<form style="padding: 15px; font-weight:bold!important; font-size:16px!important;" method="POST" action="https://bloomanity226.activehosted.com/proc.php" id="_form_5_" class="_form _form_5 _inline-form _dark" novalidate><!-- [et_pb_line_break_holder] --> <input type="hidden" name="u" value="5" /><!-- [et_pb_line_break_holder] --> <input type="hidden" name="f" value="5" /><!-- [et_pb_line_break_holder] --> <input type="hidden" name="s" /><!-- [et_pb_line_break_holder] --> <input type="hidden" name="c" value="0" /><!-- [et_pb_line_break_holder] --> <input type="hidden" name="m" value="0" /><!-- [et_pb_line_break_holder] --> <input type="hidden" name="act" value="sub" /><!-- [et_pb_line_break_holder] --> <input type="hidden" name="v" value="2" /><!-- [et_pb_line_break_holder] --> <!-- [et_pb_line_break_holder] --> <div class="_form-content"><!-- [et_pb_line_break_holder] --> <div class="_form_element _x44899116 _full_width " ><!-- [et_pb_line_break_holder] --> <div class="_field-wrapper"><!-- [et_pb_line_break_holder] --> <input style="margin-top: 0px; border: 0; padding: 10px; width: 100%; font-size:14px; font-weight:bold; -webkit-appearance: none; -moz-appearance: none; appearance: none; border-radius: 0;" type="text" name="firstname" placeholder="Prenume" /><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> <!-- [et_pb_line_break_holder] --> <div class="_form_element _x29351127 _full_width " ><!-- [et_pb_line_break_holder] --> <div class="_field-wrapper"><!-- [et_pb_line_break_holder] --> <input style="margin-top: 10px; border: 0; padding: 10px; width: 100%; font-size:14px; font-weight:bold; -webkit-appearance: none; -moz-appearance: none; appearance: none; border-radius: 0;" type="text" name="email" placeholder="Adresa de e-mail" required/><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> <!-- [et_pb_line_break_holder] --> <div class="_form_element _field6 _full_width " ><!-- [et_pb_line_break_holder] --> <div class="_field-wrapper"><!-- [et_pb_line_break_holder] --> <select name="field[6]" style="font-size:14px; font-weight:bold; width: 100%; display:block; margin:0 auto; margin-top: 10px; border: 0; padding: 10px; box-shadow: 0px 0px 0px !important; background-color: rgb(255, 255, 255)!important; -webkit-appearance: none; -moz-appearance: none; appearance: none; border-radius: 0; background: url(https://uraniacremene.ro/wp-content/uploads/2017/01/sageata-down.png) no-repeat right; background-position-x: 98%;" ><!-- [et_pb_line_break_holder] --> <option value="Selecteaza Regiunea Geografica" selected><!-- [et_pb_line_break_holder] --> Selecteaza Regiunea Geografica<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Alba" ><!-- [et_pb_line_break_holder] --> Alba<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Arad" ><!-- [et_pb_line_break_holder] --> Arad<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Arges" ><!-- [et_pb_line_break_holder] --> Arges<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Bacau" ><!-- [et_pb_line_break_holder] --> Bacau<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Bihor" ><!-- [et_pb_line_break_holder] --> Bihor<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Bistrita-Nasaud" ><!-- [et_pb_line_break_holder] --> Bistrita-Nasaud<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Braila" ><!-- [et_pb_line_break_holder] --> Braila<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Brasov" ><!-- [et_pb_line_break_holder] --> Brasov<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Botosani" ><!-- [et_pb_line_break_holder] --> Botosani<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Bucuresti" ><!-- [et_pb_line_break_holder] --> Bucuresti<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Buzau" ><!-- [et_pb_line_break_holder] --> Buzau<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Calarasi" ><!-- [et_pb_line_break_holder] --> Calarasi<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Caras-Severin" ><!-- [et_pb_line_break_holder] --> Caras-Severin<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Cluj" ><!-- [et_pb_line_break_holder] --> Cluj<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Covasna" ><!