{"html": "<div class=\"row\">\n    <div class=\"col-12\">\n        \n        \n            <form id=\"submission_form\" action=\"\" method=\"post\" class=\"ajaxform\" enctype=\"multipart/form-data\"\n                  data-submit-spinner=\"true\">\n                \n                    \n                        <div class=\"group\">\n                            <h5>Speed Mingle Profile</h5>\n                            \n                                \n                                    <div class=\"control-group mb-3\">\n                                        <label class=\"form-label text-left\" for=\"id_first_name\">\n                                            First Name *</label>\n                                        <div class=\"controls\">\n                                            \n                                                <input type=\"text\" name=\"first_name\" maxlength=\"30\" class=\" form-control form-control-sm\" required id=\"id_first_name\">\n                                            \n                                            \n                                        </div>\n                                    </div>\n                                \n                            \n                                \n                                    <div class=\"control-group mb-3\">\n                                        <label class=\"form-label text-left\" for=\"id_last_name\">\n                                            Last Name *</label>\n                                        <div class=\"controls\">\n                                            \n                                                <input type=\"text\" name=\"last_name\" maxlength=\"30\" class=\" form-control form-control-sm\" required id=\"id_last_name\">\n                                            \n                                            \n                                        </div>\n                                    </div>\n                                \n                            \n                                \n                                    <div class=\"control-group mb-3\">\n                                        <label class=\"form-label text-left\" for=\"id_email\">\n                                            Email *</label>\n                                        <div class=\"controls\">\n                                            \n                                                <input type=\"email\" name=\"email\" maxlength=\"254\" class=\" form-control form-control-sm\" required id=\"id_email\">\n                                            \n                                            \n                                        </div>\n                                    </div>\n                                \n                            \n                                \n                                    <div class=\"control-group mb-3\">\n                                        <label class=\"form-label text-left\" for=\"id_phone\">\n                                            Phone *</label>\n                                        <div class=\"controls\">\n                                            \n                                                <input type=\"hidden\" name=\"phone_full\" id=\"id_phone_full\">\n<input type=\"tel\" name=\"phone\" value=\"\"  class=\"form-control form-control-sm\" required id=\"id_phone\">\n<script type=\"text/javascript\">\n    (function init() {\n        if (document.readyState === 'loading') {\n            document.addEventListener('DOMContentLoaded', init);\n            return;\n        }\n        let input = document.getElementById('id_phone');\n        let name_len = function(){\n            let jform = input.closest('.jform');\n            let width;\n            if (jform) {\n                width = jform.parentElement.offsetWidth;\n                if (width > 255){ width = 250; }\n            } else {\n                width = input.offsetWidth;\n            }\n            if (width < 150){ return 0 }\n            let c = (width - 250) / 30;\n            if (c > 1){ c = 5 * c }else{ c = 0; }\n            return width/12 + c\n        };\n        let iti = window.intlTelInput(input, {\n            formatOnDisplay: true,\n            initialCountry: 'us',\n            preferredCountries: ['us'],\n            customContainer: 'w-100',\n            name_len: name_len(),\n        });\n        \n\n        let fullInput = document.getElementById('id_phone_full');\n\n        function updateFullNumber() {\n            if (iti.isValidNumber()) {\n                fullInput.value = iti.getNumber();\n            } else if (input.value.trim()) {\n                // Send raw input with country dial code so server can attempt parsing\n                let countryData = iti.getSelectedCountryData();\n                let rawValue = input.value.trim();\n                if (countryData && countryData.dialCode && !rawValue.startsWith('+')) {\n                    fullInput.value = '+' + countryData.dialCode + rawValue.replace(/[\\s()-]/g, '');\n                }\n            }\n        }\n\n        input.addEventListener('blur', updateFullNumber);\n        input.addEventListener('input', updateFullNumber);\n        input.addEventListener('countrychange', updateFullNumber);\n        let form = input.closest('form');\n        if (form) {\n            form.addEventListener('submit', updateFullNumber);\n        }\n        input.addEventListener('open:countrydropdown', function() {\n          let inputWidth = input.offsetWidth + 'px';\n          let country_listbox = document.getElementById('country-listbox');\n          if (country_listbox) {\n              country_listbox.style.width = inputWidth;\n              country_listbox.style.overflowX = 'hidden';\n              country_listbox.style.fontSize = '0.8rem';\n          }\n        });\n        updateFullNumber();\n    })();\n</script>\n                                            \n                                            \n                                        </div>\n                                    </div>\n                                \n                            \n                                \n                                    <div class=\"control-group mb-3\">\n                                        <label class=\"form-label text-left\" for=\"id_cover\">\n                                            Photo *</label>\n                                        <div class=\"controls\">\n                                            \n                                                <input type=\"file\" name=\"cover\" accept=\"image/*\" class=\" form-control form-control-sm\" required id=\"id_cover\">\n                                            \n                                            \n                                        </div>\n                                    </div>\n                                \n                            \n                                \n                                    <div class=\"control-group mb-3\">\n                                        <label class=\"form-label text-left\" for=\"id_your_age_group\">\n                                            Your Age Group *</label>\n                                        <div class=\"controls\">\n                                            \n                                                <select name=\"your_age_group\" class=\" form-control form-control-sm\" required id=\"id_your_age_group\">\n  <option value=\"\" selected>----</option>\n\n  <option value=\"1\">Baby Boomer (Born 1946-1964)</option>\n\n  <option value=\"2\">Generation X (Born 1965-1979)</option>\n\n  <option value=\"3\">Generation Y (Born 1980-1994)</option>\n\n  <option value=\"4\">Generation Z (Born 1995-2009)</option>\n\n  <option value=\"5\">Generation Alpha (Born 2010-2024)</option>\n\n  <option value=\"6\">Generation Beta (Born 2025-2039)</option>\n\n</select>\n                                            \n                                            \n                                        </div>\n                                    </div>\n                                \n                            \n                                \n                                    <div class=\"control-group mb-3\">\n                                        <label class=\"form-label text-left\" for=\"id_what_type_of_connection\">\n                                            What type of connection? *</label>\n                                        <div class=\"controls\">\n                                            \n                                                <select name=\"what_type_of_connection\" class=\" form-control form-control-sm\" required id=\"id_what_type_of_connection\" multiple>\n  <option value=\"1\">Networking: Professional Ascent</option>\n\n  <option value=\"2\">Friendship: Social Synergy</option>\n\n  <option value=\"3\">Dating: Romance &amp; Real Chemistry</option>\n\n  <option value=\"4\">Casual Fun: Spontaneous Adult Play</option>\n\n</select>\n                                            \n                                            \n                                        </div>\n                                    </div>\n                                \n                            \n                                \n                            \n                                \n                            \n                                \n                            \n                                \n                            \n                                \n                            \n                                \n                            \n                                \n                            \n                                \n                            \n                                \n                            \n                                \n                            \n                                \n                                    <div class=\"control-group mb-3\">\n                                        <label class=\"form-label text-left\" for=\"id_what_interest_you_adventure\">\n                                            Adventure Interest? *</label>\n                                        <div class=\"controls\">\n                                            \n                                                <select name=\"what_interest_you_adventure\" class=\" form-control form-control-sm\" required id=\"id_what_interest_you_adventure\" multiple>\n  <option value=\"1\">Fishing</option>\n\n  <option value=\"2\">Camping</option>\n\n  <option value=\"3\">Road Trips</option>\n\n  <option value=\"4\">Spending time in nature</option>\n\n  <option value=\"5\">Boating</option>\n\n  <option value=\"6\">Hunting</option>\n\n  <option value=\"7\">Skiing</option>\n\n  <option value=\"8\">Backpacking/Hiking</option>\n\n  <option value=\"9\">Hanging out at the beach/lake</option>\n\n  <option value=\"10\">Kayaking/Canoeing/Paddle boarding</option>\n\n  <option value=\"11\">Sailing</option>\n\n  <option value=\"12\">Cruises</option>\n\n  <option value=\"13\">Hanging out with friends</option>\n\n  <option value=\"14\">Weekend getaways</option>\n\n  <option value=\"15\">RVing</option>\n\n  <option value=\"16\">Traveling</option>\n\n  <option value=\"17\">Skydiving</option>\n\n  <option value=\"18\">Surfing</option>\n\n  <option value=\"19\">Slect Choice</option>\n\n</select>\n                                            \n                                            \n                                        </div>\n                                    </div>\n                                \n                            \n                                \n                                    <div class=\"control-group mb-3\">\n                                        <label class=\"form-label text-left\" for=\"id_what_interest_you_arts_culture\">\n                                            Arts &amp; Culture Interest? *</label>\n                                        <div class=\"controls\">\n                                            \n                                                <select name=\"what_interest_you_arts_culture\" class=\" form-control form-control-sm\" required id=\"id_what_interest_you_arts_culture\" multiple>\n  <option value=\"1\">Ballet</option>\n\n  <option value=\"2\">Concerts</option>\n\n  <option value=\"3\">Hip Hop</option>\n\n  <option value=\"4\">Acting</option>\n\n  <option value=\"5\">Singing</option>\n\n  <option value=\"6\">Listening to Music</option>\n\n  <option value=\"7\">Jazz</option>\n\n  <option value=\"8\">Musicals</option>\n\n  <option value=\"10\">Museums/Art Galleries</option>\n\n  <option value=\"11\">Tap Dance</option>\n\n  <option value=\"12\">Dancing</option>\n\n  <option value=\"13\">Comedy Shows</option>\n\n  <option value=\"14\">Jazz Dance</option>\n\n  <option value=\"15\">Performing Arts</option>\n\n  <option value=\"16\">Making Music</option>\n\n</select>\n                                            \n                                            \n                                        </div>\n                                    </div>\n                                \n                            \n                                \n                                    <div class=\"control-group mb-3\">\n                                        <label class=\"form-label text-left\" for=\"id_what_interest_you_creative_outlets\">\n                                            Creative Outlets Interest? *</label>\n                                        <div class=\"controls\">\n                                            \n                                                <select name=\"what_interest_you_creative_outlets\" class=\" form-control form-control-sm\" required id=\"id_what_interest_you_creative_outlets\" multiple>\n  <option value=\"1\">Printmaking</option>\n\n  <option value=\"2\">Makeup</option>\n\n  <option value=\"3\">Jewelry Making</option>\n\n  <option value=\"4\">Fashion</option>\n\n  <option value=\"5\">Home Improvement</option>\n\n  <option value=\"6\">Video/Photo Editing</option>\n\n  <option value=\"7\">DIY</option>\n\n  <option value=\"8\">Car Restoration</option>\n\n  <option value=\"9\">Interior Design</option>\n\n  <option value=\"10\">Journaling/Blogging/Vlogging</option>\n\n  <option value=\"11\">Gardening</option>\n\n  <option value=\"12\">3D Printing</option>\n\n  <option value=\"13\">Woodworking</option>\n\n  <option value=\"14\">Ceramics</option>\n\n  <option value=\"16\">Painting</option>\n\n  <option value=\"17\">Couponing</option>\n\n  <option value=\"18\">Quilting/Sewing/Knitting</option>\n\n  <option value=\"19\">Graphic Design</option>\n\n  <option value=\"20\">Photography</option>\n\n  <option value=\"21\">Crafting</option>\n\n</select>\n                                            \n                                            \n                                        </div>\n                                    </div>\n                                \n                            \n                                \n                                    <div class=\"control-group mb-3\">\n                                        <label class=\"form-label text-left\" for=\"id_what_interest_you_film_tv\">\n                                            Film &amp; TV Interest? *</label>\n                                        <div class=\"controls\">\n                                            \n                                                <select name=\"what_interest_you_film_tv\" class=\" form-control form-control-sm\" required id=\"id_what_interest_you_film_tv\" multiple>\n  <option value=\"1\">Dog/Cat Shows</option>\n\n  <option value=\"2\">HGTV Shows</option>\n\n  <option value=\"3\">Game Shows</option>\n\n  <option value=\"4\">Documentaries</option>\n\n  <option value=\"5\">Reality TV</option>\n\n  <option value=\"6\">Sports</option>\n\n  <option value=\"7\">Rom Coms</option>\n\n  <option value=\"8\">Dramas</option>\n\n  <option value=\"9\">Indie Films</option>\n\n  <option value=\"10\">Anime</option>\n\n  <option value=\"11\">Cinematography</option>\n\n  <option value=\"12\">Sitcoms</option>\n\n  <option value=\"13\">Soap Operas</option>\n\n  <option value=\"14\">Comedy Movies</option>\n\n  <option value=\"15\">Horror Movies</option>\n\n  <option value=\"16\">Science Fiction Movies</option>\n\n</select>\n                                            \n                                            \n                                        </div>\n                                    </div>\n                                \n                            \n                                \n                                    <div class=\"control-group mb-3\">\n                                        <label class=\"form-label text-left\" for=\"id_what_interest_you_fun_games\">\n                                            Fun &amp; Games Interest? *</label>\n                                        <div class=\"controls\">\n                                            \n                                                <select name=\"what_interest_you_fun_games\" class=\" form-control form-control-sm\" required id=\"id_what_interest_you_fun_games\" multiple>\n  <option value=\"1\">Board Games</option>\n\n  <option value=\"2\">Game Night</option>\n\n  <option value=\"3\">Darts</option>\n\n  <option value=\"4\">Karaoke</option>\n\n  <option value=\"5\">Billards</option>\n\n  <option value=\"6\">Trivia</option>\n\n  <option value=\"7\">Card Games</option>\n\n  <option value=\"8\">Video Games</option>\n\n  <option value=\"9\">Gambling/Poker/Blackjack</option>\n\n  <option value=\"10\">Theme Parks</option>\n\n  <option value=\"11\">Laser Tag</option>\n\n  <option value=\"12\">Fantasy Football</option>\n\n  <option value=\"13\">Bowling</option>\n\n</select>\n                                            \n                                            \n                                        </div>\n                                    </div>\n                                \n                            \n                                \n                                    <div class=\"control-group mb-3\">\n                                        <label class=\"form-label text-left\" for=\"id_what_interest_you_food_drink\">\n                                            Food &amp; Drink Interest? *</label>\n                                        <div class=\"controls\">\n                                            \n                                                <select name=\"what_interest_you_food_drink\" class=\" form-control form-control-sm\" required id=\"id_what_interest_you_food_drink\" multiple>\n  <option value=\"1\">Wine Tastings</option>\n\n  <option value=\"2\">Grilling</option>\n\n  <option value=\"3\">Cheesemaking</option>\n\n  <option value=\"4\">Whiskey</option>\n\n  <option value=\"5\">Mixology</option>\n\n  <option value=\"6\">Cooking/Baking</option>\n\n  <option value=\"7\">Coffee/Tea</option>\n\n  <option value=\"8\">Discovering Restaurants</option>\n\n  <option value=\"9\">Night Clubs</option>\n\n  <option value=\"10\">Entertaining</option>\n\n  <option value=\"11\">Craft Breweries/Wineries/Distilleries</option>\n\n</select>\n                                            \n                                            \n                                        </div>\n                                    </div>\n                                \n                            \n                                \n                                    <div class=\"control-group mb-3\">\n                                        <label class=\"form-label text-left\" for=\"id_what_interest_you_health_lifestyle\">\n                                            Health &amp; Lifestyle Interest? *</label>\n                                        <div class=\"controls\">\n                                            \n                                                <select name=\"what_interest_you_health_lifestyle\" class=\" form-control form-control-sm\" required id=\"id_what_interest_you_health_lifestyle\" multiple>\n  <option value=\"1\">Kickboxing</option>\n\n  <option value=\"2\">Spirituality</option>\n\n  <option value=\"3\">Running</option>\n\n  <option value=\"4\">Swimming</option>\n\n  <option value=\"5\">Aerobics</option>\n\n  <option value=\"6\">Weightlifting</option>\n\n  <option value=\"7\">Juicing</option>\n\n  <option value=\"8\">Working Out</option>\n\n  <option value=\"9\">Walking</option>\n\n  <option value=\"10\">Going to the gym</option>\n\n  <option value=\"11\">Yoga</option>\n\n  <option value=\"12\">Nutrition</option>\n\n  <option value=\"13\">Meditation</option>\n\n  <option value=\"14\">Healthcare</option>\n\n  <option value=\"15\">Crossfit</option>\n\n  <option value=\"16\">Water Aerobics</option>\n\n</select>\n                                            \n                                            \n                                        </div>\n                                    </div>\n                                \n                            \n                                \n                                    <div class=\"control-group mb-3\">\n                                        <label class=\"form-label text-left\" for=\"id_what_interest_you_intellectual_stimulation\">\n                                            Intellectual Stimulation Interest? *</label>\n                                        <div class=\"controls\">\n                                            \n                                                <select name=\"what_interest_you_intellectual_stimulation\" class=\" form-control form-control-sm\" required id=\"id_what_interest_you_intellectual_stimulation\" multiple>\n  <option value=\"1\">History</option>\n\n  <option value=\"2\">Comics</option>\n\n  <option value=\"3\">Podcast</option>\n\n  <option value=\"4\">Finance</option>\n\n  <option value=\"5\">Academics</option>\n\n  <option value=\"6\">Museums</option>\n\n  <option value=\"7\">Social Media</option>\n\n  <option value=\"8\">Philosophy</option>\n\n  <option value=\"9\">Astrology</option>\n\n  <option value=\"10\">Paranormal Activity</option>\n\n  <option value=\"11\">Robotics</option>\n\n  <option value=\"13\">Book Clubs</option>\n\n  <option value=\"14\">VR/AR</option>\n\n  <option value=\"15\">Current Events</option>\n\n  <option value=\"16\">Reading</option>\n\n  <option value=\"17\">Festivals</option>\n\n  <option value=\"18\">Antiquing</option>\n\n  <option value=\"19\">Science Fiction</option>\n\n</select>\n                                            \n                                            \n                                        </div>\n                                    </div>\n                                \n                            \n                                \n                                    <div class=\"control-group mb-3\">\n                                        <label class=\"form-label text-left\" for=\"id_what_interest_you_sports_activities\">\n                                            Sports &amp; Activities Interest? *</label>\n                                        <div class=\"controls\">\n                                            \n                                                <select name=\"what_interest_you_sports_activities\" class=\" form-control form-control-sm\" required id=\"id_what_interest_you_sports_activities\" multiple>\n  <option value=\"1\">Baseball</option>\n\n  <option value=\"2\">Volleyball</option>\n\n  <option value=\"3\">Tennis</option>\n\n  <option value=\"4\">Rock Climbing/Hiking</option>\n\n  <option value=\"5\">Water Sports</option>\n\n  <option value=\"6\">Boating</option>\n\n  <option value=\"7\">Golfing</option>\n\n  <option value=\"8\">Motorbiking/Go Carts</option>\n\n  <option value=\"9\">Football</option>\n\n  <option value=\"10\">Racquetball</option>\n\n  <option value=\"11\">Pickleball</option>\n\n  <option value=\"12\">Bowling</option>\n\n  <option value=\"13\">Martial Arts</option>\n\n  <option value=\"14\">Soccer</option>\n\n  <option value=\"15\">Running</option>\n\n  <option value=\"16\">Ice Hokey</option>\n\n  <option value=\"17\">Basketball</option>\n\n  <option value=\"18\">Nascar/Motorcross</option>\n\n  <option value=\"19\">Sailing/Yachting</option>\n\n  <option value=\"20\">Ultimate Frisbee</option>\n\n  <option value=\"21\">Boxing</option>\n\n</select>\n                                            \n                                            \n                                        </div>\n                                    </div>\n                                \n                            \n                                \n                            \n                                \n                            \n                                \n                            \n                        </div>\n                    \n                        <div class=\"group\">\n                            <h5>Match Preferences</h5>\n                            \n                                \n                            \n                                \n                            \n                                \n                            \n                                \n                            \n                                \n                            \n                                \n                            \n                                \n                            \n                                \n                                    <div class=\"control-group mb-3\">\n                                        <label class=\"form-label text-left\" for=\"id_partner_preference_32\">\n                                            Your Connection Age Group? *</label>\n                                        <div class=\"controls\">\n                                            \n                                                <select name=\"partner_preference_32\" class=\" form-control form-control-sm\" required id=\"id_partner_preference_32\" multiple>\n  <option value=\"1\">Baby Boomer (Born 1946-1964)</option>\n\n  <option value=\"2\">Generation X (Born 1965-1979)</option>\n\n  <option value=\"3\">Generation Y (Born 1980-1994)</option>\n\n  <option value=\"4\">Generation Z (Born 1995-2009)</option>\n\n  <option value=\"5\">Generation Alpha (Born 2010-2024)</option>\n\n  <option value=\"6\">Generation Beta (Born 2025-2039)</option>\n\n</select>\n                                            \n                                            \n                                        </div>\n                                    </div>\n                                \n                            \n                                \n                                    <div class=\"control-group mb-3\">\n                                        <label class=\"form-label text-left\" for=\"id_partner_preference_13\">\n                                            Adventure Interest? *</label>\n                                        <div class=\"controls\">\n                                            \n                                                <select name=\"partner_preference_13\" class=\" form-control form-control-sm\" required id=\"id_partner_preference_13\" multiple>\n  <option value=\"1\">Fishing</option>\n\n  <option value=\"2\">Camping</option>\n\n  <option value=\"3\">Road Trips</option>\n\n  <option value=\"4\">Spending time in nature</option>\n\n  <option value=\"5\">Boating</option>\n\n  <option value=\"6\">Hunting</option>\n\n  <option value=\"7\">Skiing</option>\n\n  <option value=\"8\">Backpacking/Hiking</option>\n\n  <option value=\"9\">Hanging out at the beach/lake</option>\n\n  <option value=\"10\">Kayaking/Canoeing/Paddle boarding</option>\n\n  <option value=\"11\">Sailing</option>\n\n  <option value=\"12\">Cruises</option>\n\n  <option value=\"13\">Hanging out with friends</option>\n\n  <option value=\"14\">Weekend getaways</option>\n\n  <option value=\"15\">RVing</option>\n\n  <option value=\"16\">Traveling</option>\n\n  <option value=\"17\">Skydiving</option>\n\n  <option value=\"18\">Surfing</option>\n\n  <option value=\"19\">Slect Choice</option>\n\n</select>\n                                            \n                                            \n                                        </div>\n                                    </div>\n                                \n                            \n                                \n                                    <div class=\"control-group mb-3\">\n                                        <label class=\"form-label text-left\" for=\"id_partner_preference_14\">\n                                            Fun &amp; Games Interest? *</label>\n                                        <div class=\"controls\">\n                                            \n                                                <select name=\"partner_preference_14\" class=\" form-control form-control-sm\" required id=\"id_partner_preference_14\" multiple>\n  <option value=\"1\">Board Games</option>\n\n  <option value=\"2\">Game Night</option>\n\n  <option value=\"3\">Darts</option>\n\n  <option value=\"4\">Karaoke</option>\n\n  <option value=\"5\">Billards</option>\n\n  <option value=\"6\">Trivia</option>\n\n  <option value=\"7\">Card Games</option>\n\n  <option value=\"8\">Video Games</option>\n\n  <option value=\"9\">Gambling/Poker/Blackjack</option>\n\n  <option value=\"10\">Theme Parks</option>\n\n  <option value=\"11\">Laser Tag</option>\n\n  <option value=\"12\">Fantasy Football</option>\n\n  <option value=\"13\">Bowling</option>\n\n</select>\n                                            \n                                            \n                                        </div>\n                                    </div>\n                                \n                            \n                                \n                                    <div class=\"control-group mb-3\">\n                                        <label class=\"form-label text-left\" for=\"id_partner_preference_15\">\n                                            Film &amp; TV Interest? *</label>\n                                        <div class=\"controls\">\n                                            \n                                                <select name=\"partner_preference_15\" class=\" form-control form-control-sm\" required id=\"id_partner_preference_15\" multiple>\n  <option value=\"1\">Dog/Cat Shows</option>\n\n  <option value=\"2\">HGTV Shows</option>\n\n  <option value=\"3\">Game Shows</option>\n\n  <option value=\"4\">Documentaries</option>\n\n  <option value=\"5\">Reality TV</option>\n\n  <option value=\"6\">Sports</option>\n\n  <option value=\"7\">Rom Coms</option>\n\n  <option value=\"8\">Dramas</option>\n\n  <option value=\"9\">Indie Films</option>\n\n  <option value=\"10\">Anime</option>\n\n  <option value=\"11\">Cinematography</option>\n\n  <option value=\"12\">Sitcoms</option>\n\n  <option value=\"13\">Soap Operas</option>\n\n  <option value=\"14\">Comedy Movies</option>\n\n  <option value=\"15\">Horror Movies</option>\n\n  <option value=\"16\">Science Fiction Movies</option>\n\n</select>\n                                            \n                                            \n                                        </div>\n                                    </div>\n                                \n                            \n                                \n                                    <div class=\"control-group mb-3\">\n                                        <label class=\"form-label text-left\" for=\"id_partner_preference_16\">\n                                            Food &amp; Drink Interest? *</label>\n                                        <div class=\"controls\">\n                                            \n                                                <select name=\"partner_preference_16\" class=\" form-control form-control-sm\" required id=\"id_partner_preference_16\" multiple>\n  <option value=\"1\">Wine Tastings</option>\n\n  <option value=\"2\">Grilling</option>\n\n  <option value=\"3\">Cheesemaking</option>\n\n  <option value=\"4\">Whiskey</option>\n\n  <option value=\"5\">Mixology</option>\n\n  <option value=\"6\">Cooking/Baking</option>\n\n  <option value=\"7\">Coffee/Tea</option>\n\n  <option value=\"8\">Discovering Restaurants</option>\n\n  <option value=\"9\">Night Clubs</option>\n\n  <option value=\"10\">Entertaining</option>\n\n  <option value=\"11\">Craft Breweries/Wineries/Distilleries</option>\n\n</select>\n                                            \n                                            \n                                        </div>\n                                    </div>\n                                \n                            \n                                \n                                    <div class=\"control-group mb-3\">\n                                        <label class=\"form-label text-left\" for=\"id_partner_preference_17\">\n                                            Sports &amp; Activities Interest? *</label>\n                                        <div class=\"controls\">\n                                            \n                                                <select name=\"partner_preference_17\" class=\" form-control form-control-sm\" required id=\"id_partner_preference_17\" multiple>\n  <option value=\"1\">Baseball</option>\n\n  <option value=\"2\">Volleyball</option>\n\n  <option value=\"3\">Tennis</option>\n\n  <option value=\"4\">Rock Climbing/Hiking</option>\n\n  <option value=\"5\">Water Sports</option>\n\n  <option value=\"6\">Boating</option>\n\n  <option value=\"7\">Golfing</option>\n\n  <option value=\"8\">Motorbiking/Go Carts</option>\n\n  <option value=\"9\">Football</option>\n\n  <option value=\"10\">Racquetball</option>\n\n  <option value=\"11\">Pickleball</option>\n\n  <option value=\"12\">Bowling</option>\n\n  <option value=\"13\">Martial Arts</option>\n\n  <option value=\"14\">Soccer</option>\n\n  <option value=\"15\">Running</option>\n\n  <option value=\"16\">Ice Hokey</option>\n\n  <option value=\"17\">Basketball</option>\n\n  <option value=\"18\">Nascar/Motorcross</option>\n\n  <option value=\"19\">Sailing/Yachting</option>\n\n  <option value=\"20\">Ultimate Frisbee</option>\n\n  <option value=\"21\">Boxing</option>\n\n</select>\n                                            \n                                            \n                                        </div>\n                                    </div>\n                                \n                            \n                                \n                                    <div class=\"control-group mb-3\">\n                                        <label class=\"form-label text-left\" for=\"id_partner_preference_18\">\n                                            Intellectual Stimulation Interest? *</label>\n                                        <div class=\"controls\">\n                                            \n                                                <select name=\"partner_preference_18\" class=\" form-control form-control-sm\" required id=\"id_partner_preference_18\" multiple>\n  <option value=\"1\">History</option>\n\n  <option value=\"2\">Comics</option>\n\n  <option value=\"3\">Podcast</option>\n\n  <option value=\"4\">Finance</option>\n\n  <option value=\"5\">Academics</option>\n\n  <option value=\"6\">Museums</option>\n\n  <option value=\"7\">Social Media</option>\n\n  <option value=\"8\">Philosophy</option>\n\n  <option value=\"9\">Astrology</option>\n\n  <option value=\"10\">Paranormal Activity</option>\n\n  <option value=\"11\">Robotics</option>\n\n  <option value=\"13\">Book Clubs</option>\n\n  <option value=\"14\">VR/AR</option>\n\n  <option value=\"15\">Current Events</option>\n\n  <option value=\"16\">Reading</option>\n\n  <option value=\"17\">Festivals</option>\n\n  <option value=\"18\">Antiquing</option>\n\n  <option value=\"19\">Science Fiction</option>\n\n</select>\n                                            \n                                            \n                                        </div>\n                                    </div>\n                                \n                            \n                                \n                                    <div class=\"control-group mb-3\">\n                                        <label class=\"form-label text-left\" for=\"id_partner_preference_19\">\n                                            Arts &amp; Culture Interest? *</label>\n                                        <div class=\"controls\">\n                                            \n                                                <select name=\"partner_preference_19\" class=\" form-control form-control-sm\" required id=\"id_partner_preference_19\" multiple>\n  <option value=\"1\">Ballet</option>\n\n  <option value=\"2\">Concerts</option>\n\n  <option value=\"3\">Hip Hop</option>\n\n  <option value=\"4\">Acting</option>\n\n  <option value=\"5\">Singing</option>\n\n  <option value=\"6\">Listening to Music</option>\n\n  <option value=\"7\">Jazz</option>\n\n  <option value=\"8\">Musicals</option>\n\n  <option value=\"10\">Museums/Art Galleries</option>\n\n  <option value=\"11\">Tap Dance</option>\n\n  <option value=\"12\">Dancing</option>\n\n  <option value=\"13\">Comedy Shows</option>\n\n  <option value=\"14\">Jazz Dance</option>\n\n  <option value=\"15\">Performing Arts</option>\n\n  <option value=\"16\">Making Music</option>\n\n</select>\n                                            \n                                            \n                                        </div>\n                                    </div>\n                                \n                            \n                                \n                                    <div class=\"control-group mb-3\">\n                                        <label class=\"form-label text-left\" for=\"id_partner_preference_20\">\n                                            Creative Outlets Interest? *</label>\n                                        <div class=\"controls\">\n                                            \n                                                <select name=\"partner_preference_20\" class=\" form-control form-control-sm\" required id=\"id_partner_preference_20\" multiple>\n  <option value=\"1\">Printmaking</option>\n\n  <option value=\"2\">Makeup</option>\n\n  <option value=\"3\">Jewelry Making</option>\n\n  <option value=\"4\">Fashion</option>\n\n  <option value=\"5\">Home Improvement</option>\n\n  <option value=\"6\">Video/Photo Editing</option>\n\n  <option value=\"7\">DIY</option>\n\n  <option value=\"8\">Car Restoration</option>\n\n  <option value=\"9\">Interior Design</option>\n\n  <option value=\"10\">Journaling/Blogging/Vlogging</option>\n\n  <option value=\"11\">Gardening</option>\n\n  <option value=\"12\">3D Printing</option>\n\n  <option value=\"13\">Woodworking</option>\n\n  <option value=\"14\">Ceramics</option>\n\n  <option value=\"16\">Painting</option>\n\n  <option value=\"17\">Couponing</option>\n\n  <option value=\"18\">Quilting/Sewing/Knitting</option>\n\n  <option value=\"19\">Graphic Design</option>\n\n  <option value=\"20\">Photography</option>\n\n  <option value=\"21\">Crafting</option>\n\n</select>\n                                            \n                                            \n                                        </div>\n                                    </div>\n                                \n                            \n                                \n                                    <div class=\"control-group mb-3\">\n                                        <label class=\"form-label text-left\" for=\"id_partner_preference_21\">\n                                            Health &amp; Lifestyle Interest? *</label>\n                                        <div class=\"controls\">\n                                            \n                                                <select name=\"partner_preference_21\" class=\" form-control form-control-sm\" required id=\"id_partner_preference_21\" multiple>\n  <option value=\"1\">Kickboxing</option>\n\n  <option value=\"2\">Spirituality</option>\n\n  <option value=\"3\">Running</option>\n\n  <option value=\"4\">Swimming</option>\n\n  <option value=\"5\">Aerobics</option>\n\n  <option value=\"6\">Weightlifting</option>\n\n  <option value=\"7\">Juicing</option>\n\n  <option value=\"8\">Working Out</option>\n\n  <option value=\"9\">Walking</option>\n\n  <option value=\"10\">Going to the gym</option>\n\n  <option value=\"11\">Yoga</option>\n\n  <option value=\"12\">Nutrition</option>\n\n  <option value=\"13\">Meditation</option>\n\n  <option value=\"14\">Healthcare</option>\n\n  <option value=\"15\">Crossfit</option>\n\n  <option value=\"16\">Water Aerobics</option>\n\n</select>\n                                            \n                                            \n                                        </div>\n                                    </div>\n                                \n                            \n                                \n                            \n                                \n                            \n                                \n                            \n                                \n                            \n                                \n                            \n                                \n                            \n                                \n                            \n                                \n                            \n                                \n                            \n                                \n                            \n                                \n                            \n                                \n                            \n                        </div>\n                    \n                \n                \n                    <div class=\"group mb-3\">\n                        <div class=\"control-group\">\n                            <div class=\"stripe-card-form row gx-2\">\n    <div class=\"col-12 mb-3\">\n        <label class=\"form-label\" for=\"card-element\">Card