{"id":3355,"date":"2021-12-19T13:51:06","date_gmt":"2021-12-19T18:51:06","guid":{"rendered":"https:\/\/www.ibmring58.com\/?page_id=3355"},"modified":"2021-12-19T14:22:26","modified_gmt":"2021-12-19T19:22:26","slug":"membership-application","status":"publish","type":"page","link":"https:\/\/www.ibmring58.com\/index.php\/membership-application\/","title":{"rendered":"Membership Application"},"content":{"rendered":"<div class=\"forminator-ui forminator-custom-form forminator-custom-form-3354 forminator-design--default  forminator_ajax\" data-forminator-render=\"0\" data-form=\"forminator-module-3354\" data-uid=\"69d4a18612454\"><br\/><\/div><form\n\t\t\t\tid=\"forminator-module-3354\"\n\t\t\t\tclass=\"forminator-ui forminator-custom-form forminator-custom-form-3354 forminator-design--default  forminator_ajax\"\n\t\t\t\tmethod=\"post\"\n\t\t\t\tdata-forminator-render=\"0\"\n\t\t\t\tdata-form-id=\"3354\"\n\t\t\t\t\n\t\t\t\tdata-design=\"default\"\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\tdata-grid=\"open\"\n\t\t\t\t\n\t\t\t\t\n\t\t\t\tstyle=\"display: none;\"\n\t\t\t\t\n\t\t\t\tdata-uid=\"69d4a18612454\"\n\t\t\t><div role=\"alert\" aria-live=\"polite\" class=\"forminator-response-message forminator-error\" aria-hidden=\"true\"><\/div><div class=\"forminator-row\"><div id=\"name-1\" class=\"forminator-field-name forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-1_69d4a18612454\" id=\"forminator-field-name-1_69d4a18612454-label\" class=\"forminator-label\">Name <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"name-1\" value=\"\" placeholder=\"E.g. John Doe\" id=\"forminator-field-name-1_69d4a18612454\" class=\"forminator-input forminator-name--field\" aria-required=\"true\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"date-1\" class=\"forminator-field-date forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-date-1-picker_69d4a18612454\" id=\"forminator-field-date-1-picker_69d4a18612454-label\" class=\"forminator-label\">Date of Birth<\/label><div class=\"forminator-input-with-icon\"><span class=\"forminator-icon-calendar\" aria-hidden=\"true\"><\/span><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-1\" value=\"\" placeholder=\"Choose Date\" id=\"forminator-field-date-1-picker_69d4a18612454\" class=\"forminator-input forminator-datepicker\" data-required=\"\" data-format=\"mm\/dd\/yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1926\" data-end-year=\"2126\" data-past-dates=\"enable\" data-start-of-week=\"0\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" \/><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"phone-1\" class=\"forminator-field-phone forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-phone-1_69d4a18612454\" id=\"forminator-field-phone-1_69d4a18612454-label\" class=\"forminator-label\">Phone<\/label><input type=\"text\" name=\"phone-1\" value=\"\" placeholder=\"E.g. +1 300 400 5000\" id=\"forminator-field-phone-1_69d4a18612454\" class=\"forminator-input forminator-field--phone\" data-required=\"\" aria-required=\"false\" autocomplete=\"off\" \/><\/div><\/div><div id=\"email-1\" class=\"forminator-field-email forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-email-1_69d4a18612454\" id=\"forminator-field-email-1_69d4a18612454-label\" class=\"forminator-label\">Email Address <span class=\"forminator-required\">*<\/span><\/label><input type=\"email\" name=\"email-1\" value=\"\" placeholder=\"E.g. john@doe.com\" id=\"forminator-field-email-1_69d4a18612454\" class=\"forminator-input forminator-email--field\" data-required=\"1\" aria-required=\"true\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"address-1\" class=\"forminator-field-address forminator-col forminator-col-12 \"><div class=\"forminator-row\"><div id=\"address-1-street_address\" class=\"forminator-col\"><div class=\"forminator-field\"><label for=\"forminator-field-address-1-street_address_69d4a18612454\" id=\"forminator-field-address-1-street_address_69d4a18612454-label\" class=\"forminator-label\">Street Address<\/label><input type=\"text\" name=\"address-1-street_address\" placeholder=\"E.g. 42 Wallaby Way\" id=\"forminator-field-address-1-street_address_69d4a18612454\" class=\"forminator-input\" data-required=\"\" aria-required=\"false\" value=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"address-1-address_line\" class=\"forminator-col\"><div class=\"forminator-field\"><label for=\"forminator-field-address-1-address_line_69d4a18612454\" id=\"forminator-field-address-1-address_line_69d4a18612454-label\" class=\"forminator-label\">Apartment, suite, etc<\/label><input