gfield_description' id='gfield_description_11_15'>Please enter the total of children and adults listed above.<\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_11_1' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_11_2' class='gform_page' data-js='page-field-id-1' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_11_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_11_16\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">3. Parent \/ Guardian Information<\/h3><div class='gsection_description' id='gfield_description_11_16'>To be completed by the parent\/guardian.<\/div><\/div><div id=\"field_11_17\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input 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_11_17'>Parent \/ Guardian Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_17' id='input_11_17' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_18\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input 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_11_18'>Relationship to Participant<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_18' id='input_11_18' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_20\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half viva-input 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_11_20'>Email Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_20' id='input_11_20' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_11_19\" class=\"gfield gfield--type-text gfield--width-half viva-input viva-phone-digits field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_19'>Contact Number<\/label><div class='ginput_container ginput_container_text'><input inputmode=\"numeric\" pattern=\"[0-9]*\" name='input_19' id='input_11_19' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_21\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">4. Emergency Contact<\/h3><\/div><div id=\"field_11_22\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input 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_11_22'>Emergency Contact Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_22' id='input_11_22' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_26\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half viva-input 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_11_26'>Relationship to Participant<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_26' id='input_11_26' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_24\" class=\"gfield gfield--type-text gfield--width-half viva-input viva-phone-digits 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_11_24'>Emergency Contact Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input inputmode=\"numeric\" pattern=\"[0-9]*\" name='input_24' id='input_11_24' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_25\" class=\"gfield gfield--type-text gfield--width-half viva-input viva-phone-digits field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_25'>Alternative Emergency Contact Number<\/label><div class='ginput_container ginput_container_text'><input inputmode=\"numeric\" pattern=\"[0-9]*\" name='input_25' id='input_11_25' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_11_27' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_11_27' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_11_3' class='gform_page' data-js='page-field-id-27' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_11_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_11_28\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">5. Participant\u2019s Cancer Journey<\/h3><\/div><fieldset id=\"field_11_29\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-five-twelfths 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' >Current Status<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_11_29'>\n\t\t\t<div class='gchoice gchoice_11_29_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='Currently undergoing treatment'  id='choice_11_29_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_29_0' id='label_11_29_0' class='gform-field-label gform-field-label--type-inline'>Currently undergoing treatment<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_29_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='In remission'  id='choice_11_29_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_29_1' id='label_11_29_1' class='gform-field-label gform-field-label--type-inline'>In remission<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_29_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='Completed treatment'  id='choice_11_29_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_29_2' id='label_11_29_2' class='gform-field-label gform-field-label--type-inline'>Completed treatment<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_29_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='Long-term survivor'  id='choice_11_29_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_29_3' id='label_11_29_3' class='gform-field-label gform-field-label--type-inline'>Long-term survivor<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_29_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='Other'  id='choice_11_29_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_29_4' id='label_11_29_4' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div data-fieldId=\"29\" class=\"spacer gfield\" style=\"grid-column: span 8;\" data-groupId=\"71a5c86c\"><\/div><div id=\"field_11_30\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-seven-twelfths viva-input field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_30'>Please specify the participant&#039;s current status<\/label><div class='ginput_container ginput_container_text'><input name='input_30' id='input_11_30' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_31\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">6. Accessibility &amp; Support<\/h3><\/div><fieldset id=\"field_11_32\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-third 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' >Assistance Required<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_11_32'><div class='gchoice gchoice_11_32_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.1' type='checkbox'  value='No additional assistance required'  id='choice_11_32_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_32_1' id='label_11_32_1' class='gform-field-label gform-field-label--type-inline'>No additional assistance required<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_32_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.2' type='checkbox'  value='Mobility assistance'  id='choice_11_32_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_32_2' id='label_11_32_2' class='gform-field-label gform-field-label--type-inline'>Mobility assistance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_32_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.3' type='checkbox'  value='Dietary assistance'  id='choice_11_32_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_32_3' id='label_11_32_3' class='gform-field-label gform-field-label--type-inline'>Dietary assistance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_32_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.4' type='checkbox'  value='Transportation assistance'  id='choice_11_32_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_32_4' id='label_11_32_4' class='gform-field-label gform-field-label--type-inline'>Transportation assistance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_32_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.5' type='checkbox'  value='Assistance with communication'  id='choice_11_32_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_32_5' id='label_11_32_5' class='gform-field-label gform-field-label--type-inline'>Assistance with communication<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_32_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.6' type='checkbox'  value='Assistance with activities'  id='choice_11_32_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_32_6' id='label_11_32_6' class='gform-field-label gform-field-label--type-inline'>Assistance with activities<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_32_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.7' type='checkbox'  value='Other'  id='choice_11_32_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_32_7' id='label_11_32_7' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_11_34\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-two-thirds viva-input field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_34'>Please specify other assistance required<\/label><div class='ginput_container ginput_container_text'><input name='input_34' id='input_11_34' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_33\" class=\"gfield gfield--type-textarea