<style>/**
Font
 */

@font-face {
  font-family: 'ProximaNovaA-Bold';
  src: url("webfonts/32478F_0_0.eot");
  src: url("webfonts/32478F_0_0.eot?#iefix") format("embedded-opentype"), url("webfonts/32478F_0_0.woff2") format("woff2"), url("webfonts/32478F_0_0.woff") format("woff"), url("webfonts/32478F_0_0.ttf") format("truetype"); }

@font-face {
  font-family: 'ProximaNovaS-Bold';
  src: url("webfonts/32478F_1_0.eot");
  src: url("webfonts/32478F_1_0.eot?#iefix") format("embedded-opentype"), url("webfonts/32478F_1_0.woff2") format("woff2"), url("webfonts/32478F_1_0.woff") format("woff"), url("webfonts/32478F_1_0.ttf") format("truetype"); }

@font-face {
  font-family: 'ProximaNovaA-BoldIt';
  src: url("webfonts/32478F_2_0.eot");
  src: url("webfonts/32478F_2_0.eot?#iefix") format("embedded-opentype"), url("webfonts/32478F_2_0.woff2") format("woff2"), url("webfonts/32478F_2_0.woff") format("woff"), url("webfonts/32478F_2_0.ttf") format("truetype"); }

@font-face {
  font-family: 'ProximaNova-Bold';
  src: url("webfonts/32478F_3_0.eot");
  src: url("webfonts/32478F_3_0.eot?#iefix") format("embedded-opentype"), url("webfonts/32478F_3_0.woff2") format("woff2"), url("webfonts/32478F_3_0.woff") format("woff"), url("webfonts/32478F_3_0.ttf") format("truetype");
  font-weight: 700;
  font-style: normal; }

@font-face {
  font-family: 'ProximaNovaS-BoldIt';
  src: url("webfonts/32478F_4_0.eot");
  src: url("webfonts/32478F_4_0.eot?#iefix") format("embedded-opentype"), url("webfonts/32478F_4_0.woff2") format("woff2"), url("webfonts/32478F_4_0.woff") format("woff"), url("webfonts/32478F_4_0.ttf") format("truetype"); }

@font-face {
  font-family: 'ProximaNova-BoldIt';
  src: url("webfonts/32478F_5_0.eot");
  src: url("webfonts/32478F_5_0.eot?#iefix") format("embedded-opentype"), url("webfonts/32478F_5_0.woff2") format("woff2"), url("webfonts/32478F_5_0.woff") format("woff"), url("webfonts/32478F_5_0.ttf") format("truetype"); }

@font-face {
  font-family: 'ProximaNovaA-Regular';
  src: url("webfonts/32478F_6_0.eot");
  src: url("webfonts/32478F_6_0.eot?#iefix") format("embedded-opentype"), url("webfonts/32478F_6_0.woff2") format("woff2"), url("webfonts/32478F_6_0.woff") format("woff"), url("webfonts/32478F_6_0.ttf") format("truetype"); }

@font-face {
  font-family: 'ProximaNovaS-Regular';
  src: url("webfonts/32478F_7_0.eot");
  src: url("webfonts/32478F_7_0.eot?#iefix") format("embedded-opentype"), url("webfonts/32478F_7_0.woff2") format("woff2"), url("webfonts/32478F_7_0.woff") format("woff"), url("webfonts/32478F_7_0.ttf") format("truetype"); }

@font-face {
  font-family: 'ProximaNovaA-RegularIt';
  src: url("webfonts/32478F_8_0.eot");
  src: url("webfonts/32478F_8_0.eot?#iefix") format("embedded-opentype"), url("webfonts/32478F_8_0.woff2") format("woff2"), url("webfonts/32478F_8_0.woff") format("woff"), url("webfonts/32478F_8_0.ttf") format("truetype"); }

@font-face {
  font-family: 'ProximaNova-Regular';
  src: url("webfonts/32478F_9_0.eot");
  src: url("webfonts/32478F_9_0.eot?#iefix") format("embedded-opentype"), url("webfonts/32478F_9_0.woff2") format("woff2"), url("webfonts/32478F_9_0.woff") format("woff"), url("webfonts/32478F_9_0.ttf") format("truetype");
  font-weight: 400;
  font-style: normal; }

@font-face {
  font-family: 'ProximaNovaS-RegularIt';
  src: url("webfonts/32478F_A_0.eot");
  src: url("webfonts/32478F_A_0.eot?#iefix") format("embedded-opentype"), url("webfonts/32478F_A_0.woff2") format("woff2"), url("webfonts/32478F_A_0.woff") format("woff"), url("webfonts/32478F_A_0.ttf") format("truetype"); }

