input {width:100%;font-size:22px;} #_form_5_submit {color:#fff;font-weight:bold;background:#0ff;padding:25px 55px;width:100%;font-size:22px;}
#_form_5_ { font-size:14px; line-height:1.6; font-family:arial, helvetica, sans-serif; margin:0; } #_form_5_ * { outline:0; } ._form_hide { display:none; visibility:hidden; } ._form_show { display:block; visibility:visible; } #_form_5_._form-top { top:0; } #_form_5_._form-bottom { bottom:0; } #_form_5_._form-left { left:0; } #_form_5_._form-right { right:0; } #_form_5_ input[type="text"],#_form_5_ input[type="date"],#_form_5_ textarea { padding:6px; height:auto; border:#979797 1px solid; border-radius:4px; color:#000 !important; font-size:14px; -webkit-box-sizing:border-box; -moz-box-sizing:border-box; box-sizing:border-box; } #_form_5_ textarea { resize:none; } #_form_5_ ._submit { -webkit-appearance:none; cursor:pointer; font-family:arial, sans-serif; font-size:14px; text-align:center; background:#333 !important; border:0 !important; -moz-border-radius:4px !important; -webkit-border-radius:4px !important; border-radius:4px !important; color:#fff !important; padding:10px !important; } #_form_5_ ._close-icon { cursor:pointer; background-image:url('https://d226aj4ao1t61q.cloudfront.net/esfkyjh1u_forms-close-dark.png'); background-repeat:no-repeat; background-size:14.2px 14.2px; position:absolute; display:block; top:11px; right:9px; overflow:hidden; width:16.2px; height:16.2px; } #_form_5_ ._close-icon:before { position:relative; } #_form_5_ ._form-body { margin-bottom:30px; } #_form_5_ ._form-image-left { width:150px; float:left; } #_form_5_ ._form-content-right { margin-left:164px; } #_form_5_ ._form-branding { color:#fff; font-size:10px; clear:both; text-align:left; margin-top:30px; font-weight:100; } #_form_5_ ._form-branding ._logo { display:block; width:130px; height:14px; margin-top:6px; background-image:url('https://d226aj4ao1t61q.cloudfront.net/hh9ujqgv5_aclogo_li.png'); background-size:130px auto; background-repeat:no-repeat; } #_form_5_ ._form-label,#_form_5_ ._form_element ._form-label { font-weight:bold; margin-bottom:5px; display:block; } #_form_5_._dark ._form-branding { color:#333; } #_form_5_._dark ._form-branding ._logo { background-image:url('https://d226aj4ao1t61q.cloudfront.net/jftq2c8s_aclogo_dk.png'); } #_form_5_ ._form_element { position:relative; margin-bottom:10px; font-size:0; max-width:100%; } #_form_5_ ._form_element * { font-size:14px; } #_form_5_ ._form_element._clear { clear:both; width:100%; float:none; } #_form_5_ ._form_element._clear:after { clear:left; } #_form_5_ ._form_element input[type="text"],#_form_5_ ._form_element input[type="date"],#_form_5_ ._form_element select,#_form_5_ ._form_element textarea:not(.g-recaptcha-response) { display:block; width:100%; -webkit-box-sizing:border-box; -moz-box-sizing:border-box; box-sizing:border-box; } #_form_5_ ._field-wrapper { position:relative; } #_form_5_ ._inline-style { float:left; } #_form_5_ ._inline-style input[type="text"] { width:150px; } #_form_5_ ._inline-style:not(._clear) + ._inline-style:not(._clear) { margin-left:20px; } #_form_5_ ._form_element img._form-image { max-width:100%; } #_form_5_ ._clear-element { clear:left; } #_form_5_ ._full_width { width:100%; } #_form_5_ ._form_full_field { display:block; width:100%; margin-bottom:10px; } #_form_5_ input[type="text"]._has_error,#_form_5_ textarea._has_error { border:#f37c7b 1px solid; } #_form_5_ input[type="checkbox"]._has_error { outline:#f37c7b 1px solid; } #_form_5_ ._error { display:block; position:absolute; font-size:14px; z-index:10000001; } #_form_5_ ._error._above { padding-bottom:4px; bottom:39px; right:0; } #_form_5_ ._error._below { padding-top:4px; top:100%; right:0; } #_form_5_ ._error._above ._error-arrow { bottom:0; right:15px; border-left:5px solid transparent; border-right:5px solid transparent; border-top:5px solid #f37c7b; } #_form_5_ ._error._below ._error-arrow { top:0; right:15px; border-left:5px solid transparent; border-right:5px solid transparent; border-bottom:5px solid #f37c7b; } #_form_5_ ._error-inner { padding:8px 12px; background-color:#f37c7b; font-size:14px; font-family:arial, sans-serif; color:#fff; text-align:center; text-decoration:none; -webkit-border-radius:4px; -moz-border-radius:4px; border-radius:4px; } #_form_5_ ._error-inner._form_error { margin-bottom:5px; text-align:left; } #_form_5_ ._button-wrapper ._error-inner._form_error { position:static; } #_form_5_ ._error-inner._no_arrow { margin-bottom:10px; } #_form_5_ ._error-arrow { position:absolute; width:0; height:0; } #_form_5_ ._error-html { margin-bottom:10px; } .pika-single { z-index:10000001 !important; } #_form_5_ input[type="text"].datetime_date { width:69%; display:inline; } #_form_5_ select.datetime_time { width:29%; display:inline; height:32px; } @media all and (min-width:320px) and (max-width:667px) { ::-webkit-scrollbar { display:none; } #_form_5_ { margin:0; width:100%; min-width:100%; max-width:100%; box-sizing:border-box; } #_form_5_ * { -webkit-box-sizing:border-box; -moz-box-sizing:border-box; box-sizing:border-box; font-size:1em; } #_form_5_ ._form-content { margin:0; width:100%; } #_form_5_ ._form-inner { display:block; min-width:100%; } #_form_5_ ._form-title,#_form_5_ ._inline-style { margin-top:0; margin-right:0; margin-left:0; } #_form_5_ ._form-title { font-size:1.2em; } #_form_5_ ._form_element { margin:0 0 20px; padding:0; width:100%; } #_form_5_ ._form-element,#_form_5_ ._inline-style,#_form_5_ input[type="text"],#_form_5_ label,#_form_5_ p,#_form_5_ textarea:not(.g-recaptcha-response) { float:none; display:block; width:100%; } #_form_5_ ._row._checkbox-radio label { display:inline; } #_form_5_ ._row,#_form_5_ p,#_form_5_ label { margin-bottom:0.7em; width:100%; } #_form_5_ ._row input[type="checkbox"],#_form_5_ ._row input[type="radio"] { margin:0 !important; vertical-align:middle !important; } #_form_5_ ._row input[type="checkbox"] + span label { display:inline; } #_form_5_ ._row span label { margin:0 !important; width:initial !important; vertical-align:middle !important; } #_form_5_ ._form-image { max-width:100%; height:auto !important; } #_form_5_ input[type="text"] { padding-left:10px; padding-right:10px; font-size:16px; line-height:1.3em; -webkit-appearance:none; } #_form_5_ input[type="radio"],#_form_5_ input[type="checkbox"] { display:inline-block; width:1.3em; height:1.3em; font-size:1em; margin:0 0.3em 0 0; vertical-align:baseline; } #_form_5_ button[type="submit"] { padding:20px; font-size:1.5em; } #_form_5_ ._inline-style { margin:20px 0 0 !important; } } #_form_5_ { position:relative; text-align:left; margin:25px auto 0; padding:20px; -webkit-box-sizing:border-box; -moz-box-sizing:border-box; box-sizing:border-box; *zoom:1; background:#fff !important; border:0px solid #b0b0b0 !important; width:500px; -moz-border-radius:0px !important; -webkit-border-radius:0px !important; border-radius:0px !important; color:#000 !important; } #_form_5_ ._form-title { font-size:22px; line-height:22px; font-weight:600; margin-bottom:0; } #_form_5_:before,#_form_5_:after { content:" "; display:table; } #_form_5_:after { clear:both; } #_form_5_._inline-style { width:auto; display:inline-block; } #_form_5_._inline-style input[type="text"],#_form_5_._inline-style input[type="date"] { padding:10px 12px; } #_form_5_._inline-style button._inline-style { position:relative; top:27px; } #_form_5_._inline-style p { margin:0; } #_form_5_._inline-style ._button-wrapper { position:relative; margin:27px 12.5px 0 20px; } #_form_5_ ._form-thank-you { position:relative; left:0; right:0; text-align:center; font-size:18px; } @media all and (min-width:320px) and (max-width:667px) { #_form_5_._inline-form._inline-style ._inline-style._button-wrapper { margin-top:20px !important; margin-left:0 !important; } }
