{"id":30,"date":"2016-07-17T09:52:34","date_gmt":"2016-07-17T09:52:34","guid":{"rendered":"http:\/\/stepchildrenmcc.co.za\/SteppiesRally\/?page_id=30"},"modified":"2016-08-29T11:18:39","modified_gmt":"2016-08-29T11:18:39","slug":"entry-form","status":"publish","type":"page","link":"http:\/\/stepchildrenmcc.co.za\/SteppiesRally\/entry-form\/","title":{"rendered":"Entry Form"},"content":{"rendered":"<h2>ALL PRE-ENTRIES TO RECEIVE 3 LUCKY DRAW TICKETS<\/h2>\n<h2>CUT OFF DAY IS 20\/01\/17<\/h2>\n<h2><span style=\"color: #0000ff;\">Please complete separate entry forms for rider and pillion<\/span><\/h2>\n<h3><a href=\"http:\/\/stepchildrenmcc.co.za\/SteppiesRally\/wp-content\/uploads\/2016\/08\/A5DS-cscc.pdf\" target=\"_blank\">Click here for the downloadable PDF version<\/a><\/h3>\n<div id=\"vfb-form-1\" class=\"visual-form-builder-container\"><form id=\"steppies-rally-2017-entry-form-1\" class=\"visual-form-builder vfb-form-1 \" method=\"post\" enctype=\"multipart\/form-data\">\n\t  \t<input type=\"hidden\" name=\"form_id\" value=\"1\" \/><fieldset class=\"vfb-fieldset vfb-fieldset-1 please-complete-all \" id=\"item-vfb-1\"><div class=\"vfb-legend\"><h3>Please complete all<\/h3><\/div><ul class=\"vfb-section vfb-section-1\"><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-14\"><label for=\"vfb-14\" class=\"vfb-desc\">Name  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-14\" id=\"vfb-14\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-15\"><label for=\"vfb-15\" class=\"vfb-desc\">Surname  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-15\" id=\"vfb-15\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-16\"><label for=\"vfb-16\" class=\"vfb-desc\">ID Number  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-16\" id=\"vfb-16\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-17\"><label for=\"vfb-17\" class=\"vfb-desc\">Postal Address  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-17\" id=\"vfb-17\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-18\"><label for=\"vfb-18\" class=\"vfb-desc\">Tel Number <\/label><span class=\"vfb-span\"><input type=\"text\" name=\"vfb-18\" id=\"vfb-18\" value=\"\" class=\"vfb-text  vfb-medium   \" \/><label>Optional<\/label><\/span><\/li><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-19\"><label for=\"vfb-19\" class=\"vfb-desc\">Cellphone Number  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-19\" id=\"vfb-19\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-20\"><label for=\"vfb-20\" class=\"vfb-desc\">Email Address  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-20\" id=\"vfb-20\" value=\"\" class=\"vfb-text  vfb-medium  required  email \" \/><\/li><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-21\"><label for=\"vfb-21\" class=\"vfb-desc\">Club Name  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-21\" id=\"vfb-21\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li><li class=\"vfb-item vfb-item-select  \" id=\"item-vfb-22\"><label for=\"vfb-22\" class=\"vfb-desc\">Rider or Pillion R200  <span class=\"vfb-required-asterisk\">*<\/span><\/label><select name=\"vfb-22\" id=\"vfb-22\" class=\"vfb-select  vfb-medium  required \"><option value=\"Rider\">Rider<\/option><option value=\"Pillion\">Pillion<\/option><\/select><\/li><li class=\"vfb-item vfb-item-checkbox  \" id=\"item-vfb-23\"><label class=\"vfb-desc\">Pre order T-Shirt (R120)  <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-23[]\" id=\"vfb-23-0\" value=\"XXL\" class=\"vfb-checkbox  required \" \/><label for=\"vfb-23-0\" class=\"vfb-choice\">XXL<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-23[]\" id=\"vfb-23-1\" value=\"XL\" class=\"vfb-checkbox  required \" \/><label for=\"vfb-23-1\" class=\"vfb-choice\">XL<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-23[]\" id=\"vfb-23-2\" value=\"L\" class=\"vfb-checkbox  required \" \/><label for=\"vfb-23-2\" class=\"vfb-choice\">L<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-23[]\" id=\"vfb-23-3\" value=\"M\" class=\"vfb-checkbox  required \" \/><label for=\"vfb-23-3\" class=\"vfb-choice\">M<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-23[]\" id=\"vfb-23-4\" value=\"S\" class=\"vfb-checkbox  required \" \/><label for=\"vfb-23-4\" class=\"vfb-choice\">S<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-23[]\" id=\"vfb-23-5\" value=\"No Thanks\" class=\"vfb-checkbox  required \" \/><label for=\"vfb-23-5\" class=\"vfb-choice\">No Thanks<\/label><\/span><div style=\"clear:both\"><\/div><\/div><\/li><li class=\"vfb-item vfb-item-checkbox  \" id=\"item-vfb-24\"><label class=\"vfb-desc\">Pre order a Cap? (R80)  <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-24[]\" id=\"vfb-24-0\" value=\"Yes Please\" class=\"vfb-checkbox  required \" \/><label for=\"vfb-24-0\" class=\"vfb-choice\">Yes Please<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-24[]\" id=\"vfb-24-1\" value=\"No Thanks\" class=\"vfb-checkbox  required \" \/><label for=\"vfb-24-1\" class=\"vfb-choice\">No Thanks<\/label><\/span><div style=\"clear:both\"><\/div><\/div><\/li><li class=\"vfb-item vfb-item-checkbox  \" id=\"item-vfb-13\"><label class=\"vfb-desc\">INDEMNITY:  <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><span><label>By ticking the box below, I hereby agree that I am attending the Steppies Rally entirely at my own risk and indemnify the organizers of any damages sustained by my person or my belongings which may result from my participation in the event. I confirm that I am 18 years or older and agree to abide by the rules and instructions of the organizers and their agents. I have read and understood the above and all the instructions<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-13[]\" id=\"vfb-13-0\" value=\"I agree\" class=\"vfb-checkbox  required \" \/><label for=\"vfb-13-0\" class=\"vfb-choice\">I agree<\/label><\/span><div style=\"clear:both\"><\/div><\/div><\/li><\/ul>&nbsp;<\/fieldset><fieldset class=\"vfb-fieldset vfb-fieldset-2 verification \" id=\"item-vfb-2\" style=\"display:block\"><div class=\"vfb-legend\"><h3>Verification<\/h3><\/div><ul class=\"vfb-section vfb-section-2\"><li class=\"vfb-item vfb-item-secret\"  style=\"display:block\"><label for=\"vfb-3\" class=\"vfb-desc\">Please enter any two digits <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"hidden\" name=\"_vfb-secret\" value=\"vfb-3\" \/><span class=\"vfb-span\"><input type=\"text\" name=\"vfb-3\" id=\"vfb-3\" value=\"\" class=\"vfb-text  vfb-medium  required {digits:true,maxlength:2,minlength:2} \" style=\"display:block\" \/><label>Example: 12<\/label><\/span><li style=\"display:none;\"><label>This box is for spam protection - &lt;strong&gt;please leave it blank&lt;\/strong&gt;:<\/label><div><input name=\"vfb-spam\" \/><\/div><\/li>\n\t\t\t<li class=\"vfb-item vfb-item-submit\" id=\"item-vfb-4\">\n\t\t\t\t<input type=\"submit\" name=\"vfb-submit\" id=\"vfb-4\" value=\"Submit\" class=\"vfb-submit \" \/>\n\t\t\t\t<\/li><\/ul>\n\t\t\t<\/fieldset><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/SteppiesRally\/wp-json\/wp\/v2\/pages\/30\" \/><\/form><\/div> <!-- .visual-form-builder-container -->\n<h2>All payments to be done via EFT and or ATM deposits. Teller deposits cost R50 more.<\/h2>\n<h2>Please use your FULL name and SURNAME as reference when making payment.<\/h2>\n<h2>Fax or Email Proof of payment to: 086 594 8737 \/ stepchildrenmcc@gmail.com<\/h2>\n<h2><\/h2>\n<h2><span style=\"color: #0000ff;\">PAYMENTS AT THE RALLY WILL BE CASH ONLY<\/span><\/h2>\n<h2><span style=\"color: #ff0000;\">THIS RALLY IS FOR ADULTS <\/span><\/h2>\n<h2><span style=\"color: #ff0000;\">ONLY OVER 18\u2019s ONLY PLEASE<\/span><\/h2>\n","protected":false},"excerpt":{"rendered":"<p>ALL PRE-ENTRIES TO RECEIVE 3 LUCKY DRAW TICKETS CUT OFF DAY IS 20\/01\/17 Please complete separate entry forms for rider and pillion Click here for the downloadable PDF version All payments to be done via EFT and or ATM deposits. Teller deposits cost R50 more. Please use your FULL name and SURNAME as reference when [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":83,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-30","page","type-page","status-publish","has-post-thumbnail","hentry"],"_links":{"self":[{"href":"http:\/\/stepchildrenmcc.co.za\/SteppiesRally\/wp-json\/wp\/v2\/pages\/30","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/stepchildrenmcc.co.za\/SteppiesRally\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"http:\/\/stepchildrenmcc.co.za\/SteppiesRally\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"http:\/\/stepchildrenmcc.co.za\/SteppiesRally\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/stepchildrenmcc.co.za\/SteppiesRally\/wp-json\/wp\/v2\/comments?post=30"}],"version-history":[{"count":13,"href":"http:\/\/stepchildrenmcc.co.za\/SteppiesRally\/wp-json\/wp\/v2\/pages\/30\/revisions"}],"predecessor-version":[{"id":129,"href":"http:\/\/stepchildrenmcc.co.za\/SteppiesRally\/wp-json\/wp\/v2\/pages\/30\/revisions\/129"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/stepchildrenmcc.co.za\/SteppiesRally\/wp-json\/wp\/v2\/media\/83"}],"wp:attachment":[{"href":"http:\/\/stepchildrenmcc.co.za\/SteppiesRally\/wp-json\/wp\/v2\/media?parent=30"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}