[gravityform id=11 title=false description=false]
<script type="text/javascript">if(!gform){window.addEventListener("DOMContentLoaded",function(){gform.domLoaded=!0});var gform={domLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded?o():window.addEventListener("DOMContentLoaded",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook("action",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook("filter",o,n,r,t)},doAction:function(o){gform.doHook("action",o,arguments)},applyFilters:function(o){return gform.doHook("filter",o,arguments)},removeAction:function(o,n){gform.removeHook("action",o,n)},removeFilter:function(o,n,r){gform.removeHook("filter",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+"_"+e.length),null==t&&(t=10),gform.hooks[o][n].push({tag:i,callable:r,priority:t})},doHook:function(o,n,r){if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[o][n]){var t,i=gform.hooks[o][n];i.sort(function(o,n){return o.priority-n.priority});for(var e=0;e<i.length;e++)"function"!=typeof(t=i[e].callable)&&(t=window[t]),"action"==o?t.apply(null,r):r[0]=t.apply(null,r)}if("filter"==o)return r[0]},removeHook:function(o,n,r,t){if(null!=gform.hooks[o][n])for(var i=gform.hooks[o][n],e=i.length-1;0<=e;e--)null!=t&&t!=i[e].tag||null!=r&&r!=i[e].priority||i.splice(e,1)}}}</script>
<div class='gf_browser_unknown gform_wrapper gform_legacy_markup_wrapper' id='gform_wrapper_11' ><form method='post' enctype='multipart/form-data' id='gform_11' action='/tag/jampak/' >
<div class='gform_body gform-body'><ul id='gform_fields_11' class='gform_fields top_label form_sublabel_below description_below'><li id="field_11_10" class="gfield hide-label field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label screen-reader-text' for='input_11_10' >First Name</label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_11_10' type='text' value='' class='medium' placeholder='First Name' aria-invalid="false" /> </div></li><li id="field_11_1" class="gfield hide-label gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label screen-reader-text' for='input_11_1' >Email Address<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_email'>
<input name='input_1' id='input_11_1' type='text' value='' class='large' placeholder='Email Address' aria-required="true" aria-invalid="false" />
</div></li><li id="field_11_5" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label gfield_label_before_complex' >Email List :<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_11_5'><li class='gchoice gchoice_11_5_1'>
<input class='gfield-choice-input' name='input_5.1' type='checkbox' value='buzz' id='choice_11_5_1' />
<label for='choice_11_5_1' id='label_11_5_1'>Bluegrass Buzz Newsletter</label>
</li></ul></div></li><li id="field_11_11" class="gfield gform_validation_container field_sublabel_below field_description_below gfield_visibility_visible" ><label class='gfield_label' for='input_11_11' >Email</label><div class='ginput_container'><input name='input_11' id='input_11_11' type='text' value='' /></div><div class='gfield_description' id='gfield_description_11_11'>This field is for validation purposes and should be left unchanged.</div></li></ul></div>
<div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_11' class='gform_button button' value='Sign Up' onclick='if(window["gf_submitting_11"]){return false;} window["gf_submitting_11"]=true; ' onkeypress='if( event.keyCode == 13 ){ if(window["gf_submitting_11"]){return false;} window["gf_submitting_11"]=true; jQuery("#gform_11").trigger("submit",[true]); }' />
<input type='hidden' class='gform_hidden' name='is_submit_11' value='1' />
<input type='hidden' class='gform_hidden' name='gform_submit' value='11' />
<input type='hidden' class='gform_hidden' name='gform_unique_id' value='' />
<input type='hidden' class='gform_hidden' name='state_11' value='WyJbXSIsIjdiZWFhNzdhMjZmM2E0NjI4MWQ1ZDY5NDIxY2FiZGVlIl0=' />
<input type='hidden' class='gform_hidden' name='gform_target_page_number_11' id='gform_target_page_number_11' value='0' />
<input type='hidden' class='gform_hidden' name='gform_source_page_number_11' id='gform_source_page_number_11' value='1' />
<input type='hidden' name='gform_field_values' value='' />
</div>
</form>
</div>
