{"id":1806,"date":"2025-02-24T16:36:17","date_gmt":"2025-02-24T16:36:17","guid":{"rendered":"http:\/\/danstherapie-coaching-amsterdam.nl\/?page_id=1806"},"modified":"2025-02-24T16:36:17","modified_gmt":"2025-02-24T16:36:17","slug":"embodied-anatomy-workshop-intake-form-page","status":"publish","type":"page","link":"https:\/\/danstherapie-coaching-amsterdam.nl\/en\/embodied-anatomy-workshop-intake-form-page\/","title":{"rendered":"Embodied Anatomy Workshop Intake Form Page"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; theme_builder_area=&#8221;post_content&#8221; _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221;][et_pb_row _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; theme_builder_area=&#8221;post_content&#8221;][et_pb_column _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; type=&#8221;4_4&#8243; theme_builder_area=&#8221;post_content&#8221;][et_pb_text _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; theme_builder_area=&#8221;post_content&#8221; hover_enabled=&#8221;0&#8243; sticky_enabled=&#8221;0&#8243; custom_margin=&#8221;||30px|||&#8221;]<\/p>\n<h2>Embodied Anatomy Workshop Intake &amp; Payment Form<\/h2>\n<p>[\/et_pb_text][et_pb_code _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; theme_builder_area=&#8221;post_content&#8221; hover_enabled=&#8221;0&#8243; sticky_enabled=&#8221;0&#8243;]<style id=\"wpforms-css-vars-1782\">\n\t\t\t\t#wpforms-1782 {\n\t\t\t\t\n\t\t\t}\n\t\t\t<\/style><div class=\"wpforms-container wpforms-container-full wpforms-render-modern\" id=\"wpforms-1782\"><form id=\"wpforms-form-1782\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"1782\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/en\/wp-json\/wp\/v2\/pages\/1806\" data-token=\"c27dd86cb34f9e19eb4503f0ac152a7a\" data-token-time=\"1776343974\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div id=\"wpforms-error-noscript\" style=\"display: none;\">Please enable JavaScript in your browser to complete this form.<\/div><div class=\"wpforms-field-container\"><div id=\"wpforms-1782-field_3-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"3\"><fieldset><legend class=\"wpforms-field-label\">Name <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-1782-field_3\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][3][first]\" aria-errormessage=\"wpforms-1782-field_3-error\" required><label for=\"wpforms-1782-field_3\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-1782-field_3-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][3][last]\" aria-errormessage=\"wpforms-1782-field_3-last-error\" required><label for=\"wpforms-1782-field_3-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><\/fieldset><\/div><div id=\"wpforms-1782-field_5-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-1782-field_5\">Telephone <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"number\" id=\"wpforms-1782-field_5\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][5]\" step=\"any\" aria-errormessage=\"wpforms-1782-field_5-error\" aria-describedby=\"wpforms-1782-field_5-description\" required><div id=\"wpforms-1782-field_5-description\" class=\"wpforms-field-description\">(include country code)<\/div><\/div><div id=\"wpforms-1782-field_6-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-1782-field_6\">E-mail <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"email\" id=\"wpforms-1782-field_6\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][6]\" spellcheck=\"false\" aria-errormessage=\"wpforms-1782-field_6-error\" required><\/div><div id=\"wpforms-1782-field_7-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"7\"><label class=\"wpforms-field-label\" for=\"wpforms-1782-field_7\">Date of Birth <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-1782-field_7\" class=\"wpforms-field-small wpforms-field-required\" name=\"wpforms[fields][7]\" aria-errormessage=\"wpforms-1782-field_7-error\" aria-describedby=\"wpforms-1782-field_7-description\" required><div id=\"wpforms-1782-field_7-description\" class=\"wpforms-field-description\">DD\/MM\/YYYY<\/div><\/div><div id=\"wpforms-1782-field_8-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"8\"><label class=\"wpforms-field-label\" for=\"wpforms-1782-field_8\">Age <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-1782-field_8\" class=\"wpforms-field-small wpforms-field-required\" name=\"wpforms[fields][8]\" aria-errormessage=\"wpforms-1782-field_8-error\" required><\/div><div id=\"wpforms-1782-field_14-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"14\"><label class=\"wpforms-field-label\" for=\"wpforms-1782-field_14\">Workshop\/Retreat you are registering for: <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-1782-field_14\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][14]\" required=\"required\"><option value=\"Embodied Anatomy Course\"  class=\"choice-1 depth-1\"  >Embodied Anatomy Course<\/option><option value=\"Dance Retreat in Spain\"  