{"id":8536,"date":"2024-10-25T20:28:42","date_gmt":"2024-10-25T17:28:42","guid":{"rendered":"https:\/\/amariatek.com\/?page_id=8536"},"modified":"2024-10-25T21:00:02","modified_gmt":"2024-10-25T18:00:02","slug":"teen","status":"publish","type":"page","link":"https:\/\/amariatek.com\/teen\/","title":{"rendered":"Teen"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"8536\" class=\"elementor elementor-8536\">\n\t\t\t\t<div class=\"elementor-element elementor-element-0663767 e-flex e-con-boxed e-con e-parent\" data-id=\"0663767\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-dd2e5cc elementor-widget elementor-widget-jet-form-builder-form\" data-id=\"dd2e5cc\" data-element_type=\"widget\" data-widget_type=\"jet-form-builder-form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<link rel='stylesheet' id='wp-block-library-css' href='https:\/\/amariatek.com\/wp-includes\/css\/dist\/block-library\/style.min.css?ver=6.8.1' type='text\/css' media=\"print\" onload=\"this.media='all'\" \/>\n<style id=\"jet-form-builder-8141-inline-css\"><\/style><form  class=\"jet-form-builder layout-column submit-type-ajax\" action=\"https:\/\/amariatek.com\/wp-json\/wp\/v2\/pages\/8536\/?5AcGk8=a01gG30xFB&amp;method=reload\" method=\"POST\" data-form-id=\"8141\" data-layout=\"column\" enctype=\"multipart\/form-data\" novalidate=\"null\">\r\n<input type=\"hidden\" name=\"_jfb_current_render_states[]\" value=\"DEFAULT.STATE\" data-jfb-sync \/><input type=\"hidden\" class=\"jet-form-builder__field hidden-field\" name=\"_jet_engine_booking_form_id\" data-field-name=\"_jet_engine_booking_form_id\" value=\"8141\">\n<input type=\"hidden\" class=\"jet-form-builder__field hidden-field\" name=\"_jet_engine_refer\" data-field-name=\"_jet_engine_refer\" value=\"https:\/\/amariatek.com\/wp-json\/wp\/v2\/pages\/8536\/\">\n<input type=\"hidden\" class=\"jet-form-builder__field hidden-field\" name=\"__queried_post_id\" data-field-name=\"__queried_post_id\" value=\"8536\">\n<div class=\"jet-form-builder-page \" data-page=\"1\" data-page-offset=\"75\">\n<h2 class=\"wp-block-heading\">Teen ( For my child)<\/h2>\n\n\n\n<div class=\"jet-form-builder-progress-pages jfb-progress-type--default\" data-type=\"default\">\t<div class=\"jet-form-builder-progress-pages__item--wrapper active-page\" data-page=\"1\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">1<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper\" data-page=\"2\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">2<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper\" data-page=\"3\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">3<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper\" data-page=\"4\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">4<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper\" data-page=\"5\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">5<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper\" data-page=\"6\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">6<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\">Last Page<\/div>\n\t\t<\/div>\n\t\t\t<\/div>\n\t<\/div>\n\n\n\n<p>Help your child thrive and reach their full potential with expert coaching tailored to their unique needs and aspirations.<\/p>\n\n\n<div  data-validation-type=\"inherit\" class=\"jet-form-builder-row field-type-checkbox-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">What concerns you about your child? (Select all that apply) <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__fields-group checkradio-wrap\" data-jfb-sync><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-checkbox\">\n<input type=\"checkbox\" name=\"teen-q101[]\" value=\"Relationship with family\" data-field-name=\"teen-q101\" data-calculate=\"Relationship with family\"  class=\"jet-form-builder__field checkboxes-field checkradio-field\" required=\"required\"><span>Relationship with family<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-checkbox\">\n<input type=\"checkbox\" name=\"teen-q101[]\" value=\"Relationship with peers\" data-field-name=\"teen-q101\" data-calculate=\"Relationship with peers\"  class=\"jet-form-builder__field checkboxes-field checkradio-field\" required=\"required\"><span>Relationship with peers<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-checkbox\">\n<input