type=\"text\" name=\"address-1-address_line\" placeholder=\"\" id=\"forminator-field-address-1-address_line_69d4a18612454\" class=\"forminator-input\" data-required=\"\" aria-required=\"false\" value=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\" data-multiple=\"true\"><div id=\"address-1-city\" class=\"forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-address-1-city_69d4a18612454\" id=\"forminator-field-address-1-city_69d4a18612454-label\" class=\"forminator-label\">City<\/label><input type=\"text\" name=\"address-1-city\" placeholder=\"E.g. Sydney\" id=\"forminator-field-address-1-city_69d4a18612454\" class=\"forminator-input\" data-required=\"\" aria-required=\"false\" value=\"\" \/><\/div><\/div><div id=\"address-1-state\" class=\"forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-address-1-state_69d4a18612454\" id=\"forminator-field-address-1-state_69d4a18612454-label\" class=\"forminator-label\">State\/Province<\/label><input type=\"text\" name=\"address-1-state\" placeholder=\"E.g. New South Wales\" id=\"forminator-field-address-1-state_69d4a18612454\" class=\"forminator-input\" data-required=\"\" aria-required=\"false\" value=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\" data-multiple=\"false\"><div id=\"address-1-zip\" class=\"forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-address-1-zip_69d4a18612454\" id=\"forminator-field-address-1-zip_69d4a18612454-label\" class=\"forminator-label\">ZIP \/ Postal Code<\/label><input type=\"text\" name=\"address-1-zip\" placeholder=\"E.g. 2000\" id=\"forminator-field-address-1-zip_69d4a18612454\" class=\"forminator-input\" value=\"\" \/><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-1\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-1_69d4a18612454\" id=\"forminator-field-textarea-1_69d4a18612454-label\" class=\"forminator-label\">Why do you want to join Ring 58?<\/label><textarea name=\"textarea-1\" placeholder=\"\" id=\"forminator-field-textarea-1_69d4a18612454\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-1\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-1-69d4a18612454-label\"><span id=\"forminator-radiogroup-radio-1-69d4a18612454-label\" class=\"forminator-label\">Membership Type<\/span><label id=\"forminator-field-radio-1-label-1\" for=\"forminator-field-radio-1-1-69d4a18612454\" class=\"forminator-radio\" title=\"Adult Member (18 or Older)\"><input type=\"radio\" name=\"radio-1\" value=\"Adult-Member-(18-or-Older)\" id=\"forminator-field-radio-1-1-69d4a18612454\" aria-labelledby=\"forminator-field-radio-1-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Adult Member (18 or Older)<\/span><\/label><label id=\"forminator-field-radio-1-label-2\" for=\"forminator-field-radio-1-2-69d4a18612454\" class=\"forminator-radio\" title=\"Youth Member (10 - 17 Years Old)*\"><input type=\"radio\" name=\"radio-1\" value=\"Youth-Member-(10---17-Years-Old)*\" id=\"forminator-field-radio-1-2-69d4a18612454\" aria-labelledby=\"forminator-field-radio-1-label-2\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Youth Member (10 - 17 Years Old)*<\/span><\/label><label id=\"forminator-field-radio-1-label-3\" for=\"forminator-field-radio-1-3-69d4a18612454\" class=\"forminator-radio\" title=\"Associate Member (Spouse or Assistant to Member)\"><input type=\"radio\" name=\"radio-1\" value=\"Associate-Member-(Spouse-or-Assistant-to-Member)\" id=\"forminator-field-radio-1-3-69d4a18612454\" aria-labelledby=\"forminator-field-radio-1-label-3\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Associate Member (Spouse or Assistant to Member)<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"section-1\" class=\"forminator-field-section forminator-col forminator-col-12 \"><div class=\"forminator-field\"><h2 class=\"forminator-title\">*Conditional Questions for Youth Members<\/h2><hr class=\"forminator-border\" style=\"border: 1px solid #120e8e;\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"name-2\" class=\"forminator-field-name forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-2_69d4a18612454\" id=\"forminator-field-name-2_69d4a18612454-label\" class=\"forminator-label\">Name<\/label><input type=\"text\" name=\"name-2\" value=\"\" placeholder=\"E.g. John Doe\" id=\"forminator-field-name-2_69d4a18612454\" class=\"forminator-input forminator-name--field\" aria-required=\"false\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"phone-2\" class=\"forminator-field-phone forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-phone-2_69d4a18612454\" id=\"forminator-field-phone-2_69d4a18612454-label\" class=\"forminator-label\">Phone<\/label><input