-- [et_pb_line_break_holder] --> Covasna<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Dambovita" ><!-- [et_pb_line_break_holder] --> Dambovita<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Constanta" ><!-- [et_pb_line_break_holder] --> Constanta<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Dolj" ><!-- [et_pb_line_break_holder] --> Dolj<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Galati" ><!-- [et_pb_line_break_holder] --> Galati<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Giurgiu" ><!-- [et_pb_line_break_holder] --> Giurgiu<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Gorj" ><!-- [et_pb_line_break_holder] --> Gorj<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Harghita" ><!-- [et_pb_line_break_holder] --> Harghita<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Hunedoara" ><!-- [et_pb_line_break_holder] --> Hunedoara<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Ialomita" ><!-- [et_pb_line_break_holder] --> Ialomita<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Iasi" ><!-- [et_pb_line_break_holder] --> Iasi<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Ilfov" ><!-- [et_pb_line_break_holder] --> Ilfov<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Maramures" ><!-- [et_pb_line_break_holder] --> Maramures<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Mehedinti" ><!-- [et_pb_line_break_holder] --> Mehedinti<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Mures" ><!-- [et_pb_line_break_holder] --> Mures<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Neamt" ><!-- [et_pb_line_break_holder] --> Neamt<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Olt" ><!-- [et_pb_line_break_holder] --> Olt<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Prahova" ><!-- [et_pb_line_break_holder] --> Prahova<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Salaj" ><!-- [et_pb_line_break_holder] --> Salaj<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Satu-Mare" ><!-- [et_pb_line_break_holder] --> Satu-Mare<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Sibiu" ><!-- [et_pb_line_break_holder] --> Sibiu<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Suceava" ><!-- [et_pb_line_break_holder] --> Suceava<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Teleorman" ><!-- [et_pb_line_break_holder] --> Teleorman<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Timis" ><!-- [et_pb_line_break_holder] --> Timis<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Tulcea" ><!-- [et_pb_line_break_holder] --> Tulcea<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Valcea" ><!-- [et_pb_line_break_holder] --> Valcea<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Vaslui" ><!-- [et_pb_line_break_holder] --> Vaslui<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Vrancea" ><!-- [et_pb_line_break_holder] --> Vrancea<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="" ><!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Republica Moldova" ><!-- [et_pb_line_break_holder] --> Republica Moldova<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Alta Tara" ><!-- [et_pb_line_break_holder] --> Alta Tara<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> </select><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> <div class="_form_element _field4 _full_width " ><!-- [et_pb_line_break_holder] --> <div class="_field-wrapper"><!-- [et_pb_line_break_holder] --> <select name="field[4]" style="font-size:14px; font-weight:bold; width: 100%; display:block; margin:0 auto; margin-top: 10px; border: 0; padding: 10px; box-shadow: 0px 0px 0px !important; background-color: rgb(255, 255, 255)!important; -webkit-appearance: none; -moz-appearance: none; appearance: none; border-radius: 0; background: url(https://uraniacremene.ro/wp-content/uploads/2017/01/sageata-down.png) no-repeat right; background-position-x: 98%;" ><!-- [et_pb_line_break_holder] --> <option value="Statut sau rol" selected><!-- [et_pb_line_break_holder] --> Statut sau rol<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Mama" ><!-- [et_pb_line_break_holder] --> Mama<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Tata" ><!