type=\"checkbox\" name=\"teen-q101[]\" value=\"Coping with life challenges\" data-field-name=\"teen-q101\" data-calculate=\"Coping with life challenges\"  class=\"jet-form-builder__field checkboxes-field checkradio-field\" required=\"required\"><span>Coping with life challenges<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-checkbox\">\n<input type=\"checkbox\" name=\"teen-q101[]\" value=\"Esteem challenges\" data-field-name=\"teen-q101\" data-calculate=\"Esteem challenges\"  class=\"jet-form-builder__field checkboxes-field checkradio-field\" required=\"required\"><span>Esteem challenges<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-checkbox\">\n<input type=\"checkbox\" name=\"teen-q101[]\" value=\"School challenges\" data-field-name=\"teen-q101\" data-calculate=\"School challenges\"  class=\"jet-form-builder__field checkboxes-field checkradio-field\" required=\"required\"><span>School challenges<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-checkbox\">\n<input type=\"checkbox\" name=\"teen-q101[]\" value=\"Substance abuse\" data-field-name=\"teen-q101\" data-calculate=\"Substance abuse\"  class=\"jet-form-builder__field checkboxes-field checkradio-field\" required=\"required\"><span>Substance abuse<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-checkbox\">\n<input type=\"checkbox\" name=\"teen-q101[]\" value=\"Mental health challenges\" data-field-name=\"teen-q101\" data-calculate=\"Mental health challenges\"  class=\"jet-form-builder__field checkboxes-field checkradio-field\" required=\"required\"><span>Mental health challenges<\/span><\/label><\/div><\/div>\n<\/div>\n\n<div class=\"jet-form-builder__next-page-wrap\">\n\t\t\t\t\t<button data-jfb-conditional=\"[{&quot;page_state&quot;:&quot;active&quot;}]\" data-jfb-func=\"disable\" class=\"jet-form-builder__next-page\" type=\"button\">Next<\/button>\n\t<\/div>\n<\/div>\n<div class=\"jet-form-builder-page jet-form-builder-page--hidden\" data-page=\"2\" data-page-offset=\"75\">\n\n\n<div class=\"jet-form-builder-progress-pages jfb-progress-type--default\" data-type=\"default\">\t<div class=\"jet-form-builder-progress-pages__item--wrapper passed-page\" data-page=\"1\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">1<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper active-page\" data-page=\"2\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">2<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper\" data-page=\"3\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">3<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper\" data-page=\"4\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">4<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper\" data-page=\"5\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">5<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper\" data-page=\"6\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">6<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\">Last Page<\/div>\n\t\t<\/div>\n\t\t\t<\/div>\n\t<\/div>\n\n\n<div  data-validation-type=\"inherit\" class=\"jet-form-builder-row field-type-checkbox-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">What are your expectations from your child\u2019s Helper? (Select all that apply) <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__fields-group checkradio-wrap\" data-jfb-sync><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-checkbox\">\n<input type=\"checkbox\" name=\"teen-q102[]\" value=\"Guide my child to make good decisions\" data-field-name=\"teen-q102\" data-calculate=\"Guide my child to make good decisions\"  class=\"jet-form-builder__field checkboxes-field checkradio-field\" required=\"required\"><span>Guide my child to make good decisions<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-checkbox\">\n<input type=\"checkbox\" name=\"teen-q102[]\" value=\"Listen to and support my child\" data-field-name=\"teen-q102\" data-calculate=\"Listen to and support my child\"  class=\"jet-form-builder__field checkboxes-field checkradio-field\" required=\"required\"><span>Listen to and support my child<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-checkbox\">\n<input type=\"checkbox\" name=\"teen-q102[]\" value=\"Teach my child skills\" data-field-name=\"teen-q102\" data-calculate=\"Teach my child skills\"  class=\"jet-form-builder__field checkboxes-field