@font-face {
  font-family: 'ProximaNova-RegularIt';
  src: url("webfonts/32478F_B_0.eot");
  src: url("webfonts/32478F_B_0.eot?#iefix") format("embedded-opentype"), url("webfonts/32478F_B_0.woff2") format("woff2"), url("webfonts/32478F_B_0.woff") format("woff"), url("webfonts/32478F_B_0.ttf") format("truetype"); }

@font-face {
  font-family: 'ProximaNovaA-Semibold';
  src: url("webfonts/32478F_C_0.eot");
  src: url("webfonts/32478F_C_0.eot?#iefix") format("embedded-opentype"), url("webfonts/32478F_C_0.woff2") format("woff2"), url("webfonts/32478F_C_0.woff") format("woff"), url("webfonts/32478F_C_0.ttf") format("truetype"); }

@font-face {
  font-family: 'ProximaNovaS-Semibold';
  src: url("webfonts/32478F_D_0.eot");
  src: url("webfonts/32478F_D_0.eot?#iefix") format("embedded-opentype"), url("webfonts/32478F_D_0.woff2") format("woff2"), url("webfonts/32478F_D_0.woff") format("woff"), url("webfonts/32478F_D_0.ttf") format("truetype"); }

@font-face {
  font-family: 'ProximaNova-Semibold';
  src: url("webfonts/32478F_E_0.eot");
  src: url("webfonts/32478F_E_0.eot?#iefix") format("embedded-opentype"), url("webfonts/32478F_E_0.woff2") format("woff2"), url("webfonts/32478F_E_0.woff") format("woff"), url("webfonts/32478F_E_0.ttf") format("truetype");
  font-weight: 600;
  font-style: normal; }

/**
Css variables
 */
html {
  --primary-color: rgba(35, 153, 240);

  --text-primary: rgba(0, 14, 36, 0.87);
  --text-caption: rgba(0, 27, 72, 0.54);
  --text-red-50: rgba(230, 54, 85);

  --controls-border-color: rgba(0, 27, 72, 0.32);
  --controls-border-radius: 8px;
  --input-focus-box-shadow: 0px 0px 0px 2px rgba(35, 153, 240, 0.5);
  --input-focus-border-color: var(--primary-color);

  --card-box-shadow: 0px 2px 8px rgba(0, 27, 72, 0.13);

  --st-color-white: #FFF;
  --st-color-primary: rgba(35, 153, 240);
  --st-color-text-disabled: rgba(0, 27, 72, 0.32);
}
/*
 * ST Signup Forms styles
 */
body {
  margin: 0;
  padding: 0;
  height: 100%;
  font-size: 14px;
  line-height: 14px;

  font-family: ProximaNova-Regular, Arial, sans-serif;

  color: var(--text-primary);
}
/* Fonts and helpers */
.st-title {
  font-size: 1.25em;
  font-weight: bold;
  line-height: 1.5em;
  color: var(--text-primary);
  margin-bottom: 8px;
}

.st-general-error {
  font-size: 1.25em;
  line-height: 1.5em;
  color: var(--text-red-50);
  margin-bottom: 8px;
  text-align: center;
}

/* Error icon */
.st-general-error img {
  width: 1.25em;
  height: 1.25em;
  margin-bottom: -0.2em;
}

.st-font-caption {
  font-size: 12px;
  color: var(--text-caption);
  line-height: 14px;
}

.st-font-caption a {
  color: var(--text-caption);
}

.st-hidden {
  display: none;
}

/* Sign-Up form */
@media (max-width: 246px) {
  .st-signupform {
    justify-content: flex-start;
  }
}
.st-signupform {
  display: flex;
  justify-content: center;
}
.st-signupform-content {
  max-width: 540px;
  box-sizing: border-box;
  padding: 32px;
  color: var(--text-primary);
  line-height: 1.5;
  background: white;
  box-shadow: var(--card-box-shadow);
  border-radius: var(--controls-border-radius);
}

.st-signupform__label {
  color: var(--text-primary);
  font-weight: bold;
  font-size: 14px;
  line-height: 2em;
  word-break: break-word;
}

.st-signupform__label .required-mark {
  color: var(--text-red-50);
}

.st-signupform input:focus,
.st-signupform select:focus,
.st-signupform textarea:focus,
.st-signupform button:focus {
  outline: none;
}

.st-signupform .st-error-message {
  margin-bottom: 4px;
  color: var(--text-red-50);
}

.st-checkbox-list {
  margin-bottom: 4px;
}
.st-checkbox {
  display: flex;
  align-items: center;
  justify-content: flex-start;

  font-size: 16px;
  line-height: 18px;
}

.st-field-option {
  margin-bottom: 8px;
}

.st-field-option:last-child {
  margin-bottom: 0;
}

.st-checkbox label {
  width: 100%;
  overflow: hidden;
  text-overflow: ellipsis;
  white-space: nowrap;
}

