Adding Form to My website makes it Crash and not Start up
Nov 20, 2012 4:19 PM
This is my Site
http://splexcity.biz/test/html5/index.html#!/page_MORE
on the Menu Bar Clicking Services and on the Bottom Right is a button i made called Bookings.... In there it will open another section where i edit the words Insert Form Here. But When I do It Crashes Site My =(
-------------------------------------Code For booking Form------------
<script src="http://max.jotfor.ms/min/g=jotform?3.1.861" type="text/javascript"></script>
<script type="text/javascript">
JotForm.init(function(){
$('input_11').hint('ex: myname@example.com');
JotForm.setCalendar("14");
JotForm.setCalendar("19");
$('input_17').hint('ex: 23');
JotForm.initCaptcha('input_21');
JotForm.highlightInputs = false;
});
</script>
<link href="http://max.jotfor.ms/min/g=formCss?3.1.861" rel="stylesheet" type="text/css" />
<link type="text/css" rel="stylesheet" href="http://jotform.us/css/styles/industrial_dark.css?3.1.861" />
<style type="text/css">
.form-label{
width:150px !important;
}
.form-label-left{
width:150px !important;
}
.form-line{
padding-top:12px;
padding-bottom:12px;
}
.form-label-right{
width:150px !important;
}
.form-all{
width:650px;
background:#000000;
color:#FFFFFF !important;
font-family:'Helvetica';
font-size:12px;
}
.form-radio-item label, .form-checkbox-item label, .form-grading-label, .form-header{
color:#FFFFFF;
}
</style>
<link type="text/css" rel="stylesheet" href="http://jotform.us/css/styles/buttons/form-submit-button-simple_carolin a_blue.css?3.1.861"/>
<form class="jotform-form" action="http://submit.jotform.us/submit/22395037114145/" method="post" name="form_22395037114145" id="22395037114145" accept-charset="utf-8">
<input type="hidden" name="formID" value="22395037114145" />
<div class="form-all">
<ul class="form-section">
<li id="cid_1" class="form-input-wide">
<div class="form-header-group">
<h2 id="header_1" class="form-header">
Your Information
</h2>
</div>
</li>
<li class="form-line" id="id_10">
<label class="form-label-left" id="label_10" for="input_10">
Full Name<span class="form-required">*</span>
</label>
<div id="cid_10" class="form-input"><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q10_fullName10[first]" id="first_10" />
<label class="form-sub-label" for="first_10" id="sublabel_first"> First Name </label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q10_fullName10[last]" id="last_10" />
<label class="form-sub-label" for="last_10" id="sublabel_last"> Last Name </label></span>
</div>
</li>
<li class="form-line" id="id_11">
<label class="form-label-left" id="label_11" for="input_11">
E-mail<span class="form-required">*</span>
</label>
<div id="cid_11" class="form-input">
<input type="email" class="form-textbox validate[required, Email]" id="input_11" name="q11_email11" size="30" />
</div>
</li>
<li class="form-line" id="id_8">
<label class="form-label-left" id="label_8" for="input_8">
Phone Number<span class="form-required">*</span>
</label>
<div id="cid_8" class="form-input"><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="tel" name="q8_phoneNumber8[area]" id="input_8_area" size="3">
-
<label class="form-sub-label" for="input_8_area" id="sublabel_area"> Area Code </label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="tel" name="q8_phoneNumber8[phone]" id="input_8_phone" size="8">
<label class="form-sub-label" for="input_8_phone" id="sublabel_phone"> Phone Number </label></span>
</div>
</li>
<li id="cid_12" class="form-input-wide">
<div class="form-header-group">
<h2 id="header_12" class="form-header">
Event Information
</h2>
</div>
</li>
<li class="form-line" id="id_16">
<label class="form-label-left" id="label_16" for="input_16">
Event Type<span class="form-required">*</span>
</label>
<div id="cid_16" class="form-input">