checkradio-field\" required=\"required\"><span>Teach my child skills<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-checkbox\">\n<input type=\"checkbox\" name=\"teen-q102[]\" value=\"I don\u2019t know\" data-field-name=\"teen-q102\" data-calculate=\"I don\u2019t know\"  class=\"jet-form-builder__field checkboxes-field checkradio-field\" required=\"required\"><span>I don\u2019t know<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap custom-option\"><button type=\"button\" class=\"add-custom-option\">+ Add New<template><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap custom-option\"><label class=\"jet-form-builder__field-label for-checkbox\"><input type=\"checkbox\" checked=\"checked\" data-field-name=\"teen-q102\" data-custom=\"1\" class=\"jet-form-builder__field checkboxes-field checkradio-field\" value=\"\"><span><input type=\"text\" name=\"teen-q102[]\" data-field-name=\"teen-q102\" class=\"jet-form-builder__field text-field\"><\/span><label><\/div><\/template><\/button><\/div><\/div>\n<\/div>\n\n<div class=\"jet-form-builder__next-page-wrap\">\n\t\t<button type=\"button\" class=\"jet-form-builder__prev-page\" data-to-page=\"1\">Back<\/button>\t\t\t<button data-jfb-conditional=\"[{&quot;page_state&quot;:&quot;active&quot;}]\" data-jfb-func=\"disable\" class=\"jet-form-builder__next-page\" type=\"button\">Next<\/button>\n\t<\/div>\n<\/div>\n<div class=\"jet-form-builder-page jet-form-builder-page--hidden\" data-page=\"3\" data-page-offset=\"75\">\n\n\n<div class=\"jet-form-builder-progress-pages jfb-progress-type--default\" data-type=\"default\">\t<div class=\"jet-form-builder-progress-pages__item--wrapper passed-page\" data-page=\"1\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">1<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper passed-page\" data-page=\"2\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">2<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper active-page\" data-page=\"3\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">3<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper\" data-page=\"4\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">4<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper\" data-page=\"5\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">5<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper\" data-page=\"6\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">6<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\">Last Page<\/div>\n\t\t<\/div>\n\t\t\t<\/div>\n\t<\/div>\n\n\n<div  data-validation-type=\"inherit\" class=\"jet-form-builder-row field-type-checkbox-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">How do you prefer your child to communicate with their helper? <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__fields-group checkradio-wrap\" data-jfb-sync><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-checkbox\">\n<input type=\"checkbox\" name=\"teen-q103[]\" value=\"Mostly via physical sessions\" data-field-name=\"teen-q103\" data-calculate=\"Mostly via physical sessions\"  class=\"jet-form-builder__field checkboxes-field checkradio-field\" required=\"required\"><span>Mostly via physical sessions<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-checkbox\">\n<input type=\"checkbox\" name=\"teen-q103[]\" value=\"Mostly online\" data-field-name=\"teen-q103\" data-calculate=\"Mostly online\"  class=\"jet-form-builder__field checkboxes-field checkradio-field\" required=\"required\"><span>Mostly online<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-checkbox\">\n<input type=\"checkbox\" name=\"teen-q103[]\" value=\"Not sure yet (decide later)\" data-field-name=\"teen-q103\" data-calculate=\"Not sure yet (decide later)\"  class=\"jet-form-builder__field checkboxes-field checkradio-field\" required=\"required\"><span>Not sure yet (decide later)<\/span><\/label><\/div><\/div>\n<\/div>\n\n<div class=\"jet-form-builder__next-page-wrap\">\n\t\t<button type=\"button\" class=\"jet-form-builder__prev-page\" data-to-page=\"2\">Back<\/button>\t\t\t<button data-jfb-conditional=\"[{&quot;page_state&quot;:&quot;active&quot;}]\" data-jfb-func=\"disable\" class=\"jet-form-builder__next-page\" type=\"button\">Next<\/button>\n\t<\/div>\n<\/div>\n<div class=\"jet-form-builder-page jet-form-builder-page--hidden\" data-page=\"4\" data-page-offset=\"75\">\n\n\n<div