.st-signupform input[type="text"],textarea {
  width: 100%;
  background-color: white;
  border: 1px solid var(--controls-border-color);
  border-radius: var(--controls-border-radius);
  box-sizing: border-box;
  padding: 8px;
  font-size: 14px;
  margin: 4px 0;
  outline: none;
  -webkit-transition: .3s all;
  transition: .3s all;
}

.st-signupform input[type="text"]:focus,
textarea:focus,
.st-signupform input[type="checkbox"]:focus,
button:focus
{
  border-color: var(--input-focus-border-color);
  box-shadow: var(--input-focus-box-shadow);
  -webkit-transition: .3s all;
  transition: .3s all;
}

.st-signupform input[type="checkbox"] {
  appearance: none;
  width: 18px;
  height: 18px;
  border-radius: 4px;
  background-color: var(--st-color-white);
  border: 1px solid var(--st-color-text-disabled);
  box-shadow: inset 0 0 3px rgb(0 0 0 / 15%);
  position: relative;
  transition: .3s all;
  cursor: pointer;
  box-sizing: border-box;
}

.st-signupform input[type="checkbox"]:disabled {
  cursor: default;
}

.st-signupform input[type="checkbox"]:before {
  content: '';
  background-image: url('../join-web-form/st-checkbox.svg');
  background-size: 8px;
  display: block;
  position: absolute;
  background-position: center;
  background-repeat: no-repeat;
  opacity: 0;
  left: 0;
  right: 0;
  bottom: 0;
  top: 0;
  transition: .3s all;
}
.st-signupform input[type="checkbox"]:after {
  content: '';
  position: absolute;
  width: 10px;
  height: 2px;
  border-radius: 2px;
  background-color: var(--st-color-white);
  opacity: 0;
  transition: .3s all;
  top: 7px;
  left: 3px;
}
.st-signupform input[type="checkbox"]:checked {
  background-color: var(--st-color-primary);
  border-color: var(--st-color-primary);
}
.st-signupform input[type="checkbox"]:checked:before {
  opacity: 1;
  background-size: 12px;
}
.st-signupform input[type="checkbox"]:indeterminate {
  background-color: var(--st-color-primary);
  border-color: var(--st-color-primary);
}
.st-signupform input[type="checkbox"]:indeterminate:after {
  opacity: 1;
}

.st-signupform button[type="submit"] {
  display: block;
  width: 100%;
  border-radius: var(--controls-border-radius);
  box-sizing: border-box;
  padding: 8px 16px;
  font-size: 16px;
  font-weight: 600;
  text-decoration: none;
  text-align: center;
  cursor: pointer;
  line-height: 20px;
  background-color: var(--primary-color);
  border: 0 none;
  color: white;
  margin: 30px 0 24px;
}

.st-signupform button[type="submit"]:disabled {
  cursor: default;
  background-color: var(--st-color-text-disabled);
  color: white;
}

.st-signupform input.st-signupform-validation-error, textarea.st-signupform-validation-error,
.st-signupform input.st-signupform-validation-error:focus, textarea.st-signupform-validation-error:focus {
  border-color: #F44336;
}

.st-signupform textarea {
  padding-right: 24px;
  resize: vertical;
  min-height: 80px;
  max-height: 200px;
}

.terms-checkbox {
  margin-bottom: 4px;
}
.st-signupform .st-terms-and-conditions {
  margin-top: 22px;
}
.st-signupform .st-terms-and-conditions-text {
  color: var(--text-primary);
  font-size: 16px;
  line-height: 18px;
}

.st-signupform .st-terms-and-conditions-caption {
  margin-left: 24px;
}

.st-signupform-terms-agreed-error {
  margin: 4px 0 0 24px;
  color: var(--text-red-50);
}

.st-signupform-server-error-message {
  color: var(--text-red-50);
}

.st-signupform footer {
  font-size: 14px;
  color: var(--text-primary);
  text-align: center;
}

.st-signupform footer a {
  color: var(--primary-color);
}
</style><!DOCTYPE html>
<html lang="en">
  <head>
    <meta charset="UTF-8" />
    <title>Join Text Messaging List</title>
    <link href="https://app2.simpletexting.com/join-web-form/style-new.css" rel="stylesheet" type="text/css" />
  </head>