class=\"choice-3 depth-1\"  >Dance Retreat in Spain<\/option><option value=\"The Body Series\"  class=\"choice-2 depth-1\"  >The Body Series<\/option><\/select><div id=\"wpforms-1782-field_14-description\" class=\"wpforms-field-description\">Please choose the workshop\/retreat for which you are registering<\/div><\/div><div id=\"wpforms-1782-field_15-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"15\"><label class=\"wpforms-field-label\" for=\"wpforms-1782-field_15\">Briefly Describe Your Dance Background: <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-1782-field_15\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][15]\" aria-errormessage=\"wpforms-1782-field_15-error\" required><\/textarea><\/div><div id=\"wpforms-1782-field_16-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"16\"><label class=\"wpforms-field-label\" for=\"wpforms-1782-field_16\">Primary Objective for Joining this Workshop\/Retreat: <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-1782-field_16\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][16]\" aria-errormessage=\"wpforms-1782-field_16-error\" required><\/textarea><\/div><div id=\"wpforms-1782-field_21-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"21\"><label class=\"wpforms-field-label\" for=\"wpforms-1782-field_21\">Is there anything about your physical health, past injuries, or accessibility needs that you&#039;d like me to know to support your experience <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-1782-field_21\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][21]\" aria-errormessage=\"wpforms-1782-field_21-error\" required><\/textarea><\/div><div id=\"wpforms-1782-field_17-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"17\"><label class=\"wpforms-field-label\" for=\"wpforms-1782-field_17\">Have You Attended a Workshops\/Retreat Before? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-1782-field_17\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][17]\" required=\"required\"><option value=\"Yes\"  class=\"choice-1 depth-1\"  >Yes<\/option><option value=\"No\"  class=\"choice-2 depth-1\"  >No<\/option><\/select><\/div><div id=\"wpforms-1782-field_19-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"19\"><label class=\"wpforms-field-label\" for=\"wpforms-1782-field_19\">How Did You Hear About This Workshop\/Retreat? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-1782-field_19\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][19]\" required=\"required\"><option value=\"Friend\"  class=\"choice-1 depth-1\"  >Friend<\/option><option value=\"Family\"  class=\"choice-2 depth-1\"  >Family<\/option><option value=\"Website\"  class=\"choice-4 depth-1\"  >Website<\/option><option value=\"Social Media\"  class=\"choice-5 depth-1\"  >Social Media<\/option><option value=\"Other\"  class=\"choice-6 depth-1\"  >Other<\/option><\/select><\/div>\t\t<div id=\"wpforms-1782-field_1-container\"\n\t\t\tclass=\"wpforms-field wpforms-field-text\"\n\t\t\tdata-field-type=\"text\"\n\t\t\tdata-field-id=\"1\"\n\t\t\t>\n\t\t\t<label class=\"wpforms-field-label\" for=\"wpforms-1782-field_1\" >Signature Name Consent<\/label>\n\t\t\t<input type=\"text\" id=\"wpforms-1782-field_1\" class=\"wpforms-field-medium\" name=\"wpforms[fields][1]\" >\n\t\t<\/div>\n\t\t<div id=\"wpforms-1782-field_20-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"20\"><fieldset><legend class=\"wpforms-field-label\">Consent and Policies <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-1782-field_20\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-1782-field_20_1\" name=\"wpforms[fields][20][]\" value=\"I agree to the terms and conditions of the Dance Anatomy Workshop\" aria-errormessage=\"wpforms-1782-field_20_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1782-field_20_1\">I agree to the terms and conditions of the Dance Anatomy Workshop<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-1782-field_22-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"22\"><label class=\"wpforms-field-label\" for=\"wpforms-1782-field_22\">Electronic Signature <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-1782-field_22\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][22]\" aria-errormessage=\"wpforms-1782-field_22-error\" aria-describedby=\"wpforms-1782-field_22-description\" required><div id=\"wpforms-1782-field_22-description\" class=\"wpforms-field-description\">By typing my name above, I confirm that the information provided is accurate and I agree to the terms of this intake form.<\/div><\/div><script>\n\t\t\t\t( function() {\n\t\t\t\t\tconst style = document.createElement( 'style' );\n\t\t\t\t\tstyle.appendChild( document.createTextNode( '#wpforms-1782-field_1-container { position: absolute !important; overflow: hidden !important; display: inline !important; height: 1px !important; width: 1px !important; z-index: -1000 !important; padding: 0 !important; } #wpforms-1782-field_1-container input { visibility: hidden; } #wpforms-conversational-form-page #wpforms-1782-field_1-container label { counter-increment: none; }' ) );\n\t\t\t\t\tdocument.head.appendChild( style );\n\t\t\t\t\tdocument.currentScript?.remove();\n\t\t\t\t} )();\n\t\t\t<\/script><\/div><!