type=\"text\" name=\"phone-2\" value=\"\" placeholder=\"E.g. +1 300 400 5000\" id=\"forminator-field-phone-2_69d4a18612454\" class=\"forminator-input forminator-field--phone\" data-required=\"\" aria-required=\"false\" autocomplete=\"off\" \/><\/div><\/div><div id=\"email-2\" class=\"forminator-field-email forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-email-2_69d4a18612454\" id=\"forminator-field-email-2_69d4a18612454-label\" class=\"forminator-label\">Email Address<\/label><input type=\"email\" name=\"email-2\" value=\"\" placeholder=\"E.g. john@doe.com\" id=\"forminator-field-email-2_69d4a18612454\" class=\"forminator-input forminator-email--field\" data-required=\"\" aria-required=\"false\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"name-3\" class=\"forminator-field-name forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-3_69d4a18612454\" id=\"forminator-field-name-3_69d4a18612454-label\" class=\"forminator-label\">Emergency Contact Name<\/label><input type=\"text\" name=\"name-3\" value=\"\" placeholder=\"E.g. John Doe\" id=\"forminator-field-name-3_69d4a18612454\" class=\"forminator-input forminator-name--field\" aria-required=\"false\" \/><\/div><\/div><div id=\"phone-3\" class=\"forminator-field-phone forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-phone-3_69d4a18612454\" id=\"forminator-field-phone-3_69d4a18612454-label\" class=\"forminator-label\">Emergency Contact Phone<\/label><input type=\"text\" name=\"phone-3\" value=\"\" placeholder=\"E.g. +1 300 400 5000\" id=\"forminator-field-phone-3_69d4a18612454\" class=\"forminator-input forminator-field--phone\" data-required=\"\" aria-required=\"false\" autocomplete=\"off\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"consent-2\" class=\"forminator-field-consent forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-consent-2_69d4a18612454\" id=\"forminator-field-consent-2_69d4a18612454-label\" class=\"forminator-label\">Statement of Consent <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-checkbox__wrapper\"><label id=\"forminator-field-consent-2_69d4a18612454__label\" class=\"forminator-checkbox forminator-consent\" aria-labelledby=\"forminator-field-consent-2_69d4a18612454-label\" aria-hidden=\"true\"><input type=\"checkbox\" name=\"consent-2\" id=\"forminator-field-consent-2_69d4a18612454\" value=\"checked\" aria-labelledby=\"forminator-field-consent-2_69d4a18612454-label\" aria-describedby=\"forminator-field-consent-2_69d4a18612454__description\" data-required=\"true\" aria-required=\"true\" \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><\/label><div id=\"forminator-field-consent-2_69d4a18612454__description\" class=\"forminator-checkbox__label forminator-consent__label\"><p>I give my child permission to join and participate in all activities and events hosted by Ring 58 of the International Brotherhood of Magicians.\u00a0 I understand that Ring 58, it's officers, and members do not explicitly assume the responsibility of my child during these activities.\u00a0 I am responsible for supervision of my youth before, during, and after all scheduled activities.\u00a0 I am responsible for providing transportation to and from these events.\u00a0 If I drop off my child, I will be on time to pick them up after the schedule event.<\/p><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"consent-3\" class=\"forminator-field-consent forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-consent-3_69d4a18612454\" id=\"forminator-field-consent-3_69d4a18612454-label\" class=\"forminator-label\">Model Release <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-checkbox__wrapper\"><label id=\"forminator-field-consent-3_69d4a18612454__label\" class=\"forminator-checkbox forminator-consent\" aria-labelledby=\"forminator-field-consent-3_69d4a18612454-label\" aria-hidden=\"true\"><input type=\"checkbox\" name=\"consent-3\" id=\"forminator-field-consent-3_69d4a18612454\" value=\"checked\" aria-labelledby=\"forminator-field-consent-3_69d4a18612454-label\" aria-describedby=\"forminator-field-consent-3_69d4a18612454__description\" data-required=\"true\" aria-required=\"true\" \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><\/label><div id=\"forminator-field-consent-3_69d4a18612454__description\" class=\"forminator-checkbox__label forminator-consent__label\"><p>I give Ring 58 and its designees permission to use my child's name, likeness, image, voice, appearance in publications associated with Ring 58.