gfield--input-type-textarea viva-input field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_33'>Please provide any additional information that may help our team support the participant<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_33' id='input_11_33' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_11_35\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">7. Dietary Requirements &amp; Allergies<\/h3><\/div><fieldset id=\"field_11_36\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-quarter 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' >Dietary Requirements<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_11_36'><div class='gchoice gchoice_11_36_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.1' type='checkbox'  value='No restrictions'  id='choice_11_36_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_36_1' id='label_11_36_1' class='gform-field-label gform-field-label--type-inline'>No restrictions<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_36_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.2' type='checkbox'  value='Vegetarian'  id='choice_11_36_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_36_2' id='label_11_36_2' class='gform-field-label gform-field-label--type-inline'>Vegetarian<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_36_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.3' type='checkbox'  value='Halal'  id='choice_11_36_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_36_3' id='label_11_36_3' class='gform-field-label gform-field-label--type-inline'>Halal<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_36_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.4' type='checkbox'  value='Other'  id='choice_11_36_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_36_4' id='label_11_36_4' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_11_37\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-three-quarter viva-input field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_37'>Please specify other dietary requirements<\/label><div class='ginput_container ginput_container_text'><input name='input_37' id='input_11_37' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_11_38\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Food Allergies \/ Intolerances<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_11_38'>\n\t\t\t<div class='gchoice gchoice_11_38_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='None'  id='choice_11_38_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_38_0' id='label_11_38_0' class='gform-field-label gform-field-label--type-inline'>None<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_38_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='Yes'  id='choice_11_38_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_38_1' id='label_11_38_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_11_52\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-two-thirds viva-input 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_11_52'>Please specify food allergies or intolerances<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_52' id='input_11_52' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_11_51\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full viva-input field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_51'>Other Allergies or Environmental Sensitivities<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_51' id='input_11_51' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_11_40' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_11_40' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_11_4' class='gform_page' data-js='page-field-id-40' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_11_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_11_41\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">8. Consent &amp; Participation<\/h3><\/div><div id=\"field_11_42\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p>I\/We understand that:<\/p>\n<ul>\n  <li>Participation in VIVA Life Programme activities is voluntary.<\/li>\n  <li>VIVA will make reasonable efforts to ensure that activities are conducted in a safe and appropriate manner.<\/li>\n  <li>Participants and\/or their parent\/guardian are responsible for informing VIVA of any relevant medical, physical, dietary, or accessibility requirements.<\/li>\n  <li>VIVA may contact the participant or parent\/guardian regarding upcoming activities and events.<\/li>\n  <li>Participation in an activity may be subject to availability, suitability, and any applicable safety requirements.<\/li>\n  <li>VIVA reserves the right to modify, postpone, or cancel activities where necessary.<\/li>\n<\/ul><\/div><fieldset id=\"field_11_43\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio 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' >I\/We have read and understood the above information and agree to the terms of participation<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_11_43'>\n\t\t\t<div class='gchoice gchoice_11_43_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='Yes'  id='choice_11_43_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_43_0' id='label_11_43_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_43_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='No'  id='choice_11_43_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_43_1' id='label_11_43_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_11_44\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">9. Photo &amp; Video Consent<\/h3><\/div><div id=\"field_11_45\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p>During VIVA activities and events, photographs and\/or videos may be taken for documentation, programme reporting, fundraising, or communication purposes.<\/p><\/div><fieldset id=\"field_11_46\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio 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' >Please indicate your preference:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_11_46'>\n\t\t\t<div class='gchoice gchoice_11_46_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='We consent to photographs\/videos of the participant being taken and used by VIVA for programme-related purposes, including VIVA&#039;s website, social media, publications, and reports.'  id='choice_11_46_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_46_0' id='label_11_46_0' class='gform-field-label gform-field-label--type-inline'><strong>We consent<\/strong> to photographs\/videos of the participant being taken and used by VIVA for programme-related purposes, including VIVA's website, social media, publications, and reports.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_46_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='We do not consent to photographs\/videos of the participant being used for these purposes.'  id='choice_11_46_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_46_1' id='label_11_46_1' class='gform-field-label gform-field-label--type-inline'><strong>We do not consent<\/strong> to photographs\/videos of the participant being used for these purposes.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_11_47' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_11_47' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_11_5' class='gform_page' data-js='page-field-id-47' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_11_5' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_11_48\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">10. Declaration<\/h3><\/div><div id=\"field_11_49\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p>I\/We confirm that the information provided in this registration form is accurate and complete to the best of my\/our knowledge.<\/p>\n\n<p>I\/We understand that I\/we should inform VIVA if there are any changes to the participant's medical, physical, dietary, or other relevant circumstances that may affect participation in VIVA Life Programme activities.<\/p><\/div><fieldset id=\"field_11_50\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio 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' >Is the information provided accurate and complete?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_11_50'>\n\t\t\t<div class='gchoice gchoice_11_50_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='Yes'  id='choice_11_50_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_50_0' id='label_11_50_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_50_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='No'  id='choice_11_50_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_50_1' id='label_11_50_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div><\/div>\n        <div class='gform-page-footer 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