<select class="form-dropdown validate[required]" style="width:150px" id="input_16" name="q16_eventType">
<option> </option>
<option value="Wedding Reception "> Wedding Reception </option>
<option value="High School Dance"> High School Dance </option>
<option value="Middle School Dance "> Middle School Dance </option>
<option value="College Dance"> College Dance </option>
<option value="Private Party "> Private Party </option>
<option value="Corporate Event "> Corporate Event </option>
<option value="Club Event"> Club Event </option>
<option value="Other "> Other </option>
</select>
</div>
</li>
<li class="form-line form-line-column" id="id_14">
<label class="form-label-top" id="label_14" for="input_14">
Event Start Date & Time<span class="form-required">*</span>
</label>
<div id="cid_14" class="form-input-wide"><span class="form-sub-label-container"><input class="form-textbox validate[required]" id="month_14" name="q14_eventStart[month]" type="text" size="2" maxlength="2" value="" /><span class="date-separate"> /</span>
<label class="form-sub-label" for="month_14" id="sublabel_month"> Month </label></span><span class="form-sub-label-container"><input class="noDefault form-textbox validate[required]" id="day_14" name="q14_eventStart[day]" type="text" size="2" maxlength="2" value="" /><span class="date-separate"> /</span>
<label class="form-sub-label" for="day_14" id="sublabel_day"> Day </label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" id="year_14" name="q14_eventStart[year]" type="text" size="4" maxlength="4" value="" />
<label class="form-sub-label" for="year_14" id="sublabel_year"> Year </label></span><span class="form-sub-label-container"><div id="at_14">
at
</div>
<label class="form-sub-label" for="at_14"> </label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" id="hour_14" name="q14_eventStart[hour]" type="text" size="2" maxlength="2" value="" /><span class="date-separate"> :</span>
<label class="form-sub-label" for="hour_14" id="sublabel_hour"> Hour </label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" id="min_14" name="q14_eventStart[min]" type="text" size="2" maxlength="2" value="" />
<label class="form-sub-label" for="min_14" id="sublabel_minutes"> Minutes </label></span><span class="form-sub-label-container"><select class="form-dropdown validate[required]" id="ampm_14" name="q14_eventStart[ampm]">
<option value="AM"> AM </option>
<option value="PM"> PM </option>
</select>
<label class="form-sub-label" for="ampm_14"> </label></span><span class="form-sub-label-container"><img alt="Pick a Date" id="input_14_pick" src="http://jotform.us/images/calendar.png" align="absmiddle" />
<label class="form-sub-label" for="input_14_pick"> </label></span>
</div>
</li>
<li class="form-line form-line-column" id="id_19">
<label class="form-label-top" id="label_19" for="input_19">
Event Ending Date & Time<span class="form-required">*</span>
</label>
<div id="cid_19" class="form-input-wide"><span class="form-sub-label-container"><input class="form-textbox validate[required]" id="month_19" name="q19_eventEnding[month]" type="text" size="2" maxlength="2" value="" /><span class="date-separate"> /</span>
<label class="form-sub-label" for="month_19" id="sublabel_month"> Month </label></span><span class="form-sub-label-container"><input class="noDefault form-textbox validate[required]" id="day_19" name="q19_eventEnding[day]" type="text" size="2" maxlength="2" value="" /><span class="date-separate"> /</span>
<label class="form-sub-label" for="day_19" id="sublabel_day"> Day </label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" id="year_19" name="q19_eventEnding[year]" type="text" size="4" maxlength="4" value="" />
<label class="form-sub-label" for="year_19" id="sublabel_year"> Year </label></span><span class="form-sub-label-container"><div id="at_19">