-- [et_pb_line_break_holder] --> Tata<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Bunic" ><!-- [et_pb_line_break_holder] --> Bunic<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Bunica" ><!-- [et_pb_line_break_holder] --> Bunica<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Educatoare" ><!-- [et_pb_line_break_holder] --> Educatoare<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Invatatoare" ><!-- [et_pb_line_break_holder] --> Invatatoare<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Profesor" ><!-- [et_pb_line_break_holder] --> Profesor<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Babysitter" ><!-- [et_pb_line_break_holder] --> Babysitter<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Viitoare mama" ><!-- [et_pb_line_break_holder] --> Viitoare mama<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Viitor tata" ><!-- [et_pb_line_break_holder] --> Viitor tata<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> <option value="Altul" ><!-- [et_pb_line_break_holder] --> Altul<!-- [et_pb_line_break_holder] --> </option><!-- [et_pb_line_break_holder] --> </select><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> <div class="_button-wrapper _full_width"><!-- [et_pb_line_break_holder] --> <button id="_form_5_submit" class="_submit" type="submit" style="font-size:14px; font-weight:bold; margin-top: 10px; padding: 15px; width: 100%; background-color: #ebeb46; border: 0; color: #727272; -webkit-appearance: none; -moz-appearance: none; appearance: none; border-radius: 0;"><!-- [et_pb_line_break_holder] --> Vreau sa vad video-urile<!-- [et_pb_line_break_holder] --> </button><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> <div class="_clear-element"><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> <div class="_form-thank-you" style="display:none;"><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --></form><script type="text/javascript"><!-- [et_pb_line_break_holder] -->window.cfields = {"6":"judet","4":"urania_statut_sau_rol"};<!-- [et_pb_line_break_holder] -->window._show_thank_you = function(id, message, trackcmp_url) {<!-- [et_pb_line_break_holder] --> var form = document.getElementById('_form_' + id + '_'), thank_you = form.querySelector('._form-thank-you');<!-- [et_pb_line_break_holder] --> form.querySelector('._form-content').style.display = 'none';<!-- [et_pb_line_break_holder] --> thank_you.innerHTML = message;<!-- [et_pb_line_break_holder] --> thank_you.style.display = 'block';<!-- [et_pb_line_break_holder] --> if (typeof(trackcmp_url) != 'undefined' && trackcmp_url) {<!-- [et_pb_line_break_holder] --> // Site tracking URL to use after inline form submission.<!-- [et_pb_line_break_holder] --> _load_script(trackcmp_url);<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> if (typeof window._form_callback !== 'undefined') window._form_callback(id);<!-- [et_pb_line_break_holder] -->};<!-- [et_pb_line_break_holder] -->window._show_error = function(id, message, html) {<!-- [et_pb_line_break_holder] --> var form = document.getElementById('_form_' + id + '_'), err = document.createElement('div'), button = form.querySelector('button'), old_error = form.querySelector('._form_error');<!-- [et_pb_line_break_holder] --> if (old_error) old_error.parentNode.removeChild(old_error);<!-- [et_pb_line_break_holder] --> err.innerHTML = message;<!-- [et_pb_line_break_holder] --> err.className = '_error-inner _form_error _no_arrow';<!-- [et_pb_line_break_holder] --> var wrapper = document.createElement('div');<!-- [et_pb_line_break_holder] --> wrapper.className = '_form-inner';<!-- [et_pb_line_break_holder] --> wrapper.appendChild(err);<!-- [et_pb_line_break_holder] --> button.parentNode.insertBefore(wrapper, button);<!-- [et_pb_line_break_holder] --> document.querySelector('[id^="_form"][id$="_submit"]').disabled = false;<!-- [et_pb_line_break_holder] --> if (html) {<!-- [et_pb_line_break_holder] --> var div = document.createElement('div');<!-- [et_pb_line_break_holder] --> div.className = '_error-html';<!-- [et_pb_line_break_holder] --> div.innerHTML = html;<!-- [et_pb_line_break_holder] --> err.appendChild(div);<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] -->};<!-- [et_pb_line_break_holder] -->window._load_script = function(url, callback) {<!