Number</label>\n        <div id=\"card-element\" class=\"form-control\"></div>\n    </div>\n    <div id=\"error-message\" class=\"error-message text-danger\"></div>\n    <input id=\"payment_method_id\" type=\"hidden\" name=\"payment_method_id\" class=\"form-control form-control-sm\">\n</div>\n<script type=\"text/javascript\">\n    $(document).ready(function () {\n        document.querySelectorAll('.ajaxform-submit').forEach(submitButton => {\n            document.querySelectorAll('.modal-footer .modal-submit-spinner').forEach(element => element.remove());\n        })\n        const cardElementContainer = document.getElementById('card-element');\n        const paymentMethodId = document.getElementById('payment_method_id');\n        const stripe = Stripe('pk_live_0gaeouJ67bUjacekGOHVtd2D', {stripeAccount: 'acct_1SzqQtRrl1gEwjBq'});\n\n        const elements = stripe.elements({\n            locale: 'US',\n        });\n\n        const style = {\n            base: {\n                fontSize: '16px',\n                color: '#32325d',\n            },\n        };\n        const cardElement = elements.create('card', {\n            style: style,\n            hidePostalCode: true,\n            disableLink: true,\n        });\n        cardElement.mount('#card-element', {style: style});\n\n        // Error Handling\n        const errorDiv = document.getElementById('error-message');\n        cardElement.on('change', function (event) {\n            if (event.error) {\n                errorDiv.textContent = event.error.message;\n            } else {\n                errorDiv.textContent = '';\n            }\n        });\n\n        const observer = new MutationObserver((mutationsList) => {\n            mutationsList.forEach((mutation) => {\n                if (mutation.type === 'attributes' && mutation.attributeName === 'class') {\n                    if (cardElementContainer.classList.contains('StripeElement--complete')) {\n                        getPaymentMethodId();\n                    }\n                    if (cardElementContainer.classList.contains('StripeElement--invalid') ||\n                        cardElementContainer.classList.contains('StripeElement--empty')) {\n                        paymentMethodId.setAttribute('value', '');\n                    }\n                }\n            });\n        });\n\n        const observerOptions = {\n            attributes: true,\n            attributeFilter: ['class']\n        };\n\n        observer.observe(cardElementContainer, observerOptions);\n\n        let getPaymentMethodId = async () => {\n            if (cardElement._isValid === false || cardElement._complete === false || errorDiv.textContent !== '') {\n                return;\n            }\n\n            try {\n                const result = await stripe.createPaymentMethod({\n                    type: 'card',\n                    card: cardElement,\n                });\n\n                if (result.error) {\n                    let errorDiv = document.getElementById('error-message');\n                    errorDiv.textContent = result.error.message;\n                } else {\n                    paymentMethodId.setAttribute('value', result.paymentMethod.id);\n                    return result.paymentMethod.id;\n                }\n            } catch (error) {\n                console.error('Error creating payment method:', error.message);\n                throw error;\n            }\n        };\n    });\n</script>\n                            <span class=\"text-danger\"></span>\n                        </div>\n                    </div>\n                \n                \n                    <div class=\"group\">\n                        <div class=\"control-group\">\n                            <script src=\"https://www.google.com/recaptcha/api.js?render=6LcWmBorAAAAAKgMa-zMlsDjdd1YQ8COnZzS8i0M\"></script>\n                            <input type=\"hidden\" id=\"recaptchaToken\" data-recaptcha-key=\"6LcWmBorAAAAAKgMa-zMlsDjdd1YQ8COnZzS8i0M\"\n                                   name=\"g-recaptcha-response\"/>\n                            \n                        </div>\n                    </div>\n                \n                \n                    <div class=\"group mb-3\" id=\"group-terms-and_conditions\">\n                        <div class=\"control-group \">\n                            <div class=\"controls\">\n                                <input type=\"checkbox\" id=\"id_terms_and_conditions\"\n                                       name=\"terms_and_conditions\"\n                                       class=\"form-check-input cursor-pointer \">\n                                <label class=\"form-check-label mb-0 \"\n                                       for=\"id_terms_and_conditions\">\n                                    I accept the <a href=\"/book_ticket/terms_and_conditions/bKACOEXY56/\" target=\"_blank\">Terms and Conditions</a>\n                                </label>\n\n                                \n                            </div>\n                        </div>\n                    </div>\n                \n                <input type=\"hidden\" name=\"csrfmiddlewaretoken\" value=\"gFM3OeQNWnz3E4b2hOR2GxbRG7gj6QSb34wsPeSejvDQ8Nd3mOcuEXYjpISYbnHa\">\n            </form>\n        \n    </div>\n</div>\n<script type=\"text/javascript\">\n    $(document).ready(function () {\n        document.querySelectorAll('.fa-spinner').forEach(function(element) {\n            element.remove();\n        });\n\n        const disablePayBtn = () => {\n            document.querySelectorAll('.ajaxform-submit').forEach(submitButton => {\n                submitButton.classList.add('disabled');\n            })};\n\n        const enablePayBtn = () => {\n            document.querySelectorAll('.ajaxform-submit').forEach(submitButton => {\n                submitButton.classList.remove('disabled');\n            })};\n\n        disablePayBtn();\n\n        document.getElementById('id_terms_and_conditions').addEventListener('click', 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