class=\"jet-form-builder-progress-pages jfb-progress-type--default\" data-type=\"default\">\t<div class=\"jet-form-builder-progress-pages__item--wrapper passed-page\" data-page=\"1\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">1<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper passed-page\" data-page=\"2\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">2<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper passed-page\" data-page=\"3\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">3<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper active-page\" data-page=\"4\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">4<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper\" data-page=\"5\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">5<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper\" data-page=\"6\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">6<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\">Last Page<\/div>\n\t\t<\/div>\n\t\t\t<\/div>\n\t<\/div>\n\n\n<div  data-validation-type=\"inherit\" class=\"jet-form-builder-row field-type-checkbox-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">How Did You Hear About Us? (Select all that apply) <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__fields-group checkradio-wrap\" data-jfb-sync><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-checkbox\">\n<input type=\"checkbox\" name=\"teen-q104[]\" value=\"Online Search\" data-field-name=\"teen-q104\" data-calculate=\"Online Search\"  class=\"jet-form-builder__field checkboxes-field checkradio-field\" required=\"required\"><span>Online Search<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-checkbox\">\n<input type=\"checkbox\" name=\"teen-q104[]\" value=\"Facebook\" data-field-name=\"teen-q104\" data-calculate=\"Facebook\"  class=\"jet-form-builder__field checkboxes-field checkradio-field\" required=\"required\"><span>Facebook<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-checkbox\">\n<input type=\"checkbox\" name=\"teen-q104[]\" value=\"Instagram\" data-field-name=\"teen-q104\" data-calculate=\"Instagram\"  class=\"jet-form-builder__field checkboxes-field checkradio-field\" required=\"required\"><span>Instagram<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-checkbox\">\n<input type=\"checkbox\" name=\"teen-q104[]\" value=\"Twitter\" data-field-name=\"teen-q104\" data-calculate=\"Twitter\"  class=\"jet-form-builder__field checkboxes-field checkradio-field\" required=\"required\"><span>Twitter<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-checkbox\">\n<input type=\"checkbox\" name=\"teen-q104[]\" value=\"LinkedIn\" data-field-name=\"teen-q104\" data-calculate=\"LinkedIn\"  class=\"jet-form-builder__field checkboxes-field checkradio-field\" required=\"required\"><span>LinkedIn<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-checkbox\">\n<input type=\"checkbox\" name=\"teen-q104[]\" value=\"YouTube\" data-field-name=\"teen-q104\" data-calculate=\"YouTube\"  class=\"jet-form-builder__field checkboxes-field checkradio-field\" required=\"required\"><span>YouTube<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-checkbox\">\n<input type=\"checkbox\" name=\"teen-q104[]\" value=\"TikTok\" data-field-name=\"teen-q104\" data-calculate=\"TikTok\"  class=\"jet-form-builder__field checkboxes-field checkradio-field\" required=\"required\"><span>TikTok<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-checkbox\">\n<input type=\"checkbox\" name=\"teen-q104[]\" value=\"Referral\" data-field-name=\"teen-q104\" data-calculate=\"Referral\"  class=\"jet-form-builder__field checkboxes-field checkradio-field\" required=\"required\"><span>Referral<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-checkbox\">\n<input type=\"checkbox\" name=\"teen-q104[]\" value=\"Article\" data-field-name=\"teen-q104\" data-calculate=\"Article\"  class=\"jet-form-builder__field checkboxes-field checkradio-field\" required=\"required\"><span>Article<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-checkbox\">\n<input type=\"checkbox\" name=\"teen-q104[]\" value=\"Newspaper\" data-field-name=\"teen-q104\" data-calculate=\"Newspaper\"  class=\"jet-form-builder__field checkboxes-field checkradio-field\" required=\"required\"><span>Newspaper<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap custom-option\"><button type=\"button\" class=\"add-custom-option\">+ Add New<template><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap custom-option\"><label class=\"jet-form-builder__field-label for-checkbox\"><input type=\"checkbox\" checked=\"checked\" data-field-name=\"teen-q104\" data-custom=\"1\" class=\"jet-form-builder__field checkboxes-field checkradio-field\" value=\"\"><span><input type=\"text\" name=\"teen-q104[]\" data-field-name=\"teen-q104\" class=\"jet-form-builder__field text-field\"><\/span><label><\/div><\/template><\/button><\/div><\/div>\n<\/div>\n\n<div class=\"jet-form-builder__next-page-wrap\">\n\t\t<button type=\"button\" class=\"jet-form-builder__prev-page\" data-to-page=\"3\">Back<\/button>\t\t\t<button data-jfb-conditional=\"[{&quot;page_state&quot;:&quot;active&quot;}]\" data-jfb-func=\"disable\" class=\"jet-form-builder__next-page\" type=\"button\">Next<\/button>\n\t<\/div>\n<\/div>\n<div class=\"jet-form-builder-page jet-form-builder-page--hidden\" data-page=\"5\" data-page-offset=\"75\">\n\n\n<div class=\"jet-form-builder-progress-pages jfb-progress-type--default\" data-type=\"default\">\t<div class=\"jet-form-builder-progress-pages__item--wrapper passed-page\" data-page=\"1\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">1<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper passed-page\" data-page=\"2\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">2<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper passed-page\" data-page=\"3\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">3<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper passed-page\" data-page=\"4\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">4<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper active-page\" data-page=\"5\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">5<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper\" data-page=\"6\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">6<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\">Last Page<\/div>\n\t\t<\/div>\n\t\t\t<\/div>\n\t<\/div>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div  data-validation-type=\"inherit\" class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">First Name <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"your_first_name\" id=\"your_first_name\" type=\"text\" data-field-name=\"your_first_name\" class=\"jet-form-builder__field text-field\" maxlength=\"15\" data-jfb-sync=\"null\" autocomplete=\"off_L81vEhdB\">\n\t\t\t\t\t<\/div><div class=\"jet-form-builder__desc\"><small>Joe<\/small><\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div  data-validation-type=\"inherit\" class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Last Name <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"your_last_name\" id=\"your_last_name\" type=\"text\" data-field-name=\"your_last_name\" class=\"jet-form-builder__field text-field\" maxlength=\"15\" data-jfb-sync=\"null\" autocomplete=\"off_f7IuHOY5\">\n\t\t\t\t\t<\/div><div class=\"jet-form-builder__desc\"><small>Ssekidde<\/small><\/div>\n<\/div><\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div  data-validation-type=\"inherit\" class=\"jet-form-builder-row field-type-number-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Age<\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t<input type=\"number\" class=\"jet-form-builder__field text-field\" min=\"18\" max=\"80\" name=\"your_age\" data-field-name=\"your_age\" id=\"your_age\" data-jfb-sync=\"null\">\n\t<\/div><div class=\"jet-form-builder__desc\"><small>From 18 to 80 yrs<\/small><\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div  data-validation-type=\"inherit\" class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Phone <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"your_phone\" id=\"your_phone\" type=\"tel\" data-field-name=\"your_phone\" class=\"jet-form-builder__field text-field\" maxlength=\"15\" data-jfb-sync=\"null\" autocomplete=\"off_ZTiB5W3o\">\n\t\t\t\t\t<\/div><div class=\"jet-form-builder__desc\"><small>e.g. +256772666777<\/small><\/div>\n<\/div><\/div>\n<\/div>\n\n\n<div class=\"jet-form-builder__next-page-wrap\">\n\t\t\t\t\t<button data-jfb-conditional=\"[{&quot;page_state&quot;:&quot;active&quot;}]\" data-jfb-func=\"disable\" class=\"jet-form-builder__next-page\" type=\"button\">Next<\/button>\n\t<\/div>\n<\/div>\n<div