-- [et_pb_line_break_holder] --> var head = document.querySelector('head'), script = document.createElement('script'), r = false;<!-- [et_pb_line_break_holder] --> script.type = 'text/javascript';<!-- [et_pb_line_break_holder] --> script.charset = 'utf-8';<!-- [et_pb_line_break_holder] --> script.src = url;<!-- [et_pb_line_break_holder] --> if (callback) {<!-- [et_pb_line_break_holder] --> script.onload = script.onreadystatechange = function() {<!-- [et_pb_line_break_holder] --> if (!r && (!this.readyState || this.readyState == 'complete')) {<!-- [et_pb_line_break_holder] --> r = true;<!-- [et_pb_line_break_holder] --> callback();<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> };<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> head.appendChild(script);<!-- [et_pb_line_break_holder] -->};<!-- [et_pb_line_break_holder] -->(function() {<!-- [et_pb_line_break_holder] --> if (window.location.search.search("excludeform") !== -1) return false;<!-- [et_pb_line_break_holder] --> var getCookie = function(name) {<!-- [et_pb_line_break_holder] --> var match = document.cookie.match(new RegExp('(^|; )' + name + '=([^;]+)'));<!-- [et_pb_line_break_holder] --> return match ? match[2] : null;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> var setCookie = function(name, value) {<!-- [et_pb_line_break_holder] --> var now = new Date();<!-- [et_pb_line_break_holder] --> var time = now.getTime();<!-- [et_pb_line_break_holder] --> var expireTime = time + 1000 * 60 * 60 * 24 * 365;<!-- [et_pb_line_break_holder] --> now.setTime(expireTime);<!-- [et_pb_line_break_holder] --> document.cookie = name + '=' + value + '; expires=' + now + ';path=/';<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> var addEvent = function(element, event, func) {<!-- [et_pb_line_break_holder] --> if (element.addEventListener) {<!-- [et_pb_line_break_holder] --> element.addEventListener(event, func);<!-- [et_pb_line_break_holder] --> } else {<!-- [et_pb_line_break_holder] --> var oldFunc = element['on' + event];<!-- [et_pb_line_break_holder] --> element['on' + event] = function() {<!-- [et_pb_line_break_holder] --> oldFunc.apply(this, arguments);<!-- [et_pb_line_break_holder] --> func.apply(this, arguments);<!-- [et_pb_line_break_holder] --> };<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> var _removed = false;<!-- [et_pb_line_break_holder] --> var form_to_submit = document.getElementById('_form_5_');<!-- [et_pb_line_break_holder] --> var allInputs = form_to_submit.querySelectorAll('input, select, textarea'), tooltips = [], submitted = false;<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> var getUrlParam = function(name) {<!-- [et_pb_line_break_holder] --> var regexStr = '[\?&]' + name + '=([^&#]*)';<!-- [et_pb_line_break_holder] --> var results = new RegExp(regexStr, 'i').exec(window.location.href);<!-- [et_pb_line_break_holder] --> return results != undefined ? decodeURIComponent(results[1]) : false;<!-- [et_pb_line_break_holder] --> };<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> for (var i = 0; i < allInputs.length; i++) {<!-- [et_pb_line_break_holder] --> var regexStr = "field\\[(\\d+)\\]";<!-- [et_pb_line_break_holder] --> var results = new RegExp(regexStr).exec(allInputs[i].name);<!-- [et_pb_line_break_holder] --> if (results != undefined) {<!-- [et_pb_line_break_holder] --> allInputs[i].dataset.name = window.cfields[results[1]];<!-- [et_pb_line_break_holder] --> } else {<!-- [et_pb_line_break_holder] --> allInputs[i].dataset.name = allInputs[i].name;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> var fieldVal = getUrlParam(allInputs[i].dataset.name);<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> if (fieldVal) {<!-- [et_pb_line_break_holder] --> if (allInputs[i].type == "radio" || allInputs[i].type == "checkbox") {<!-- [et_pb_line_break_holder] --> if (allInputs[i].value == fieldVal) {<!-- [et_pb_line_break_holder] --> allInputs[i].checked = true;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> } else {<!-- [et_pb_line_break_holder] --> allInputs[i].value = fieldVal;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> var remove_tooltips = function() {<!