at
</div>
<label class="form-sub-label" for="at_19"> </label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" id="hour_19" name="q19_eventEnding[hour]" type="text" size="2" maxlength="2" value="" /><span class="date-separate"> :</span>
<label class="form-sub-label" for="hour_19" id="sublabel_hour"> Hour </label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" id="min_19" name="q19_eventEnding[min]" type="text" size="2" maxlength="2" value="" />
<label class="form-sub-label" for="min_19" id="sublabel_minutes"> Minutes </label></span><span class="form-sub-label-container"><select class="form-dropdown validate[required]" id="ampm_19" name="q19_eventEnding[ampm]">
<option value="AM"> AM </option>
<option value="PM"> PM </option>
</select>
<label class="form-sub-label" for="ampm_19"> </label></span><span class="form-sub-label-container"><img alt="Pick a Date" id="input_19_pick" src="http://jotform.us/images/calendar.png" align="absmiddle" />
<label class="form-sub-label" for="input_19_pick"> </label></span>
</div>
</li>
<li class="form-line" id="id_15">
<label class="form-label-left" id="label_15" for="input_15">
Event Location<span class="form-required">*</span>
</label>
<div id="cid_15" class="form-input">
<table summary="" class="form-address-table" border="0" cellpadding="0" cellspacing="0">
<tr>
<td colspan="2"><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-line" type="text" name="q15_eventLocation[addr_line1]" id="input_15_addr_line1" />
<label class="form-sub-label" for="input_15_addr_line1" id="sublabel_addr_line1"> Street Address </label></span>
</td>
</tr>
<tr>
<td colspan="2"><span class="form-sub-label-container"><input class="form-textbox form-address-line" type="text" name="q15_eventLocation[addr_line2]" id="input_15_addr_line2" size="46" />
<label class="form-sub-label" for="input_15_addr_line2" id="sublabel_addr_line2"> Street Address Line 2 </label></span>
</td>
</tr>
<tr>
<td width="50%"><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-city" type="text" name="q15_eventLocation[city]" id="input_15_city" size="21" />
<label class="form-sub-label" for="input_15_city" id="sublabel_city"> City </label></span>
</td>
<td><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-state" type="text" name="q15_eventLocation[state]" id="input_15_state" size="22" />
<label class="form-sub-label" for="input_15_state" id="sublabel_state"> State / Province </label></span>
</td>
</tr>
<tr>
<td width="50%"><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-postal" type="text" name="q15_eventLocation[postal]" id="input_15_postal" size="10" />
<label class="form-sub-label" for="input_15_postal" id="sublabel_postal"> Postal / Zip Code </label></span>
</td>
<td><span class="form-sub-label-container"><select class="form-dropdown validate[required] form-address-country" name="q15_eventLocation[country]" id="input_15_country">
<option selected> Please Select </option>
<option selected="selected" value="United States"> United States </option>
<option value="Abkhazia"> Abkhazia </option>
<option value="Afghanistan"> Afghanistan </option>
<option value="Albania"> Albania </option>
<option value="Algeria"> Algeria </option>
<option value="American Samoa"> American Samoa </option>
<option value="Andorra"> Andorra </option>
<option value="Angola"> Angola </option>
<option value="Anguilla"> Anguilla </option>
<option value="Antigua and Barbuda"> Antigua and Barbuda </option>
<option value="Argentina"> Argentina </option>
<option value="Armenia"> Armenia </option>
<option value="Aruba"> Aruba </option>
<option value="Australia"> Australia </option>
<option value="Austria"> Austria </option>
<option value="Azerbaijan"> Azerbaijan </option>
<option value="The Bahamas"> The Bahamas </option>
<option value="Bahrain"> Bahrain </option>