-- .wpforms-field-container --><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"1782\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/danstherapie-coaching-amsterdam.nl\/en\/wp-json\/wp\/v2\/pages\/1806\"><input type=\"hidden\" name=\"url_referer\" value=\"\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-1782\" class=\"wpforms-submit\" data-alt-text=\"On to payment...\" data-submit-text=\"Submit &amp; On to Payment...\" aria-live=\"assertive\" value=\"wpforms-submit\">Submit &amp; On to Payment...<\/button><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/danstherapie-coaching-amsterdam.nl\/wp-content\/plugins\/wpforms-lite\/assets\/images\/submit-spin.svg\" class=\"wpforms-submit-spinner\" style=\"display: none;\" width=\"26\" height=\"26\" alt=\"Loading\"><\/div><\/form><\/div>  <!-- .wpforms-container -->[\/et_pb_code][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n<span class=\"et_bloom_bottom_trigger\"><\/span>","protected":false},"excerpt":{"rendered":"<p>Embodied Anatomy Workshop Intake &amp; Payment Form<style id=\"wpforms-css-vars-1782\">\n\t\t\t\t#wpforms-1782 {\n\t\t\t\t\n\t\t\t}\n\t\t\t<\/style><div class=\"wpforms-container wpforms-container-full wpforms-render-modern\" id=\"wpforms-1782\"><form id=\"wpforms-form-1782\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"1782\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/en\/wp-json\/wp\/v2\/pages\/1806\" data-token=\"c27dd86cb34f9e19eb4503f0ac152a7a\" data-token-time=\"1776343974\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div id=\"wpforms-error-noscript\" style=\"display: none;\">Please enable JavaScript in your browser to complete this form.<\/div><div class=\"wpforms-field-container\"><div id=\"wpforms-1782-field_3-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"3\"><fieldset><legend class=\"wpforms-field-label\">Name <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-1782-field_3\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][3][first]\" aria-errormessage=\"wpforms-1782-field_3-error\" required><label for=\"wpforms-1782-field_3\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-1782-field_3-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][3][last]\" aria-errormessage=\"wpforms-1782-field_3-last-error\" required><label for=\"wpforms-1782-field_3-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><\/fieldset><\/div><div id=\"wpforms-1782-field_5-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-1782-field_5\">Telephone <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"number\" id=\"wpforms-1782-field_5\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][5]\" step=\"any\" aria-errormessage=\"wpforms-1782-field_5-error\" aria-describedby=\"wpforms-1782-field_5-description\" required><div id=\"wpforms-1782-field_5-description\" class=\"wpforms-field-description\">(include country code)<\/div><\/div><div id=\"wpforms-1782-field_6-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-1782-field_6\">E-mail <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"email\" id=\"wpforms-1782-field_6\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][6]\" spellcheck=\"false\" aria-errormessage=\"wpforms-1782-field_6-error\" required><\/div><div id=\"wpforms-1782-field_7-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"7\"><label class=\"wpforms-field-label\" for=\"wpforms-1782-field_7\">Date of Birth <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-1782-field_7\" class=\"wpforms-field-small wpforms-field-required\" name=\"wpforms[fields][7]\" aria-errormessage=\"wpforms-1782-field_7-error\" aria-describedby=\"wpforms-1782-field_7-description\" required><div id=\"wpforms-1782-field_7-description\" class=\"wpforms-field-description\">DD\/MM\/YYYY<\/div><\/div><div id=\"wpforms-1782-field_8-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"8\"><label class=\"wpforms-field-label\" for=\"wpforms-1782-field_8\">Age <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-1782-field_8\" class=\"wpforms-field-small wpforms-field-required\" name=\"wpforms[fields][8]\" aria-errormessage=\"wpforms-1782-field_8-error\" required><\/div><div id=\"wpforms-1782-field_14-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"14\"><label class=\"wpforms-field-label\" for=\"wpforms-1782-field_14\">Workshop\/Retreat you are registering for: <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-1782-field_14\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][14]\" required=\"required\"><option value=\"Embodied Anatomy Course\"  class=\"choice-1 depth-1\"  >Embodied Anatomy Course<\/option><option value=\"Dance Retreat in Spain\"  class=\"choice-3 depth-1\"  >Dance Retreat in