class=\"jet-form-builder-page jet-form-builder-page--hidden\" data-page=\"6\" data-page-offset=\"75\">\n\n\n<div class=\"jet-form-builder-progress-pages jfb-progress-type--default\" data-type=\"default\">\t<div class=\"jet-form-builder-progress-pages__item--wrapper passed-page\" data-page=\"1\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">1<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper passed-page\" data-page=\"2\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">2<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper passed-page\" data-page=\"3\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">3<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper passed-page\" data-page=\"4\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">4<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper passed-page\" data-page=\"5\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">5<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper active-page\" data-page=\"6\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">6<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\">Last Page<\/div>\n\t\t<\/div>\n\t\t\t<\/div>\n\t<\/div>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Create Your Personal Account<\/strong><\/h2>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div  data-validation-type=\"inherit\" class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Email: <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"your_email\" id=\"your_email\" type=\"email\" data-field-name=\"your_email\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_fxjNcwWT\">\n\t\t\t\t\t<\/div><div class=\"jet-form-builder__desc\"><small>e.g. info@example.com<\/small><\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div  data-validation-type=\"inherit\" class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Username: <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"your_username\" id=\"your_username\" type=\"text\" data-field-name=\"your_username\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_w8STPoD7\">\n\t\t\t\t\t<\/div><div class=\"jet-form-builder__desc\"><small>e.g. betty2020<\/small><\/div>\n<\/div><\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div  data-validation-type=\"advanced\" class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Password <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__field-wrap has-eye-icon\">\n\t\t\t\t<input required=\"required\" name=\"password\" id=\"password\" type=\"password\" data-field-name=\"password\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_fldJY5GN\">\n\t\t\t\t\t<span\n\t\t\t\t\tclass=\"jfb-eye-icon seen\"\n\t\t\t\t\trole=\"button\"\n\t\t\t\t\ttabindex=\"0\"\n\t\t\t\t\tstyle=\"\"\n\t\t\t>\n\t\t\t\t<svg class=\"seen-icon\" viewBox=\"0 0 24 24\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"24\" height=\"24\" aria-hidden=\"true\" focusable=\"false\" fill=\"currentColor\"><path d=\"M3.99961 13C4.67043 13.3354 4.6703 13.3357 4.67017 13.3359L4.67298 13.3305C4.67621 13.3242 4.68184 13.3135 4.68988 13.2985C4.70595 13.2686 4.7316 13.2218 4.76695 13.1608C4.8377 13.0385 4.94692 12.8592 5.09541 12.6419C5.39312 12.2062 5.84436 11.624 6.45435 11.0431C7.67308 9.88241 9.49719 8.75 11.9996 8.75C14.502 8.75 16.3261 9.88241 17.5449 11.0431C18.1549 11.624 18.6061 12.2062 18.9038 12.6419C19.0523 12.8592 19.1615 13.0385 19.2323 13.1608C19.2676 13.2218 19.2933 13.2686 19.3093 13.2985C19.3174 13.3135 19.323 13.3242 19.3262 13.3305L19.3291 13.3359C19.3289 13.3357 19.3288 13.3354 19.9996 13C20.6704 12.6646 20.6703 12.6643 20.6701 12.664L20.6697 12.6632L20.6688 12.6614L20.6662 12.6563L20.6583 12.6408C20.6517 12.6282 20.6427 12.6108 20.631 12.5892C20.6078 12.5459 20.5744 12.4852 20.5306 12.4096C20.4432 12.2584 20.3141 12.0471 20.1423 11.7956C19.7994 11.2938 19.2819 10.626 18.5794 9.9569C17.1731 8.61759 14.9972 7.25 11.9996 7.25C9.00203 7.25 6.82614 8.61759 5.41987 9.9569C4.71736 10.626 4.19984 11.2938 3.85694 11.7956C3.68511 12.0471 3.55605 12.2584 3.4686 12.4096C3.42484 12.4852 3.39142 12.5459 3.36818 12.5892C3.35656 12.6108 3.34748 12.6282 3.34092 12.6408L3.33297 12.6563L3.33041 12.6614L3.32948 12.6632L3.32911 12.664C3.32894 12.6643 3.32879 12.6646 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