{"id":1110,"date":"2020-12-07T18:08:12","date_gmt":"2020-12-07T18:08:12","guid":{"rendered":"http:\/\/edwardcockerton.com\/?page_id=1110"},"modified":"2024-09-30T00:10:51","modified_gmt":"2024-09-30T00:10:51","slug":"trial-lesson-registration-form","status":"publish","type":"page","link":"https:\/\/edwardcockerton.com\/?page_id=1110","title":{"rendered":"Trial Lesson Registration Form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1110\" class=\"elementor elementor-1110\" data-elementor-settings=\"[]\">\n\t\t\t\t\t\t<div class=\"elementor-inner\">\n\t\t\t\t\t\t\t<div class=\"elementor-section-wrap\">\n\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-a53e787 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"a53e787\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t\t\t<div class=\"elementor-row\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-21af0a3\" data-id=\"21af0a3\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-column-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-836d21d elementor-widget__width-inherit elementor-widget elementor-widget-html\" data-id=\"836d21d\" data-element_type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<script src=\"https:\/\/cdn03.jotfor.ms\/static\/prototype.forms.js?v=3.3.57241\" type=\"text\/javascript\"><\/script>\r\n<script src=\"https:\/\/cdn01.jotfor.ms\/static\/jotform.forms.js?v=3.3.57241\" type=\"text\/javascript\"><\/script>\r\n<script src=\"https:\/\/cdn02.jotfor.ms\/js\/punycode-1.4.1.min.js?v=3.3.57241\" type=\"text\/javascript\" defer><\/script>\r\n<script src=\"https:\/\/cdn03.jotfor.ms\/js\/vendor\/maskedinput_5.0.9.min.js?v=3.3.57241\" type=\"text\/javascript\"><\/script>\r\n<script src=\"https:\/\/cdn01.jotfor.ms\/s\/umd\/99679ab0726\/for-form-branding-footer.js?v=3.3.57241\" type=\"text\/javascript\" defer><\/script>\r\n<script type=\"text\/javascript\">\tJotForm.newDefaultTheme = false; JotForm.extendsNewTheme = false; JotForm.singleProduct = false; JotForm.newPaymentUIForNewCreatedForms = false; JotForm.texts = {\"confirmEmail\":\"E-mail does not match\",\"pleaseWait\":\"Please wait...\",\"validateEmail\":\"You need to validate this e-mail\",\"confirmClearForm\":\"Are you sure you want to clear the form\",\"lessThan\":\"Your score should be less than or equal to\",\"incompleteFields\":\"There are incomplete required fields. 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\/*__INSPECT_SEPERATOR__*\/\r\n.form-label.form-label-auto { display : block; float : none; text-align : left; width : 100%;\r\n} \/* Injected CSS Code *\/\r\n<\/style> <form class=\"jotform-form\" onsubmit=\"return typeof testSubmitFunction !== 'undefined' && testSubmitFunction();\" action=\"https:\/\/submit.jotform.com\/submit\/201526217098252\" method=\"post\" name=\"form_201526217098252\" id=\"201526217098252\" accept-charset=\"utf-8\" autocomplete=\"on\"><input type=\"hidden\" name=\"formID\" value=\"201526217098252\" \/><input type=\"hidden\" id=\"JWTContainer\" value=\"\" \/><input type=\"hidden\" id=\"cardinalOrderNumber\" value=\"\" \/><input type=\"hidden\" id=\"jsExecutionTracker\" name=\"jsExecutionTracker\" value=\"build-date-1727655035897\" \/><input type=\"hidden\" id=\"submitSource\" name=\"submitSource\" value=\"unknown\" \/><input type=\"hidden\" id=\"buildDate\" name=\"buildDate\" value=\"1727655035897\" \/> <div id=\"formCoverLogo\" style=\"margin-bottom:10px\" class=\"form-cover-wrapper form-has-cover form-page-cover-image-align-center\"> <div class=\"form-page-cover-image-wrapper\" style=\"max-width:690px\"><img loading=\"lazy\" src=\"https:\/\/www.jotform.com\/uploads\/edwardsacademy\/form_files\/Horizontal%20Logo%20Smaller%20for%20forms.5fc6a25b7717e6.04855180.png\" class=\"form-page-cover-image\" width=\"300\" height=\"132\" aria-label=\"Form Logo\" style=\"aspect-ratio:300\/132\" \/><\/div> <\/div> <div role=\"main\" class=\"form-all\"> <ul class=\"form-section page-section\"> <li id=\"cid_3\" class=\"form-input-wide\" data-type=\"control_head\"> <div class=\"form-header-group header-small\"> <div class=\"header-text httal htvam\"> <h3 id=\"header_3\" class=\"form-header\" data-component=\"header\">Trial Music Lesson Registration Form<\/h3> <\/div> <\/div> <\/li> <li class=\"form-line form-line-column form-col-1\" data-type=\"control_fullname\" id=\"id_4\"><label class=\"form-label form-label-top\" id=\"label_4\" for=\"first_4\" aria-hidden=\"false\"> Parent \/ Guardian Name <\/label> <div id=\"cid_4\" class=\"form-input-wide\"> <div data-wrapper-react=\"true\"><span class=\"form-sub-label-container\" style=\"vertical-align:top\" data-input-type=\"first\"><input type=\"text\" id=\"first_4\" name=\"q4_parent[first]\" class=\"form-textbox\" data-defaultvalue=\"\" autoComplete=\"section-input_4 