<option value="Bangladesh"> Bangladesh </option>
<option value="Barbados"> Barbados </option>
<option value="Belarus"> Belarus </option>
<option value="Belgium"> Belgium </option>
<option value="Belize"> Belize </option>
<option value="Benin"> Benin </option>
<option value="Bermuda"> Bermuda </option>
<option value="Bhutan"> Bhutan </option>
<option value="Bolivia"> Bolivia </option>
<option value="Bosnia and Herzegovina"> Bosnia and Herzegovina </option>
<option value="Botswana"> Botswana </option>
<option value="Brazil"> Brazil </option>
<option value="Brunei"> Brunei </option>
<option value="Bulgaria"> Bulgaria </option>
<option value="Burkina Faso"> Burkina Faso </option>
<option value="Burundi"> Burundi </option>
<option value="Cambodia"> Cambodia </option>
<option value="Cameroon"> Cameroon </option>
<option value="Canada"> Canada </option>
<option value="Cape Verde"> Cape Verde </option>
<option value="Cayman Islands"> Cayman Islands </option>
<option value="Central African Republic"> Central African Republic </option>
<option value="Chad"> Chad </option>
<option value="Chile"> Chile </option>
<option value="People's Republic of China"> People's Republic of China </option>
<option value="Republic of China"> Republic of China </option>
<option value="Christmas Island"> Christmas Island </option>
<option value="Cocos (Keeling) Islands"> Cocos (Keeling) Islands </option>
<option value="Colombia"> Colombia </option>
<option value="Comoros"> Comoros </option>
<option value="Congo"> Congo </option>
<option value="Cook Islands"> Cook Islands </option>
<option value="Costa Rica"> Costa Rica </option>
<option value="Cote d'Ivoire"> Cote d'Ivoire </option>
<option value="Croatia"> Croatia </option>
<option value="Cuba"> Cuba </option>
<option value="Cyprus"> Cyprus </option>
<option value="Czech Republic"> Czech Republic </option>
<option value="Denmark"> Denmark </option>
<option value="Djibouti"> Djibouti </option>
<option value="Dominica"> Dominica </option>
<option value="Dominican Republic"> Dominican Republic </option>
<option value="Ecuador"> Ecuador </option>
<option value="Egypt"> Egypt </option>
<option value="El Salvador"> El Salvador </option>
<option value="Equatorial Guinea"> Equatorial Guinea </option>
<option value="Eritrea"> Eritrea </option>
<option value="Estonia"> Estonia </option>
<option value="Ethiopia"> Ethiopia </option>
<option value="Falkland Islands"> Falkland Islands </option>
<option value="Faroe Islands"> Faroe Islands </option>
<option value="Fiji"> Fiji </option>
<option value="Finland"> Finland </option>
<option value="France"> France </option>
<option value="French Polynesia"> French Polynesia </option>
<option value="Gabon"> Gabon </option>
<option value="The Gambia"> The Gambia </option>
<option value="Georgia"> Georgia </option>
<option value="Germany"> Germany </option>
<option value="Ghana"> Ghana </option>
<option value="Gibraltar"> Gibraltar </option>
<option value="Greece"> Greece </option>
<option value="Greenland"> Greenland </option>
<option value="Grenada"> Grenada </option>
<option value="Guadeloupe"> Guadeloupe </option>
<option value="Guam"> Guam </option>
<option value="Guatemala"> Guatemala </option>
<option value="Guernsey"> Guernsey </option>
<option value="Guinea"> Guinea </option>
<option value="Guinea-Bissau"> Guinea-Bissau </option>
<option value="Guyana"> Guyana </option>
<option value="Haiti"> Haiti </option>
<option value="Honduras"> Honduras </option>
<option value="Hong Kong"> Hong Kong </option>
<option value="Hungary"> Hungary </option>
<option value="Iceland"> Iceland </option>
<option value="India"> India </option>
<option value="Indonesia"> Indonesia </option>
<option value="Iran"> Iran </option>
<option value="Iraq"> Iraq </option>
<option value="Ireland"> Ireland </option>
<option value="Israel"> Israel </option>