window.cfields = []; window._show_thank_you = function(id, message, trackcmp_url) { var form = document.getElementById('_form_' + id + '_'), thank_you = form.querySelector('._form-thank-you'); form.querySelector('._form-content').style.display = 'none'; thank_you.innerHTML = message; thank_you.style.display = 'block'; if (typeof(trackcmp_url) != 'undefined' && trackcmp_url) { // Site tracking URL to use after inline form submission. _load_script(trackcmp_url); } if (typeof window._form_callback !== 'undefined') window._form_callback(id); }; window._show_error = function(id, message, html) { var form = document.getElementById('_form_' + id + '_'), err = document.createElement('div'), button = form.querySelector('button'), old_error = form.querySelector('._form_error'); if (old_error) old_error.parentNode.removeChild(old_error); err.innerHTML = message; err.className = '_error-inner _form_error _no_arrow'; var wrapper = document.createElement('div'); wrapper.className = '_form-inner'; wrapper.appendChild(err); button.parentNode.insertBefore(wrapper, button); document.querySelector('[id^="_form"][id$="_submit"]').disabled = false; if (html) { var div = document.createElement('div'); div.className = '_error-html'; div.innerHTML = html; err.appendChild(div); } }; window._load_script = function(url, callback) { var head = document.querySelector('head'), script = document.createElement('script'), r = false; script.type = 'text/javascript'; script.charset = 'utf-8'; script.src = url; if (callback) { script.onload = script.onreadystatechange = function() { if (!r && (!this.readyState || this.readyState == 'complete')) { r = true; callback(); } }; } head.appendChild(script); }; (function() { if (window.location.search.search("excludeform") !== -1) return false; var getCookie = function(name) { var match = document.cookie.match(new RegExp('(^|; )' + name + '=([^;]+)')); return match ? match[2] : null; } var setCookie = function(name, value) { var now = new Date(); var time = now.getTime(); var expireTime = time + 1000 * 60 * 60 * 24 * 365; now.setTime(expireTime); document.cookie = name + '=' + value + '; expires=' + now + ';path=/'; } var addEvent = function(element, event, func) { if (element.addEventListener) { element.addEventListener(event, func); } else { var oldFunc = element['on' + event]; element['on' + event] = function() { oldFunc.apply(this, arguments); func.apply(this, arguments); }; } } var _removed = false; var form_to_submit = document.getElementById('_form_5_'); var allInputs = form_to_submit.querySelectorAll('input, select, textarea'), tooltips = [], submitted = false;
var getUrlParam = function(name) { var regexStr = '[?&]' + name + '=([^&#]*)'; var results = new RegExp(regexStr, 'i').exec(window.location.href); return results != undefined ? decodeURIComponent(results[1]) : false; };
for (var i = 0; i < allInputs.length; i++) {
var regexStr = "field[(d+)]";
var results = new RegExp(regexStr).exec(allInputs[i].name);
if (results != undefined) {
allInputs[i].dataset.name = window.cfields[results[1]];
} else {
allInputs[i].dataset.name = allInputs[i].name;
}
var fieldVal = getUrlParam(allInputs[i].dataset.name);
if (fieldVal) {
if (allInputs[i].dataset.autofill === "false") {
continue;
}
if (allInputs[i].type == "radio" || allInputs[i].type == "checkbox") {
if (allInputs[i].value == fieldVal) {
allInputs[i].checked = true;