  <body>
    <script>
      (function joinWebForm(
    win, doc, webFormId, formFields,
    DUPLICATE_EMAIL_EXCEPTION, DUPLICATE_PHONE_EXCEPTION,CUSTOM_FIELDS_VALIDATION_EXCEPTION,
) {
  const XHR = ('onload' in new win.XMLHttpRequest()) ? win.XMLHttpRequest : win.XDomainRequest;

  const fieldErrorClassName = 'st-signupform-validation-error';

  function getFormServerErrorMessage(form) {
    return form.querySelector('.st-signupform-server-error-message');
  }

  function getFormTermsAgreedError(form) {
    return form.querySelector('.st-signupform-terms-agreed-error');
  }

  function getSubmitButton(form) {
    return form.querySelector('#subscribeNow');
  }

  function setServerErrorMessage(form, message) {
    const formServerErrorMessage = getFormServerErrorMessage(form);
    formServerErrorMessage.innerText = message;

    if (message) {
      formServerErrorMessage.classList.add("st-hidden");
    } else {
      formServerErrorMessage.classList.remove("st-hidden");
    }
  }

  function isTermsAgreedAccepted(form) {
    return form.querySelector('input[name="terms-agreed"]').checked;
  }
  function showTermsAgreedError(form) {
    const submitButton = getSubmitButton(form);
    const formTermsAgreedError = getFormTermsAgreedError(form);
    submitButton.disabled = false;
    formTermsAgreedError.classList.remove("st-hidden");
  }
  function hideTermsAgreedError(form) {
    const formTermsAgreedError = getFormTermsAgreedError(form);
    formTermsAgreedError.classList.add("st-hidden");
  }

  function clearFormErrors(form) {
    const fields = form.querySelectorAll(`.${fieldErrorClassName}`);

    fields.forEach(function (field) {
      field.classList.remove(fieldErrorClassName);
      const fieldError = form.querySelector(`#js-error-${field.name}`);
      fieldError.innerText = '';
    });

    setServerErrorMessage(form, '');
    hideTermsAgreedError(form);
  }

  function collectFormData(form) {
    const formData = new FormData(form);

    const data = {
      webFormId,
      fieldValues: {},
      listIds: [],
    };

    formData.forEach(function (value, name) {
      if (name === 'list') {
        data.listIds.push(value);
      } else if (name === 'phone') {
        data.fieldValues[name] = value.replace(/\D/g, '');
      } else if (!['terms-agreed', 'webFormId'].includes(name)) {
        data.fieldValues[name] = value;
      }
    });

    return data;
  }

  function convertServerErrorMessage(fieldName, errorMessage) {
    const field = formFields.find(formField => formField.name === fieldName);

    if (errorMessage === 'Required field value is empty') {
      return `${field.label} is required`;
    } else {
      if (field.type === 'phone') {
        return `${field.label} is required in (XXX) XXX-XXXX format`;
      } else if (field.type === 'date') {
        return `${field.label} is required in MM/DD/YYYY format`;
      } else if (field.type === 'zipCode') {
        if (field.format === 'US') {
          return `${field.label} is required in XXXXX format`;
        } else {
          return `${field.label} is required in XXX-XXX format`;
        }
      } else if (field.type === 'url') {
        return `${field.label} is required in http(s)://xxxxxx.xx format`;
      } else if (field.type === 'gender') {
        return `${field.label} is required in M, m, F, f, Male, Female, male, female format`;
      } else if (field.type === 'number') {
        return `${field.label} is required in number format`;
      } else if (field.name === 'birthday') {
        return `${field.label} is required in MM/DD/YYYY format`;
      }

      return errorMessage;
    }
  }

  function parseServerValidationError(response) {
    let results;

    try {
      const error = win.JSON.parse(response);

      if (error.code === DUPLICATE_PHONE_EXCEPTION) {
        results = [
          {
            fieldName: 'phone',
            errorMessage: 'Phone number already exists.'
          }
        ];
      } else if (error.code === DUPLICATE_EMAIL_EXCEPTION) {
        results = [
          {
            fieldName: 'email',
            errorMessage: 'Email already exists.'
          }
        ];
      } else if (error.code === CUSTOM_FIELDS_VALIDATION_EXCEPTION) {
        results = Object.entries(error.reasons).map(([key, value]) => ({
          fieldName: key,
          errorMessage: convertServerErrorMessage(key, value)
        }));
      } else {
        results = [
          {
            fieldName: error.invalidValueName,
            errorMessage: convertServerErrorMessage(key, error.reason)
          }
        ];
      }
    } catch (error) {
      results = [
        {
          fieldName: '',
          errorMessage: 'Validation error.'
        }
      ];
    }

    return results;
  }

  function handleLoadForm(form) {
    const submitButton = getSubmitButton(form);
    if (this.status === 200) {
      const formData = new FormData(form);
      const confirmationTextEl = form.querySelector('.step2-confirmationText');
      confirmationTextEl.innerText = confirmationTextEl.innerText.replace('%%phone%%', formData.get('phone'));

      form.querySelector('.step1-form').style.display = 'none';
      confirmationTextEl.style.display = 'block';