<option value="Italy"> Italy </option>
<option value="Jamaica"> Jamaica </option>
<option value="Japan"> Japan </option>
<option value="Jersey"> Jersey </option>
<option value="Jordan"> Jordan </option>
<option value="Kazakhstan"> Kazakhstan </option>
<option value="Kenya"> Kenya </option>
<option value="Kiribati"> Kiribati </option>
<option value="North Korea"> North Korea </option>
<option value="South Korea"> South Korea </option>
<option value="Kosovo"> Kosovo </option>
<option value="Kuwait"> Kuwait </option>
<option value="Kyrgyzstan"> Kyrgyzstan </option>
<option value="Laos"> Laos </option>
<option value="Latvia"> Latvia </option>
<option value="Lebanon"> Lebanon </option>
<option value="Lesotho"> Lesotho </option>
<option value="Liberia"> Liberia </option>
<option value="Libya"> Libya </option>
<option value="Liechtenstein"> Liechtenstein </option>
<option value="Lithuania"> Lithuania </option>
<option value="Luxembourg"> Luxembourg </option>
<option value="Macau"> Macau </option>
<option value="Macedonia"> Macedonia </option>
<option value="Madagascar"> Madagascar </option>
<option value="Malawi"> Malawi </option>
<option value="Malaysia"> Malaysia </option>
<option value="Maldives"> Maldives </option>
<option value="Mali"> Mali </option>
<option value="Malta"> Malta </option>
<option value="Marshall Islands"> Marshall Islands </option>
<option value="Martinique"> Martinique </option>
<option value="Mauritania"> Mauritania </option>
<option value="Mauritius"> Mauritius </option>
<option value="Mayotte"> Mayotte </option>
<option value="Mexico"> Mexico </option>
<option value="Micronesia"> Micronesia </option>
<option value="Moldova"> Moldova </option>
<option value="Monaco"> Monaco </option>
<option value="Mongolia"> Mongolia </option>
<option value="Montenegro"> Montenegro </option>
<option value="Montserrat"> Montserrat </option>
<option value="Morocco"> Morocco </option>
<option value="Mozambique"> Mozambique </option>
<option value="Myanmar"> Myanmar </option>
<option value="Nagorno-Karabakh"> Nagorno-Karabakh </option>
<option value="Namibia"> Namibia </option>
<option value="Nauru"> Nauru </option>
<option value="Nepal"> Nepal </option>
<option value="Netherlands"> Netherlands </option>
<option value="Netherlands Antilles"> Netherlands Antilles </option>
<option value="New Caledonia"> New Caledonia </option>
<option value="New Zealand"> New Zealand </option>
<option value="Nicaragua"> Nicaragua </option>
<option value="Niger"> Niger </option>
<option value="Nigeria"> Nigeria </option>
<option value="Niue"> Niue </option>
<option value="Norfolk Island"> Norfolk Island </option>
<option value="Turkish Republic of Northern Cyprus"> Turkish Republic of Northern Cyprus </option>
<option value="Northern Mariana"> Northern Mariana </option>
<option value="Norway"> Norway </option>
<option value="Oman"> Oman </option>
<option value="Pakistan"> Pakistan </option>
<option value="Palau"> Palau </option>
<option value="Palestine"> Palestine </option>
<option value="Panama"> Panama </option>
<option value="Papua New Guinea"> Papua New Guinea </option>
<option value="Paraguay"> Paraguay </option>
<option value="Peru"> Peru </option>
<option value="Philippines"> Philippines </option>
<option value="Pitcairn Islands"> Pitcairn Islands </option>
<option value="Poland"> Poland </option>
<option value="Portugal"> Portugal </option>
<option value="Puerto Rico"> Puerto Rico </option>
<option value="Qatar"> Qatar </option>
<option value="Romania"> Romania </option>
<option value="Russia"> Russia </option>
<option value="Rwanda"> Rwanda </option>
<option value="Saint Barthelemy"> Saint Barthelemy </option>
<option value="Saint Helena"> Saint Helena </option>
<option value="Saint Kitts and Nevis"> Saint Kitts and Nevis </option>
