[gravityforms id=5]
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<div class='gf_browser_unknown gform_wrapper gravity-theme' id='gform_wrapper_5' >
<div class='gform_heading'>
<h2 class="gform_title">How did you hear about us?</h2>
<span class='gform_description'></span>
</div><form method='post' enctype='multipart/form-data' id='gform_5' action='/store-locator/?line=power-crunch-kids' >
<input type='hidden' class='gforms-pum' value='{"closepopup":false,"closedelay":0,"openpopup":false,"openpopup_id":0}' />
<div class='gform_body gform-body'><div id='gform_fields_5' class='gform_fields top_label form_sublabel_below description_below'><fieldset id="field_5_1" class="gfield field_sublabel_below field_description_below hidden_label gfield_visibility_visible" ><legend class='gfield_label gfield_label_before_complex' >How did you hear about us?</legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_5_1'><div class='gchoice gchoice_5_1_1'>
<input class='gfield-choice-input' name='input_1.1' type='checkbox' value='Google' id='choice_5_1_1' />
<label for='choice_5_1_1' id='label_5_1_1'>Google</label>
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<input class='gfield-choice-input' name='input_1.2' type='checkbox' value='Social Media' id='choice_5_1_2' />
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<input class='gfield-choice-input' name='input_1.3' type='checkbox' value='YouTube' id='choice_5_1_3' />
<label for='choice_5_1_3' id='label_5_1_3'>YouTube</label>
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<input class='gfield-choice-input' name='input_1.4' type='checkbox' value='TV' id='choice_5_1_4' />
<label for='choice_5_1_4' id='label_5_1_4'>TV</label>
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<input class='gfield-choice-input' name='input_1.5' type='checkbox' value='Radio' id='choice_5_1_5' />
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<input class='gfield-choice-input' name='input_1.6' type='checkbox' value='In Store' id='choice_5_1_6' />
<label for='choice_5_1_6' id='label_5_1_6'>In Store</label>
</div><div class='gchoice gchoice_5_1_7'>
<input class='gfield-choice-input' name='input_1.7' type='checkbox' value='Other' id='choice_5_1_7' />
<label for='choice_5_1_7' id='label_5_1_7'>Other</label>
</div></div></div></fieldset></div></div>
<div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_5' class='gform_button button' value='Submit' onclick='if(window["gf_submitting_5"]){return false;} window["gf_submitting_5"]=true; ' onkeypress='if( event.keyCode == 13 ){ if(window["gf_submitting_5"]){return false;} window["gf_submitting_5"]=true; jQuery("#gform_5").trigger("submit",[true]); }' />
<input type='hidden' class='gform_hidden' name='is_submit_5' value='1' />
<input type='hidden' class='gform_hidden' name='gform_submit' value='5' />
<input type='hidden' class='gform_hidden' name='gform_unique_id' value='' />
<input type='hidden' class='gform_hidden' name='state_5' value='WyJbXSIsIjI0YmYzOGFlN2Q3NzIyMWRlNzIxYTM4YTRmMDIyY2RkIl0=' />
<input type='hidden' class='gform_hidden' name='gform_target_page_number_5' id='gform_target_page_number_5' value='0' />
<input type='hidden' class='gform_hidden' name='gform_source_page_number_5' id='gform_source_page_number_5' value='1' />
<input type='hidden' name='gform_field_values' value='' />
</div>
</form>
</div>