      form.reset();
    } else if (this.status === 418) {
      submitButton.disabled = false;
      const validations = parseServerValidationError(this.responseText);

      if (validations.length > 0) {
        if (validations[0].fieldName) {
          validations.forEach((validation) => {
            const fields =
                form.querySelectorAll(
                    `input[name="${validation.fieldName}"], textarea[name="${validation.fieldName}"]`
                );
            fields.forEach((field) => {
              field.classList.add(fieldErrorClassName);
            });
            const fieldError =
                form.querySelector(`#js-error-${validation.fieldName}`);
            fieldError.innerText = validation.errorMessage;
          });
        } else {
          setServerErrorMessage(form, validations[0].errorMessage);
        }
      } else {
        setServerErrorMessage(form, 'Internal Error. Please, try later.');
      }
    } else {
      submitButton.disabled = false;
      setServerErrorMessage(form, 'Internal Error. Please, try later.');
    }
  }

  function handleErrorForm(form) {
    const submitButton = getSubmitButton(form);
    submitButton.disabled = false;
    setServerErrorMessage(form, 'Internal Error. Please, try later.');
  }

  function sendForm(form) {
    const data = collectFormData(form);
    const url = `${form.action}?r=${Date.now()}`;
    const request = new XHR();

    request.open(form.method, url);

    request.onload = function () { handleLoadForm.call(this, form) };
    request.onerror = function () { handleErrorForm.call(this, form) };
    request.ontimeout = function () { handleErrorForm.call(this, form) };

    try {
      request.setRequestHeader('Content-Type', 'application/json; charset=UTF-8');
    } catch (_) { /* ignore if we can't set headers */
    }

    request.send(win.JSON.stringify(data));
  }

  function handleSubmitForm(event) {
    event.preventDefault();

    const form = event.target;
    const submitButton = getSubmitButton(form);

    try {
      submitButton.disabled = true;
      clearFormErrors(form);

      if (!isTermsAgreedAccepted(form)) {
        showTermsAgreedError(form);
      } else {
        sendForm(form);
      }
    } catch (e) {
      console.error(e);
      setServerErrorMessage(form, 'Internal Error. Please, try later.');
      submitButton.disabled = false;
    }
  }

  function formatPhone(value) {
    const numbers = value.replace(/\D/g, '');
    const firstPart = numbers.substring(0, 3);
    const secondPart = numbers.substring(3, 6);
    const thirdPart = numbers.substring(6, 10);
    let result = '';

    if (firstPart) {
      result += `(${firstPart}`;
    }

    if (secondPart) {
      result += `) ${secondPart}`;
    }

    if (thirdPart) {
      result += `-${thirdPart}`;
    }

    return result;
  }

  function handleChangePhoneField(event) {
    const field = event.currentTarget;
    field.value = formatPhone(field.value);
  }

  function handleChangeDateField(event) {
    const field = event.currentTarget;
    const numbers = field.value.replace(/\D/g, '');
    const month = numbers.substr(0, 2);
    const day = numbers.substr(2, 2);
    const year = numbers.substr(4, 4);
    field.value = `${month}${day ? `/${day}` : ''}${year ? `/${year}` : ''}`;
  }

  function handleChangeZipCodeField(event) {
    const field = event.currentTarget;
    field.value = field.value.replace(/\D/g, '').substr(0, 5);
  }

  function handleChangePostalCodeField(event) {
    const field = event.currentTarget;
    const numbers = field.value.replace(/([^a-zA-Z0-9])/g, '');
    const code1 = numbers.substr(0, 3);
    const code2 = numbers.substr(3, 3);
    field.value = `${code1}${code2 ? `-${code2}` : ''}`;
  }

  function handleChangeNumberField(event) {
    const field = event.currentTarget;
    field.value = field.value.replace(/[^0-9,.]/g, '');
  }

  function handleLoad() {
    const forms = doc.querySelectorAll(`#st-join-web-form-${webFormId}`);

    for(let i=0; i<forms.length; i++) {
      const form = forms[i];

      if (!form.hasAttribute('data-form-initialized')) {
        form.setAttribute('data-form-initialized', true);
        form.addEventListener('submit', handleSubmitForm);

        const phoneFields = form.querySelectorAll('input[data-type="phone"]');
        phoneFields.forEach(function (field) {
          field.addEventListener('input', handleChangePhoneField);
        });

        const dateFields = form.querySelectorAll('input[data-type="date"]');
        dateFields.forEach(function (field) {
          field.addEventListener('input', handleChangeDateField);
        });

        const postalCodeFields = form.querySelectorAll('input[data-type="zipCode"][data-format="CA"]');
        postalCodeFields.forEach(function (field) {
          field.addEventListener('input', handleChangePostalCodeField);
        });