}
} else {
allInputs[i].value = fieldVal;
}
}
}
var remove_tooltips = function() {
for (var i = 0; i < tooltips.length; i++) {
tooltips[i].tip.parentNode.removeChild(tooltips[i].tip);
}
tooltips = [];
};
var remove_tooltip = function(elem) {
for (var i = 0; i < tooltips.length; i++) {
if (tooltips[i].elem === elem) {
tooltips[i].tip.parentNode.removeChild(tooltips[i].tip);
tooltips.splice(i, 1);
return;
}
}
};
var create_tooltip = function(elem, text) {
var tooltip = document.createElement('div'), arrow = document.createElement('div'), inner = document.createElement('div'), new_tooltip = {};
if (elem.type != 'radio' && elem.type != 'checkbox') {
tooltip.className = '_error';
arrow.className = '_error-arrow';
inner.className = '_error-inner';
inner.innerHTML = text;
tooltip.appendChild(arrow);
tooltip.appendChild(inner);
elem.parentNode.appendChild(tooltip);
} else {
tooltip.className = '_error-inner _no_arrow';
tooltip.innerHTML = text;
elem.parentNode.insertBefore(tooltip, elem);
new_tooltip.no_arrow = true;
}
new_tooltip.tip = tooltip;
new_tooltip.elem = elem;
tooltips.push(new_tooltip);
return new_tooltip;
};
var resize_tooltip = function(tooltip) {
var rect = tooltip.elem.getBoundingClientRect();
var doc = document.documentElement, scrollPosition = rect.top - ((window.pageYOffset || doc.scrollTop) - (doc.clientTop || 0));
if (scrollPosition < 40) {
tooltip.tip.className = tooltip.tip.className.replace(/ ?(_above|_below) ?/g, '') + ' _below';
} else {
tooltip.tip.className = tooltip.tip.className.replace(/ ?(_above|_below) ?/g, '') + ' _above';
}
};
var resize_tooltips = function() {
if (_removed) return;
for (var i = 0; i < tooltips.length; i++) {
if (!tooltips[i].no_arrow) resize_tooltip(tooltips[i]);
}
};
var validate_field = function(elem, remove) {
var tooltip = null, value = elem.value, no_error = true;
remove ? remove_tooltip(elem) : false;
if (elem.type != 'checkbox') elem.className = elem.className.replace(/ ?_has_error ?/g, '');
if (elem.getAttribute('required') !== null) {
if (elem.type == 'radio' || (elem.type == 'checkbox' && /any/.test(elem.className))) {
var elems = form_to_submit.elements[elem.name];
if (!(elems instanceof NodeList || elems instanceof HTMLCollection) || elems.length <= 1) {
no_error = elem.checked;
}
else {
no_error = false;
for (var i = 0; i < elems.length; i++) {
if (elems[i].checked) no_error = true;
}
}
if (!no_error) {
tooltip = create_tooltip(elem, "Please select an option.");
}
} else if (elem.type =='checkbox') {
var elems = form_to_submit.elements[elem.name], found = false, err = [];
no_error = true;
for (var i = 0; i < elems.length; i++) {
if (elems[i].getAttribute('required') === null) continue;
if (!found && elems[i] !== elem) return true;
found = true;
elems[i].className = elems[i].className.replace(/ ?_has_error ?/g, '');
if (!elems[i].checked) {
no_error = false;
elems[i].className = elems[i].className + ' _has_error';
err.push("Checking %s is required".replace("%s", elems[i].value));
}
}
if (!no_error) {
tooltip = create_tooltip(elem, err.join('
'));
}
} else if (elem.tagName == 'SELECT') {
var selected = true;
if (elem.multiple) {
selected = false;
for (var i = 0; i < elem.options.length; i++) {
if (elem.options[i].selected) {
selected = true;
break;
}
}
} else {
for (var i = 0; i < elem.options.length; i++) {
if (elem.options[i].selected && !elem.options[i].value) {
selected = false;
}
}
}
if (!selected) {
elem.className = elem.className + ' _has_error';
no_error = false;
tooltip = create_tooltip(elem, "Please select an option.");
}
} else if (value === undefined || value === null || value === '') {
elem.className = elem.className + ' _has_error';
no_error = false;
tooltip = create_tooltip(elem, "This field is required.");