-- [et_pb_line_break_holder] --> for (var i = 0; i < tooltips.length; i++) {<!-- [et_pb_line_break_holder] --> tooltips[i].tip.parentNode.removeChild(tooltips[i].tip);<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> tooltips = [];<!-- [et_pb_line_break_holder] --> };<!-- [et_pb_line_break_holder] --> var remove_tooltip = function(elem) {<!-- [et_pb_line_break_holder] --> for (var i = 0; i < tooltips.length; i++) {<!-- [et_pb_line_break_holder] --> if (tooltips[i].elem === elem) {<!-- [et_pb_line_break_holder] --> tooltips[i].tip.parentNode.removeChild(tooltips[i].tip);<!-- [et_pb_line_break_holder] --> tooltips.splice(i, 1);<!-- [et_pb_line_break_holder] --> return;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> };<!-- [et_pb_line_break_holder] --> var create_tooltip = function(elem, text) {<!-- [et_pb_line_break_holder] --> var tooltip = document.createElement('div'), arrow = document.createElement('div'), inner = document.createElement('div'), new_tooltip = {};<!-- [et_pb_line_break_holder] --> if (elem.type != 'radio' && elem.type != 'checkbox') {<!-- [et_pb_line_break_holder] --> tooltip.className = '_error';<!-- [et_pb_line_break_holder] --> arrow.className = '_error-arrow';<!-- [et_pb_line_break_holder] --> inner.className = '_error-inner';<!-- [et_pb_line_break_holder] --> inner.innerHTML = text;<!-- [et_pb_line_break_holder] --> tooltip.appendChild(arrow);<!-- [et_pb_line_break_holder] --> tooltip.appendChild(inner);<!-- [et_pb_line_break_holder] --> elem.parentNode.appendChild(tooltip);<!-- [et_pb_line_break_holder] --> } else {<!-- [et_pb_line_break_holder] --> tooltip.className = '_error-inner _no_arrow';<!-- [et_pb_line_break_holder] --> tooltip.innerHTML = text;<!-- [et_pb_line_break_holder] --> elem.parentNode.insertBefore(tooltip, elem);<!-- [et_pb_line_break_holder] --> new_tooltip.no_arrow = true;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> new_tooltip.tip = tooltip;<!-- [et_pb_line_break_holder] --> new_tooltip.elem = elem;<!-- [et_pb_line_break_holder] --> tooltips.push(new_tooltip);<!-- [et_pb_line_break_holder] --> return new_tooltip;<!-- [et_pb_line_break_holder] --> };<!-- [et_pb_line_break_holder] --> var resize_tooltip = function(tooltip) {<!-- [et_pb_line_break_holder] --> var rect = tooltip.elem.getBoundingClientRect();<!-- [et_pb_line_break_holder] --> var doc = document.documentElement, scrollPosition = rect.top - ((window.pageYOffset || doc.scrollTop) - (doc.clientTop || 0));<!-- [et_pb_line_break_holder] --> if (scrollPosition < 40) {<!-- [et_pb_line_break_holder] --> tooltip.tip.className = tooltip.tip.className.replace(/ ?(_above|_below) ?/g, '') + ' _below';<!-- [et_pb_line_break_holder] --> } else {<!-- [et_pb_line_break_holder] --> tooltip.tip.className = tooltip.tip.className.replace(/ ?(_above|_below) ?/g, '') + ' _above';<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> };<!-- [et_pb_line_break_holder] --> var resize_tooltips = function() {<!-- [et_pb_line_break_holder] --> if (_removed) return;<!-- [et_pb_line_break_holder] --> for (var i = 0; i < tooltips.length; i++) {<!-- [et_pb_line_break_holder] --> if (!tooltips[i].no_arrow) resize_tooltip(tooltips[i]);<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> };<!-- [et_pb_line_break_holder] --> var validate_field = function(elem, remove) {<!-- [et_pb_line_break_holder] --> var tooltip = null, value = elem.value, no_error = true;<!-- [et_pb_line_break_holder] --> remove ? remove_tooltip(elem) : false;<!-- [et_pb_line_break_holder] --> if (elem.type != 'checkbox') elem.className = elem.className.replace(/ ?_has_error ?/g, '');<!-- [et_pb_line_break_holder] --> if (elem.getAttribute('required') !== null) {<!-- [et_pb_line_break_holder] --> if (elem.type == 'radio' || (elem.type == 'checkbox' && /any/.test(elem.className))) {<!-- [et_pb_line_break_holder] --> var elems = form_to_submit.elements[elem.name];<!-- [et_pb_line_break_holder] --> if (!(elems instanceof NodeList || elems instanceof HTMLCollection) || elems.length <= 1) {<!-- [et_pb_line_break_holder] --> no_error = elem.checked;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> else {<!-- [et_pb_line_break_holder] --> no_error = false;<!