        const zipCodeFields = form.querySelectorAll('input[data-type="zipCode"][data-format="US"]');
        zipCodeFields.forEach(function (field) {
          field.addEventListener('input', handleChangeZipCodeField);
        });

        const numberFields = form.querySelectorAll('input[data-type="number"]');
        numberFields.forEach(function (field) {
          field.addEventListener('input', handleChangeNumberField);
        });

        const agreedFields = form.querySelector(`#terms-agreed-checkbox-${webFormId}`);
        agreedFields.id += `-${i.toString(10)}`;
        const agreedTerms = form.querySelector('.st-terms-and-conditions-text');
        agreedTerms.setAttribute('for', agreedFields.id);
      }
    }
  }

  win.addEventListener('load', handleLoad);
}
)(
        window, document, '6831d5c9e996832e485cda85', [{"name":"firstname","label":"Contact first name","placeholder":"John","type":"text","value":"","required":true},{"name":"lastname","label":"Contact last name","placeholder":"Smith","type":"text","value":"","required":true},{"name":"phone","label":"Phone","placeholder":"(XXX) XXX-XXXX","type":"phone","value":"","required":true},{"name":"birthday","label":"Birthday","placeholder":"mm/dd/yyyy (example: 05/24/2025)","type":"date","value":"","required":true},{"name":"list","options":[{"value":"6830811e1ecaa373d60df612","label":"Club News"},{"value":"68308133e996832e483128e6","label":"Deals"},{"value":"68308140f23b6e651572872a","label":"Events"},{"value":"6830819e44d5033e4cedfb25","label":"Order/Shipping Status"}],"label":"List","type":"select","value":"","required":true}],
        'DuplicateContactEmailException', 'DuplicateContactPhoneException', 'CustomFieldsValidationException'
      );
    </script>
    <div class="st-signupform">
      <form
        id="st-join-web-form-6831d5c9e996832e485cda85"
        class="st-signupform-content"
        action="https://app2.simpletexting.com/join/joinContact"
        method="POST"
      >
        <div class="step1-form">
            <div class="required">
              <label class="st-signupform__label" for="firstname">
                  First name

                  <span class="required-mark">
                    <svg width="10" height="10" viewBox="0 0 10 10" fill="none" xmlns="http://www.w3.org/2000/svg">
                      <path d="M3.84534 5.66669H1.00004C0.631851 5.66669 0.333374 5.36821 0.333374 5.00002C0.333374 4.63183 0.631851 4.33335 1.00004 4.33335H3.84534L2.42269 1.86925C2.2386 1.55039 2.34785 1.14266 2.66671 0.958568C2.98557 0.774473 3.3933 0.883724 3.57739 1.20259L5.00004 3.66669L6.42269 1.20259C6.60679 0.883724 7.01451 0.774473 7.33337 0.958568C7.65224 1.14266 7.76149 1.55039 7.57739 1.86925L6.15474 4.33335H9.00004C9.36823 4.33335 9.66671 4.63183 9.66671 5.00002C9.66671 5.36821 9.36823 5.66669 9.00004 5.66669H6.15474L7.57739 8.13079C7.76149 8.44965 7.65224 8.85738 7.33337 9.04147C7.01451 9.22557 6.60679 9.11632 6.42269 8.79745L5.00004 6.33335L3.57739 8.79745C3.3933 9.11632 2.98557 9.22557 2.66671 9.04147C2.34785 8.85738 2.2386 8.44965 2.42269 8.13079L3.84534 5.66669Z" fill="#E63655"/>
                    </svg>
                  </span>
              </label>
                      <input
                              id="firstname"
                              name="firstname"
                              type="text"
                              placeholder="Taylor"
                              maxlength="1600"
                              data-type="text"
                      />
            </div>

            <div id="js-error-firstname" class="st-error-message"></div>
            <div class="required">
              <label class="st-signupform__label" for="lastname">
                  Last name

                  <span class="required-mark">
                    <svg width="10" height="10" viewBox="0 0 10 10" fill="none" xmlns="http://www.w3.org/2000/svg">
                      <path d="M3.84534 5.66669H1.00004C0.631851 5.66669 0.333374 5.36821 0.333374 5.00002C0.333374 4.63183 0.631851 4.33335 1.00004 4.33335H3.84534L2.42269 1.86925C2.2386 1.55039 2.34785 1.14266 2.66671 0.958568C2.98557 0.774473 3.3933 0.883724 3.57739 1.20259L5.00004 3.66669L6.42269 1.20259C6.60679 0.883724 7.01451 0.774473 7.33337 0.958568C7.65224 1.14266 7.76149 1.55039 7.57739 1.86925L6.15474 4.33335H9.00004C9.36823 4.33335 9.66671 4.63183 9.66671 5.00002C9.66671 5.36821 9.36823 5.66669 9.00004 5.66669H6.15474L7.57739 8.13079C7.76149 8.44965 7.65224 8.85738 7.33337 9.04147C7.01451 9.22557 6.60679 9.11632 6.42269 8.79745L5.00004 6.33335L3.57739 8.79745C3.3933 9.11632 2.98557 9.22557 2.66671 9.04147C2.34785 8.85738 2.2386 8.44965 2.42269 8.13079L3.84534 5.66669Z" fill="#E63655"/>
                    </svg>
                  </span>
              </label>
                      <input
                              id="lastname"
                              name="lastname"
                              type="text"
                              placeholder="Smith"
                              maxlength="1600"
                              data-type="text"
                      />
            </div>