}
}
if (no_error && elem.name == 'email') {
if (!value.match(/^[+_a-z0-9-'&=]+(.[+_a-z0-9-']+)*@[a-z0-9-]+(.[a-z0-9-]+)*(.[a-z]{2,})$/i)) {
elem.className = elem.className + ' _has_error';
no_error = false;
tooltip = create_tooltip(elem, "Enter a valid email address.");
}
}
if (no_error && /date_field/.test(elem.className)) {
if (!value.match(/^dddd-dd-dd$/)) {
elem.className = elem.className + ' _has_error';
no_error = false;
tooltip = create_tooltip(elem, "Enter a valid date.");
}
}
tooltip ? resize_tooltip(tooltip) : false;
return no_error;
};
var needs_validate = function(el) {
if(el.getAttribute('required') !== null){
return true
}
if(el.name === 'email' && el.value !== ""){
return true
}
return false
};
var validate_form = function(e) {
var err = form_to_submit.querySelector('._form_error'), no_error = true;
if (!submitted) {
submitted = true;
for (var i = 0, len = allInputs.length; i < len; i++) {
var input = allInputs[i];
if (needs_validate(input)) {
if (input.type == 'text') {
addEvent(input, 'blur', function() {
this.value = this.value.trim();
validate_field(this, true);
});
addEvent(input, 'input', function() {
validate_field(this, true);
});
} else if (input.type == 'radio' || input.type == 'checkbox') {
(function(el) {
var radios = form_to_submit.elements[el.name];
for (var i = 0; i < radios.length; i++) {
addEvent(radios[i], 'click', function() {
validate_field(el, true);
});
}
})(input);
} else if (input.tagName == 'SELECT') {
addEvent(input, 'change', function() {
validate_field(this, true);
});
} else if (input.type == 'textarea'){
addEvent(input, 'input', function() {
validate_field(this, true);
});
}
}
}
}
remove_tooltips();
for (var i = 0, len = allInputs.length; i < len; i++) {
var elem = allInputs[i];
if (needs_validate(elem)) {
if (elem.tagName.toLowerCase() !== "select") {
elem.value = elem.value.trim();
}
validate_field(elem) ? true : no_error = false;
}
}
if (!no_error && e) {
e.preventDefault();
}
resize_tooltips();
return no_error;
};
addEvent(window, 'resize', resize_tooltips);
addEvent(window, 'scroll', resize_tooltips);
window['recaptcha_callback'] = function() {
// Get all recaptchas in the DOM (there may be more than one form on the page).
var recaptchas = document.getElementsByClassName("g-recaptcha");
for (var i in recaptchas) {
// Set the recaptcha element ID, so the recaptcha can be applied to each element.
var recaptcha_id = "recaptcha_" + i;
recaptchas[i].id = recaptcha_id;
var el = document.getElementById(recaptcha_id);
if (el != null) {
var sitekey = el.getAttribute("data-sitekey");
var stoken = el.getAttribute("data-stoken");
grecaptcha.render(recaptcha_id, {"sitekey":sitekey,"stoken":stoken});
}
}
}; _load_script("//www.google.com/recaptcha/api.js?onload=recaptcha_callback&render=explicit");
window._old_serialize = null;
if (typeof serialize !== 'undefined') window._old_serialize = window.serialize;
_load_script("//d3rxaij56vjege.cloudfront.net/form-serialize/0.3/serialize.min.js", function() {
window._form_serialize = window.serialize;
if (window._old_serialize) window.serialize = window._old_serialize;
});
var form_submit = function(e) {
e.preventDefault();
if (validate_form()) {
// use this trick to get the submit button & disable it using plain javascript
document.querySelector('#_form_5_submit').disabled = true;
var serialized = _form_serialize(document.getElementById('_form_5_'));
var err = form_to_submit.querySelector('._form_error');
err ? err.parentNode.removeChild(err) : false;
_load_script('https://macayamiracle59140.activehosted.com/proc.php?' + serialized + '&jsonp=true');
}
return false;
};
addEvent(form_to_submit, 'submit', form_submit);
})();
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