-- [et_pb_line_break_holder] --> for (var i = 0; i < elems.length; i++) {<!-- [et_pb_line_break_holder] --> if (elems[i].checked) no_error = true;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> if (!no_error) {<!-- [et_pb_line_break_holder] --> tooltip = create_tooltip(elem, "Please select an option.");<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> } else if (elem.type =='checkbox') {<!-- [et_pb_line_break_holder] --> var elems = form_to_submit.elements[elem.name], found = false, err = [];<!-- [et_pb_line_break_holder] --> no_error = true;<!-- [et_pb_line_break_holder] --> for (var i = 0; i < elems.length; i++) {<!-- [et_pb_line_break_holder] --> if (elems[i].getAttribute('required') === null) continue;<!-- [et_pb_line_break_holder] --> if (!found && elems[i] !== elem) return true;<!-- [et_pb_line_break_holder] --> found = true;<!-- [et_pb_line_break_holder] --> elems[i].className = elems[i].className.replace(/ ?_has_error ?/g, '');<!-- [et_pb_line_break_holder] --> if (!elems[i].checked) {<!-- [et_pb_line_break_holder] --> no_error = false;<!-- [et_pb_line_break_holder] --> elems[i].className = elems[i].className + ' _has_error';<!-- [et_pb_line_break_holder] --> err.push("Checking %s is required".replace("%s", elems[i].value));<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> if (!no_error) {<!-- [et_pb_line_break_holder] --> tooltip = create_tooltip(elem, err.join('<br/>'));<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> } else if (elem.tagName == 'SELECT') {<!-- [et_pb_line_break_holder] --> var selected = true;<!-- [et_pb_line_break_holder] --> if (elem.multiple) {<!-- [et_pb_line_break_holder] --> selected = false;<!-- [et_pb_line_break_holder] --> for (var i = 0; i < elem.options.length; i++) {<!-- [et_pb_line_break_holder] --> if (elem.options[i].selected) {<!-- [et_pb_line_break_holder] --> selected = true;<!-- [et_pb_line_break_holder] --> break;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> } else {<!-- [et_pb_line_break_holder] --> for (var i = 0; i < elem.options.length; i++) {<!-- [et_pb_line_break_holder] --> if (elem.options[i].selected && !elem.options[i].value) {<!-- [et_pb_line_break_holder] --> selected = false;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> if (!selected) {<!-- [et_pb_line_break_holder] --> no_error = false;<!-- [et_pb_line_break_holder] --> tooltip = create_tooltip(elem, "Please select an option.");<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> } else if (value === undefined || value === null || value === '') {<!-- [et_pb_line_break_holder] --> elem.className = elem.className + ' _has_error';<!-- [et_pb_line_break_holder] --> no_error = false;<!-- [et_pb_line_break_holder] --> tooltip = create_tooltip(elem, "This field is required.");<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> if (no_error && elem.name == 'email') {<!-- [et_pb_line_break_holder] --> if (!value.match(/^[\+_a-z0-9-'&=]+(\.[\+_a-z0-9-']+)*@[a-z0-9-]+(\.[a-z0-9-]+)*(\.[a-z]{2,})$/i)) {<!-- [et_pb_line_break_holder] --> elem.className = elem.className + ' _has_error';<!-- [et_pb_line_break_holder] --> no_error = false;<!-- [et_pb_line_break_holder] --> tooltip = create_tooltip(elem, "Enter a valid email address.");<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> if (no_error && /date_field/.test(elem.className)) {<!-- [et_pb_line_break_holder] --> if (!value.match(/^\d\d\d\d-\d\d-\d\d$/)) {<!-- [et_pb_line_break_holder] --> elem.className = elem.className + ' _has_error';<!-- [et_pb_line_break_holder] --> no_error = false;<!-- [et_pb_line_break_holder] --> tooltip = create_tooltip(elem, "Enter a valid date.");<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> tooltip ? resize_tooltip(tooltip) : false;<!-- [et_pb_line_break_holder] --> return no_error;<!-- [et_pb_line_break_holder] --> };<!-- [et_pb_line_break_holder] --> var needs_validate = function(el) {<!-- [et_pb_line_break_holder] --> return el.name == 'email' || el.getAttribute('required') !== null;<!-- [et_pb_line_break_holder] --> };<!-- [et_pb_line_break_holder] --> var validate_form = function(e) {<!-- [et_pb_line_break_holder] --> var err = form_to_submit.querySelector('._form_error'), no_error = true;<!