            <div id="js-error-lastname" class="st-error-message"></div>
            <div class="required">
              <label class="st-signupform__label" for="phone">
                  Phone

                  <span class="required-mark">
                    <svg width="10" height="10" viewBox="0 0 10 10" fill="none" xmlns="http://www.w3.org/2000/svg">
                      <path d="M3.84534 5.66669H1.00004C0.631851 5.66669 0.333374 5.36821 0.333374 5.00002C0.333374 4.63183 0.631851 4.33335 1.00004 4.33335H3.84534L2.42269 1.86925C2.2386 1.55039 2.34785 1.14266 2.66671 0.958568C2.98557 0.774473 3.3933 0.883724 3.57739 1.20259L5.00004 3.66669L6.42269 1.20259C6.60679 0.883724 7.01451 0.774473 7.33337 0.958568C7.65224 1.14266 7.76149 1.55039 7.57739 1.86925L6.15474 4.33335H9.00004C9.36823 4.33335 9.66671 4.63183 9.66671 5.00002C9.66671 5.36821 9.36823 5.66669 9.00004 5.66669H6.15474L7.57739 8.13079C7.76149 8.44965 7.65224 8.85738 7.33337 9.04147C7.01451 9.22557 6.60679 9.11632 6.42269 8.79745L5.00004 6.33335L3.57739 8.79745C3.3933 9.11632 2.98557 9.22557 2.66671 9.04147C2.34785 8.85738 2.2386 8.44965 2.42269 8.13079L3.84534 5.66669Z" fill="#E63655"/>
                    </svg>
                  </span>
              </label>
                      <input
                              id="phone"
                              name="phone"
                              type="text"
                              placeholder="(XXX) XXX-XXXX"
                              maxlength="1600"
                              data-type="phone"
                      />
            </div>

            <div id="js-error-phone" class="st-error-message"></div>
            <div class="required">
              <label class="st-signupform__label" for="birthday">
                  Birthday

                  <span class="required-mark">
                    <svg width="10" height="10" viewBox="0 0 10 10" fill="none" xmlns="http://www.w3.org/2000/svg">
                      <path d="M3.84534 5.66669H1.00004C0.631851 5.66669 0.333374 5.36821 0.333374 5.00002C0.333374 4.63183 0.631851 4.33335 1.00004 4.33335H3.84534L2.42269 1.86925C2.2386 1.55039 2.34785 1.14266 2.66671 0.958568C2.98557 0.774473 3.3933 0.883724 3.57739 1.20259L5.00004 3.66669L6.42269 1.20259C6.60679 0.883724 7.01451 0.774473 7.33337 0.958568C7.65224 1.14266 7.76149 1.55039 7.57739 1.86925L6.15474 4.33335H9.00004C9.36823 4.33335 9.66671 4.63183 9.66671 5.00002C9.66671 5.36821 9.36823 5.66669 9.00004 5.66669H6.15474L7.57739 8.13079C7.76149 8.44965 7.65224 8.85738 7.33337 9.04147C7.01451 9.22557 6.60679 9.11632 6.42269 8.79745L5.00004 6.33335L3.57739 8.79745C3.3933 9.11632 2.98557 9.22557 2.66671 9.04147C2.34785 8.85738 2.2386 8.44965 2.42269 8.13079L3.84534 5.66669Z" fill="#E63655"/>
                    </svg>
                  </span>
              </label>
                      <input
                        id="birthday"
                        name="birthday"
                        type="text"
                        placeholder="mm/dd/yyyy (example: 05/24/2025) - You must be over 21"
                        maxlength="1600"
                        data-type="date"
                      />
            </div>

            <div id="js-error-birthday" class="st-error-message"></div>
            <div class="required">
              <label class="st-signupform__label" for="list">
                  Your Interests