\u00a0 This includes, but is not limited to, the club website, social media platforms, all print media, and digital broadcasting.\u00a0 I expressly release and indemnify Ring 58, its officers, members, and designees from any and all claims known and unknown arising out of or in any way connected with the above-granted uses and representations.\u00a0 The rights granted are perpetual and worldwide.<\/p><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"section-2\" class=\"forminator-field-section forminator-col forminator-col-12 \"><div class=\"forminator-field\"><hr class=\"forminator-border\" style=\"border: 1px solid #0f2c9e;\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"consent-1\" class=\"forminator-field-consent forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-consent-1_69d4a18612454\" id=\"forminator-field-consent-1_69d4a18612454-label\" class=\"forminator-label\">Membership Oath <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-checkbox__wrapper\"><label id=\"forminator-field-consent-1_69d4a18612454__label\" class=\"forminator-checkbox forminator-consent\" aria-labelledby=\"forminator-field-consent-1_69d4a18612454-label\" aria-hidden=\"true\"><input type=\"checkbox\" name=\"consent-1\" id=\"forminator-field-consent-1_69d4a18612454\" value=\"checked\" aria-labelledby=\"forminator-field-consent-1_69d4a18612454-label\" aria-describedby=\"forminator-field-consent-1_69d4a18612454__description\" data-required=\"true\" aria-required=\"true\" \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><\/label><div id=\"forminator-field-consent-1_69d4a18612454__description\" class=\"forminator-checkbox__label forminator-consent__label\"><p>I agree to support the mission of Ring 58 to enhance the art of magic in East Tennessee.\u00a0 I will maintain an active membership status as detailed in the Ring Bylaws and adhere to IBM's code of ethics.<\/p><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"captcha-1\" class=\"forminator-field-captcha forminator-col forminator-col-12 \"><div class=\"forminator-captcha-left forminator-g-recaptcha recaptcha-invisible\" data-theme=\"light\" data-badge=\"inline\" data-sitekey=\"6Lc1BR8eAAAAAKIqq6g2KosjjeWiZG1mdHNuMy-l\" data-size=\"invisible\"><\/div> <\/div><\/div><input type=\"hidden\" name=\"referer_url\" value=\"\" \/><div class=\"forminator-row forminator-row-last\"><div class=\"forminator-col\"><div class=\"forminator-field\"><button class=\"forminator-button forminator-button-submit\">Submit Registration<\/button><\/div><\/div><\/div><input type=\"hidden\" id=\"forminator_nonce\" name=\"forminator_nonce\" value=\"3ad9fe87a7\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/index.php\/wp-json\/wp\/v2\/pages\/3355\" \/><input type=\"hidden\" name=\"form_id\" value=\"3354\"><input type=\"hidden\" name=\"page_id\" value=\"3355\"><input type=\"hidden\" name=\"form_type\" value=\"default\"><input type=\"hidden\" name=\"current_url\" value=\"https:\/\/www.ibmring58.com\/index.php\/membership-application\/\"><input type=\"hidden\" name=\"render_id\" value=\"0\"><input type=\"hidden\" name=\"action\" value=\"forminator_submit_form_custom-forms\"><\/form>\n","protected":false},"excerpt":{"rendered":"<p>Name *Date of BirthPhoneEmail Address *Street AddressApartment, suite, etcCityState\/ProvinceZIP \/ Postal CodeWhy do you want to join Ring 58?Membership TypeAdult Member (18 or Older)Youth Member (10 &#8211; 17 Years Old)*Associate Member (Spouse or Assistant to Member)*Conditional Questions for Youth MembersNamePhoneEmail AddressEmergency Contact NameEmergency Contact PhoneStatement of Consent *I give my child permission to join and&hellip;<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"class_list":["post-3355","page","type-page","status-publish","hentry","description-off"],"_links":{"self":[{"href":"https:\/\/www.ibmring58.com\/index.php\/wp-json\/wp\/v2\/pages\/3355","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ibmring58.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.ibmring58.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.ibmring58.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ibmring58.com\/index.php\/wp-json\/wp\/v2\/comments?post=3355"}],"version-history":[{"count":2,"href":"https:\/\/www.ibmring58.com\/index.php\/wp-json\/wp\/v2\/pages\/3355\/revisions"}],"predecessor-version":[{"id":3357,"href":"https:\/\/www.ibmring58.com\/index.php\/wp-json\/wp\/v2\/pages\/3355\/revisions\/3357"}],"wp:attachment":[{"href":"https:\/\/www.ibmring58.com\/index.php\/wp-json\/wp\/v2\/media?parent=3355"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}