<option value="Saint Lucia"> Saint Lucia </option>
<option value="Saint Martin"> Saint Martin </option>
<option value="Saint Pierre and Miquelon"> Saint Pierre and Miquelon </option>
<option value="Saint Vincent and the Grenadines"> Saint Vincent and the Grenadines </option>
<option value="Samoa"> Samoa </option>
<option value="San Marino"> San Marino </option>
<option value="Sao Tome and Principe"> Sao Tome and Principe </option>
<option value="Saudi Arabia"> Saudi Arabia </option>
<option value="Senegal"> Senegal </option>
<option value="Serbia"> Serbia </option>
<option value="Seychelles"> Seychelles </option>
<option value="Sierra Leone"> Sierra Leone </option>
<option value="Singapore"> Singapore </option>
<option value="Slovakia"> Slovakia </option>
<option value="Slovenia"> Slovenia </option>
<option value="Solomon Islands"> Solomon Islands </option>
<option value="Somalia"> Somalia </option>
<option value="Somaliland"> Somaliland </option>
<option value="South Africa"> South Africa </option>
<option value="South Ossetia"> South Ossetia </option>
<option value="Spain"> Spain </option>
<option value="Sri Lanka"> Sri Lanka </option>
<option value="Sudan"> Sudan </option>
<option value="Suriname"> Suriname </option>
<option value="Svalbard"> Svalbard </option>
<option value="Swaziland"> Swaziland </option>
<option value="Sweden"> Sweden </option>
<option value="Switzerland"> Switzerland </option>
<option value="Syria"> Syria </option>
<option value="Taiwan"> Taiwan </option>
<option value="Tajikistan"> Tajikistan </option>
<option value="Tanzania"> Tanzania </option>
<option value="Thailand"> Thailand </option>
<option value="Timor-Leste"> Timor-Leste </option>
<option value="Togo"> Togo </option>
<option value="Tokelau"> Tokelau </option>
<option value="Tonga"> Tonga </option>
<option value="Transnistria Pridnestrovie"> Transnistria Pridnestrovie </option>
<option value="Trinidad and Tobago"> Trinidad and Tobago </option>
<option value="Tristan da Cunha"> Tristan da Cunha </option>
<option value="Tunisia"> Tunisia </option>
<option value="Turkey"> Turkey </option>
<option value="Turkmenistan"> Turkmenistan </option>
<option value="Turks and Caicos Islands"> Turks and Caicos Islands </option>
<option value="Tuvalu"> Tuvalu </option>
<option value="Uganda"> Uganda </option>
<option value="Ukraine"> Ukraine </option>
<option value="United Arab Emirates"> United Arab Emirates </option>
<option value="United Kingdom"> United Kingdom </option>
<option value="Uruguay"> Uruguay </option>
<option value="Uzbekistan"> Uzbekistan </option>
<option value="Vanuatu"> Vanuatu </option>
<option value="Vatican City"> Vatican City </option>
<option value="Venezuela"> Venezuela </option>
<option value="Vietnam"> Vietnam </option>
<option value="British Virgin Islands"> British Virgin Islands </option>
<option value="US Virgin Islands"> US Virgin Islands </option>
<option value="Wallis and Futuna"> Wallis and Futuna </option>
<option value="Western Sahara"> Western Sahara </option>
<option value="Yemen"> Yemen </option>
<option value="Zambia"> Zambia </option>
<option value="Zimbabwe"> Zimbabwe </option>
<option value="other"> Other </option>
</select>
<label class="form-sub-label" for="input_15_country" id="sublabel_country"> Country </label></span>
</td>
</tr>
</table>
</div>
</li>
<li class="form-line" id="id_20">
<label class="form-label-left" id="label_20" for="input_20"> Music Preference </label>
<div id="cid_20" class="form-input">
<div class="form-multiple-column"><span class="form-checkbox-item"><input type="checkbox" class="form-checkbox" id="input_20_0" name="q20_musicPreference[]" value="House" />
<label for="input_20_0"> House </label></span><span class="clearfix"></span><span class="form-checkbox-item"><input type="checkbox" class="form-checkbox" id="input_20_1" name="q20_musicPreference[]" value="Hip-Hop" />