                  <span class="required-mark">
                    <svg width="10" height="10" viewBox="0 0 10 10" fill="none" xmlns="http://www.w3.org/2000/svg">
                      <path d="M3.84534 5.66669H1.00004C0.631851 5.66669 0.333374 5.36821 0.333374 5.00002C0.333374 4.63183 0.631851 4.33335 1.00004 4.33335H3.84534L2.42269 1.86925C2.2386 1.55039 2.34785 1.14266 2.66671 0.958568C2.98557 0.774473 3.3933 0.883724 3.57739 1.20259L5.00004 3.66669L6.42269 1.20259C6.60679 0.883724 7.01451 0.774473 7.33337 0.958568C7.65224 1.14266 7.76149 1.55039 7.57739 1.86925L6.15474 4.33335H9.00004C9.36823 4.33335 9.66671 4.63183 9.66671 5.00002C9.66671 5.36821 9.36823 5.66669 9.00004 5.66669H6.15474L7.57739 8.13079C7.76149 8.44965 7.65224 8.85738 7.33337 9.04147C7.01451 9.22557 6.60679 9.11632 6.42269 8.79745L5.00004 6.33335L3.57739 8.79745C3.3933 9.11632 2.98557 9.22557 2.66671 9.04147C2.34785 8.85738 2.2386 8.44965 2.42269 8.13079L3.84534 5.66669Z" fill="#E63655"/>
                    </svg>
                  </span>
              </label>
                      <div class="st-checkbox-list">
                          <div class="st-checkbox st-field-option">
                            <input
                              id="list-6830811e1ecaa373d60df612"
                              name="list"
                              type="checkbox"
                              data-type="select"
                              value="6830811e1ecaa373d60df612"
                            />
                            <label
                              for="list-6830811e1ecaa373d60df612"
                              title="Club News"
                            > Club News</label>
                          </div>
                          <div class="st-checkbox st-field-option">
                            <input
                              id="list-68308133e996832e483128e6"
                              name="list"
                              type="checkbox"
                              data-type="select"
                              value="68308133e996832e483128e6"
                            />
                            <label
                              for="list-68308133e996832e483128e6"
                              title="Deals"
                            > Deals</label>
                          </div>
                          <div class="st-checkbox st-field-option">
                            <input
                              id="list-68308140f23b6e651572872a"
                              name="list"
                              type="checkbox"
                              data-type="select"
                              value="68308140f23b6e651572872a"
                            />
                            <label
                              for="list-68308140f23b6e651572872a"
                              title="Events"
                            > Events</label>
                          </div>
                          <div class="st-checkbox st-field-option">
                            <input
                              id="list-6830819e44d5033e4cedfb25"
                              name="list"
                              type="checkbox"
                              data-type="select"
                              value="6830819e44d5033e4cedfb25"
                            />
                            <label
                              for="list-6830819e44d5033e4cedfb25"
                              title="Order/Shipping Status"
                            > Order/Shipping Status</label>
                          </div>
                      </div>
            </div>

            <div id="js-error-list" class="st-error-message"></div>

          <div class="st-terms-and-conditions">
            <div class="st-checkbox terms-checkbox">
              <input id="terms-agreed-checkbox-6831d5c9e996832e485cda85" type="checkbox" name="terms-agreed" />
              <label class="st-terms-and-conditions-text" for="terms-agreed-checkbox-6831d5c9e996832e485cda85">
                 Terms and conditions
              </label>
            </div>
            <div class="st-terms-and-conditions-caption st-font-caption">
              <div>
                I agree to receive promotional messages from Page Springs Cellars approx 4 Msgs/Month.
                This agreement isn't a condition of any purchase.
                I also agree to the
                <a href="https://app2.simpletexting.com/web-forms/terms/6831d5c9e996832e485cda85" target="_blank">Terms of Service</a> and
                <a href="https://app2.simpletexting.com/web-forms/privacy-policy/6831d5c9e996832e485cda85" target="_blank">Privacy Policy</a>.
                Msg & Data rates may apply. I agree that my mobile information will not be shared
                with third parties/affiliates for marketing/promotional purposes. Text STOP to opt-out. Text HELP for help.<br/><br/>
              </div>
            </div>
            <div class="st-signupform-terms-agreed-error st-hidden">
              You have to agree on terms in order to proceed to the subscription.
            </div>
          </div>

          <div class="st-join-web-form-submit-button-box">
            <button id="subscribeNow" type="submit">Subscribe now</button>
            <p class="st-signupform-server-error-message st-color-red st-hidden"></p>
          </div>
        </div>

        <div class="step2-confirmationText" style="display: none;">
          <p>
            Thank you for signing up! You will receive messages from Page Springs Cellars.
          </p>
        </div>

        <footer>
          SMS wine marketing powered by
          <a href="https://www.vinteractive.com" title="SMS wine marketing - VinterActive.com">VinterActive</a>
        </footer>
      </form>
    </div>
  </body>
</html>