Spain<\/option><option value=\"The Body Series\"  class=\"choice-2 depth-1\"  >The Body Series<\/option><\/select><div id=\"wpforms-1782-field_14-description\" class=\"wpforms-field-description\">Please choose the workshop\/retreat for which you are registering<\/div><\/div><div id=\"wpforms-1782-field_15-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"15\"><label class=\"wpforms-field-label\" for=\"wpforms-1782-field_15\">Briefly Describe Your Dance Background: <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-1782-field_15\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][15]\" aria-errormessage=\"wpforms-1782-field_15-error\" required><\/textarea><\/div><div id=\"wpforms-1782-field_16-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"16\"><label class=\"wpforms-field-label\" for=\"wpforms-1782-field_16\">Primary Objective for Joining this Workshop\/Retreat: <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-1782-field_16\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][16]\" aria-errormessage=\"wpforms-1782-field_16-error\" required><\/textarea><\/div><div id=\"wpforms-1782-field_21-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"21\"><label class=\"wpforms-field-label\" for=\"wpforms-1782-field_21\">Is there anything about your physical health, past injuries, or accessibility needs that you&#039;d like me to know to support your experience <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-1782-field_21\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][21]\" aria-errormessage=\"wpforms-1782-field_21-error\" required><\/textarea><\/div><div id=\"wpforms-1782-field_17-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"17\"><label class=\"wpforms-field-label\" for=\"wpforms-1782-field_17\">Have You Attended a Workshops\/Retreat Before? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-1782-field_17\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][17]\" required=\"required\"><option value=\"Yes\"  class=\"choice-1 depth-1\"  >Yes<\/option><option value=\"No\"  class=\"choice-2 depth-1\"  >No<\/option><\/select><\/div>\t\t<div id=\"wpforms-1782-field_1-container\"\n\t\t\tclass=\"wpforms-field wpforms-field-text\"\n\t\t\tdata-field-type=\"text\"\n\t\t\tdata-field-id=\"1\"\n\t\t\t>\n\t\t\t<label class=\"wpforms-field-label\" for=\"wpforms-1782-field_1\" >Background: Consent of<\/label>\n\t\t\t<input type=\"text\" id=\"wpforms-1782-field_1\" class=\"wpforms-field-medium\" name=\"wpforms[fields][1]\" >\n\t\t<\/div>\n\t\t<div id=\"wpforms-1782-field_19-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"19\"><label class=\"wpforms-field-label\" for=\"wpforms-1782-field_19\">How Did You Hear About This Workshop\/Retreat? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-1782-field_19\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][19]\" required=\"required\"><option value=\"Friend\"  class=\"choice-1 depth-1\"  >Friend<\/option><option value=\"Family\"  class=\"choice-2 depth-1\"  >Family<\/option><option value=\"Website\"  class=\"choice-4 depth-1\"  >Website<\/option><option value=\"Social Media\"  class=\"choice-5 depth-1\"  >Social Media<\/option><option value=\"Other\"  class=\"choice-6 depth-1\"  >Other<\/option><\/select><\/div><div id=\"wpforms-1782-field_20-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"20\"><fieldset><legend class=\"wpforms-field-label\">Consent and Policies <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-1782-field_20\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-1782-field_20_1\" name=\"wpforms[fields][20][]\" value=\"I agree to the terms and conditions of the Dance Anatomy Workshop\" aria-errormessage=\"wpforms-1782-field_20_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1782-field_20_1\">I agree to the terms and conditions of the Dance Anatomy Workshop<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-1782-field_22-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"22\"><label class=\"wpforms-field-label\" for=\"wpforms-1782-field_22\">Electronic Signature <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-1782-field_22\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][22]\" aria-errormessage=\"wpforms-1782-field_22-error\" aria-describedby=\"wpforms-1782-field_22-description\" required><div id=\"wpforms-1782-field_22-description\" class=\"wpforms-field-description\">By typing my name above, I confirm that the information provided is accurate and I agree to the terms of this intake form.<\/div><\/div><script>\n\t\t\t\t( function() {\n\t\t\t\t\tconst style = document.createElement( 'style' );\n\t\t\t\t\tstyle.appendChild( document.createTextNode( '#wpforms-1782-field_1-container { position: absolute !important; overflow: hidden !important; display: inline !important; height: 1px !important; width: 1px !important; z-index: -1000 !important; padding: 0 !important; } #wpforms-1782-field_1-container 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