<label for="input_20_1"> Hip-Hop </label></span><span class="clearfix"></span><span class="form-checkbox-item"><input type="checkbox" class="form-checkbox" id="input_20_2" name="q20_musicPreference[]" value="R&B" />
<label for="input_20_2"> R&B </label></span><span class="clearfix"></span><span class="form-checkbox-item" style="clear:left;"><input type="checkbox" class="form-checkbox" id="input_20_3" name="q20_musicPreference[]" value="Dance" />
<label for="input_20_3"> Dance </label></span><span class="clearfix"></span><span class="form-checkbox-item"><input type="checkbox" class="form-checkbox" id="input_20_4" name="q20_musicPreference[]" value="Reggae" />
<label for="input_20_4"> Reggae </label></span><span class="clearfix"></span><span class="form-checkbox-item"><input type="checkbox" class="form-checkbox" id="input_20_5" name="q20_musicPreference[]" value="Top 40" />
<label for="input_20_5"> Top 40 </label></span><span class="clearfix"></span><span class="form-checkbox-item" style="clear:left;"><input type="checkbox" class="form-checkbox" id="input_20_6" name="q20_musicPreference[]" value="Reggaeton" />
<label for="input_20_6"> Reggaeton </label></span><span class="clearfix"></span><span class="form-checkbox-item"><input type="checkbox" class="form-checkbox" id="input_20_7" name="q20_musicPreference[]" value="Any Genres" />
<label for="input_20_7"> Any Genres </label></span><span class="clearfix"></span><span class="form-checkbox-item"><input type="checkbox" class="form-checkbox" id="input_20_8" name="q20_musicPreference[]" value="Old School" />
<label for="input_20_8"> Old School </label></span><span class="clearfix"></span>
</div>
</div>
</li>
<li class="form-line" id="id_17">
<label class="form-label-left" id="label_17" for="input_17"> Number Of Guests </label>
<div id="cid_17" class="form-input">
<input type="number" class="form-textbox validate[Numeric]" id="input_17" name="q17_numberOf" size="5" />
</div>
</li>
<li class="form-line" id="id_18">
<label class="form-label-left" id="label_18" for="input_18"> Questions and/or Comments </label>
<div id="cid_18" class="form-input">
<textarea id="input_18" class="form-textarea" name="q18_questionsAndor" cols="40" rows="6"></textarea>
</div>
</li>
<li class="form-line" id="id_21">
<label class="form-label-left" id="label_21" for="input_21">
Enter the message as it's shown<span class="form-required">*</span>
</label>
<div id="cid_21" class="form-input">
<div class="form-captcha">
<label for="input_21"> <img alt="Captcha - Reload if it's not displayed" id="input_21_captcha" class="form-captcha-image" style="background:url(http://jotform.us/images/loader-big.gif) no-repeat center;" src="http://jotform.us/images/blank.gif" width="150" height="41" /> </label>
<div style="white-space:nowrap;">
<input type="text" id="input_21" class="form-textbox validate[required]" name="captcha" style="width:130px;" />
<img src="http://jotform.us/images/reload.png" alt="Reload" align="absmiddle" style="cursor:pointer" onclick="JotForm.reloadCaptcha('input_21');" />
<input type="hidden" name="captcha_id" id="input_21_captcha_id" value="0" />
</div>
</div>
</div>
</li>
<li class="form-line" id="id_2">
<div id="cid_2" class="form-input-wide">
<div style="text-align:center" class="form-buttons-wrapper">
<button id="input_2" type="submit" class="form-submit-button form-submit-button-simple_carolina_blue">
Submit
</button>
</div>
</div>
</li>
<li style="display:none">
Should be Empty:
<input type="text" name="website" value="" />
</li>
</ul>
</div>
<input type="hidden" id="simple_spc" name="simple_spc" value="22395037114145" />
<script type="text/javascript">
document.getElementById("si" + "mple" + "_spc").value = "22395037114145-22395037114145";
</script>
</form>
------------End-------