-- [et_pb_line_break_holder] --> if (!submitted) {<!-- [et_pb_line_break_holder] --> submitted = true;<!-- [et_pb_line_break_holder] --> for (var i = 0, len = allInputs.length; i < len; i++) {<!-- [et_pb_line_break_holder] --> var input = allInputs[i];<!-- [et_pb_line_break_holder] --> if (needs_validate(input)) {<!-- [et_pb_line_break_holder] --> if (input.type == 'text') {<!-- [et_pb_line_break_holder] --> addEvent(input, 'blur', function() {<!-- [et_pb_line_break_holder] --> this.value = this.value.trim();<!-- [et_pb_line_break_holder] --> validate_field(this, true);<!-- [et_pb_line_break_holder] --> });<!-- [et_pb_line_break_holder] --> addEvent(input, 'input', function() {<!-- [et_pb_line_break_holder] --> validate_field(this, true);<!-- [et_pb_line_break_holder] --> });<!-- [et_pb_line_break_holder] --> } else if (input.type == 'radio' || input.type == 'checkbox') {<!-- [et_pb_line_break_holder] --> (function(el) {<!-- [et_pb_line_break_holder] --> var radios = form_to_submit.elements[el.name];<!-- [et_pb_line_break_holder] --> for (var i = 0; i < radios.length; i++) {<!-- [et_pb_line_break_holder] --> addEvent(radios[i], 'click', function() {<!-- [et_pb_line_break_holder] --> validate_field(el, true);<!-- [et_pb_line_break_holder] --> });<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> })(input);<!-- [et_pb_line_break_holder] --> } else if (input.tagName == 'SELECT') {<!-- [et_pb_line_break_holder] --> addEvent(input, 'change', function() {<!-- [et_pb_line_break_holder] --> validate_field(input, true);<!-- [et_pb_line_break_holder] --> });<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> remove_tooltips();<!-- [et_pb_line_break_holder] --> for (var i = 0, len = allInputs.length; i < len; i++) {<!-- [et_pb_line_break_holder] --> var elem = allInputs[i];<!-- [et_pb_line_break_holder] --> if (needs_validate(elem)) {<!-- [et_pb_line_break_holder] --> if (elem.tagName.toLowerCase() !== "select") {<!-- [et_pb_line_break_holder] --> elem.value = elem.value.trim();<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> validate_field(elem) ? true : no_error = false;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> if (!no_error && e) {<!-- [et_pb_line_break_holder] --> e.preventDefault();<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> resize_tooltips();<!-- [et_pb_line_break_holder] --> return no_error;<!-- [et_pb_line_break_holder] --> };<!-- [et_pb_line_break_holder] --> addEvent(window, 'resize', resize_tooltips);<!-- [et_pb_line_break_holder] --> addEvent(window, 'scroll', resize_tooltips);<!-- [et_pb_line_break_holder] --> window._old_serialize = null;<!-- [et_pb_line_break_holder] --> if (typeof serialize !== 'undefined') window._old_serialize = window.serialize;<!-- [et_pb_line_break_holder] --> _load_script("//d3rxaij56vjege.cloudfront.net/form-serialize/0.3/serialize.min.js", function() {<!-- [et_pb_line_break_holder] --> window._form_serialize = window.serialize;<!-- [et_pb_line_break_holder] --> if (window._old_serialize) window.serialize = window._old_serialize;<!-- [et_pb_line_break_holder] --> });<!-- [et_pb_line_break_holder] --> var form_submit = function(e) {<!-- [et_pb_line_break_holder] --> e.preventDefault();<!-- [et_pb_line_break_holder] --> if (validate_form()) {<!-- [et_pb_line_break_holder] --> // use this trick to get the submit button & disable it using plain javascript<!-- [et_pb_line_break_holder] --> document.querySelector('[id^="_form"][id$="_submit"]').disabled = true;<!-- [et_pb_line_break_holder] --> var serialized = _form_serialize(document.getElementById('_form_5_'));<!-- [et_pb_line_break_holder] --> var err = form_to_submit.querySelector('._form_error');<!-- [et_pb_line_break_holder] --> err ? err.parentNode.removeChild(err) : false;<!-- [et_pb_line_break_holder] --> _load_script('https://bloomanity226.activehosted.com/proc.php?' + serialized + '&jsonp=true');<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> return false;<!-- [et_pb_line_break_holder] --> };<!-- [et_pb_line_break_holder] --> addEvent(form_to_submit, 'submit', form_submit);<!-- [et_pb_line_break_holder] -->})();<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --></script>