<img src="https://givebackmom.com/images/LA_Fitness_Contest_Form.png"
      alt="LA Fitness Contest"
      style="max-width:100%; height:auto; display:block; margin:0 auto 20px;" />

<h2>{global:formtitle}</h2>
{error}
<div class="formContainer" id="rsform_{global:formid}_page_0">
	<div class="row">
		<div class="col-md-12">
			<div class="mb-3 rsform-block rsform-block-first-name rsform-type-textbox{First Name:errorClass}">
{if {First Name:caption}}
				<label class="form-label formControlLabel" data-bs-toggle="tooltip" title="{First Name:descriptionhtml}" for="First Name">{First Name:caption}<strong class="formRequired">(*)</strong></label>
{/if}
				<div class="formControls">
					{First Name:body}
					<div><span class="formValidation">{First Name:validation}</span></div>
				</div>
			</div>
			<div class="mb-3 rsform-block rsform-block-last-name rsform-type-textbox{Last_Name:errorClass}">
{if {Last_Name:caption}}
				<label class="form-label formControlLabel" data-bs-toggle="tooltip" title="{Last_Name:descriptionhtml}" for="Last_Name">{Last_Name:caption}<strong class="formRequired">(*)</strong></label>
{/if}
				<div class="formControls">
					{Last_Name:body}
					<div><span class="formValidation">{Last_Name:validation}</span></div>
				</div>
			</div>
			<div class="mb-3 rsform-block rsform-block-email rsform-type-textbox{Email:errorClass}">
{if {Email:caption}}
				<label class="form-label formControlLabel" data-bs-toggle="tooltip" title="{Email:descriptionhtml}" for="Email">{Email:caption}<strong class="formRequired">(*)</strong></label>
{/if}
				<div class="formControls">
					{Email:body}
					<div><span class="formValidation">{Email:validation}</span></div>
				</div>
			</div>
			<div class="mb-3 rsform-block rsform-block-phone rsform-type-textbox{Phone:errorClass}">
{if {Phone:caption}}
				<label class="form-label formControlLabel" data-bs-toggle="tooltip" title="{Phone:descriptionhtml}" for="Phone">{Phone:caption}</label>
{/if}
				<div class="formControls">
					{Phone:body}
					<div><span class="formValidation">{Phone:validation}</span></div>
				</div>
			</div>
			<div class="mb-3 rsform-block rsform-block-child-care rsform-type-checkboxgroup{Child_Care:errorClass}">
{if {Child_Care:caption}}
				<label class="form-label formControlLabel" data-bs-toggle="tooltip" title="{Child_Care:descriptionhtml}" id="Child_Care-grouplbl">{Child_Care:caption}</label>
{/if}
				<div class="formControls" role="group" aria-labelledby="Child_Care-grouplbl">
					{Child_Care:body}
					<div><span class="formValidation">{Child_Care:validation}</span></div>
				</div>
			</div>
			<div class="mb-3 rsform-block rsform-block-specific-fitness-interests rsform-type-checkboxgroup{Specific_Fitness_Interests:errorClass}">
{if {Specific_Fitness_Interests:caption}}
				<label class="form-label formControlLabel" data-bs-toggle="tooltip" title="{Specific_Fitness_Interests:descriptionhtml}" id="Specific_Fitness_Interests-grouplbl">{Specific_Fitness_Interests:caption}</label>
{/if}
				<div class="formControls" role="group" aria-labelledby="Specific_Fitness_Interests-grouplbl">
					{Specific_Fitness_Interests:body}
					<div><span class="formValidation">{Specific_Fitness_Interests:validation}</span></div>
				</div>
			</div>
			<div class="mb-3 rsform-block rsform-block-fitness-goals rsform-type-textarea{Fitness_Goals:errorClass}">
{if {Fitness_Goals:caption}}
				<label class="form-label formControlLabel" data-bs-toggle="tooltip" title="{Fitness_Goals:descriptionhtml}" for="Fitness_Goals">{Fitness_Goals:caption}</label>
{/if}
				<div class="formControls">
					{Fitness_Goals:body}
					<div><span class="formValidation">{Fitness_Goals:validation}</span></div>
				</div>
			</div>
{if {global:userid} == "0"}
			<div class="mb-3 rsform-block rsform-block-captcha rsform-type-captcha{Captcha:errorClass}">
{if {Captcha:caption}}
				<label class="form-label formControlLabel" data-bs-toggle="tooltip" title="{Captcha:descriptionhtml}" for="captchaTxt123">{Captcha:caption}<strong class="formRequired">(*)</strong></label>
{/if}
				<div class="formControls">
					{Captcha:body}
					<div><span class="formValidation">{Captcha:validation}</span></div>
				</div>
			</div>
{/if}
			<div class="mb-3 rsform-block rsform-block-submit rsform-type-submitbutton{SUBMIT:errorClass}">
{if {SUBMIT:caption}}
				<label class="form-label formControlLabel" data-bs-toggle="tooltip" title="{SUBMIT:descriptionhtml}">{SUBMIT:caption}</label>
{/if}
				<div class="formControls">
					{SUBMIT:body}
					<div><span class="formValidation">{SUBMIT:validation}</span></div>
				</div>
			</div>
		</div>
	</div>
</div>