given-name\" size=\"10\" data-component=\"first\" aria-labelledby=\"label_4 sublabel_4_first\" value=\"\" \/><label class=\"form-sub-label\" for=\"first_4\" id=\"sublabel_4_first\" style=\"min-height:13px\">First Name<\/label><\/span><span class=\"form-sub-label-container\" style=\"vertical-align:top\" data-input-type=\"last\"><input type=\"text\" id=\"last_4\" name=\"q4_parent[last]\" class=\"form-textbox\" data-defaultvalue=\"\" autoComplete=\"section-input_4 family-name\" size=\"15\" data-component=\"last\" aria-labelledby=\"label_4 sublabel_4_last\" value=\"\" \/><label class=\"form-sub-label\" for=\"last_4\" id=\"sublabel_4_last\" style=\"min-height:13px\">Last Name<\/label><\/span><\/div> <\/div> <\/li> <li class=\"form-line form-line-column form-col-2 jf-required\" data-type=\"control_email\" id=\"id_7\"><label class=\"form-label form-label-top\" id=\"label_7\" for=\"input_7\" aria-hidden=\"false\"> E-mail Address<span class=\"form-required\">*<\/span> <\/label> <div id=\"cid_7\" class=\"form-input-wide jf-required\"> <input type=\"email\" id=\"input_7\" name=\"q7_emailAddress\" class=\"form-textbox validate[required, Email]\" data-defaultvalue=\"\" autoComplete=\"section-input_7 email\" size=\"25\" placeholder=\"example@example.com\" data-component=\"email\" aria-labelledby=\"label_7\" required=\"\" value=\"\" \/> <\/div> <\/li> <li class=\"form-line form-line-column form-col-3\" data-type=\"control_phone\" id=\"id_5\"><label class=\"form-label form-label-top\" id=\"label_5\" for=\"input_5_full\"> Phone Number <\/label> <div id=\"cid_5\" class=\"form-input-wide\"> <span class=\"form-sub-label-container\" style=\"vertical-align:top\"><input type=\"tel\" id=\"input_5_full\" name=\"q5_phoneNumber[full]\" data-type=\"mask-number\" class=\"mask-phone-number form-textbox validate[Fill Mask]\" data-defaultvalue=\"\" autoComplete=\"section-input_5 tel-national\" data-masked=\"true\" data-component=\"phone\" aria-labelledby=\"label_5\" value=\"\" \/><\/span> <\/div> <\/li> <li class=\"form-line\" data-type=\"control_radio\" id=\"id_112\"><label class=\"form-label form-label-top form-label-auto\" id=\"label_112\" aria-hidden=\"false\"> Where would you prefer lessons to be held? <\/label> <div id=\"cid_112\" class=\"form-input-wide\"> <div class=\"form-single-column\" role=\"group\" aria-labelledby=\"label_112\" data-component=\"radio\"><span class=\"form-radio-item\" style=\"clear:left\"><span class=\"dragger-item\"><\/span><input type=\"radio\" aria-describedby=\"label_112\" class=\"form-radio\" id=\"input_112_0\" name=\"q112_whereWould\" value=\"At home\" \/><label id=\"label_input_112_0\" for=\"input_112_0\">At home<\/label><\/span><span class=\"form-radio-item\" style=\"clear:left\"><span class=\"dragger-item\"><\/span><input type=\"radio\" aria-describedby=\"label_112\" class=\"form-radio\" id=\"input_112_1\" name=\"q112_whereWould\" value=\"Online\" \/><label id=\"label_input_112_1\" for=\"input_112_1\">Online<\/label><\/span><\/div> <\/div> <\/li> <li class=\"form-line\" data-type=\"control_address\" id=\"id_8\" data-compound-hint=\",,,ON,A#A #A#,\"><label class=\"form-label form-label-top\" id=\"label_8\" for=\"input_8_addr_line1\" aria-hidden=\"false\"> Home Address <\/label> <div id=\"cid_8\" class=\"form-input-wide\"> <div summary=\"\" class=\"form-address-table jsTest-addressField\"> <div class=\"form-address-line-wrapper jsTest-address-line-wrapperField\"><span class=\"form-address-line form-address-street-line jsTest-address-lineField\"><span class=\"form-sub-label-container\" style=\"vertical-align:top\"><input 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for=\"input_8_addr_line2\" id=\"sublabel_8_addr_line2\" style=\"min-height:13px\">Unit Number<\/label><\/span><\/span><\/div> <div class=\"form-address-line-wrapper jsTest-address-line-wrapperField\"><span class=\"form-address-line form-address-city-line jsTest-address-lineField \"><span class=\"form-sub-label-container\" style=\"vertical-align:top\"><input type=\"text\" id=\"input_8_city\" name=\"q8_homeAddress8[city]\" class=\"form-textbox form-address-city\" data-defaultvalue=\"\" autoComplete=\"section-input_8 address-level2\" data-component=\"city\" aria-labelledby=\"label_8 sublabel_8_city\" value=\"\" \/><label class=\"form-sub-label\" for=\"input_8_city\" id=\"sublabel_8_city\" style=\"min-height:13px\">City<\/label><\/span><\/span><span class=\"form-address-line form-address-state-line jsTest-address-lineField \"><span class=\"form-sub-label-container\" style=\"vertical-align:top\"><input type=\"text\" id=\"input_8_state\" name=\"q8_homeAddress8[state]\" class=\"form-textbox form-address-state\" data-defaultvalue=\"\" autoComplete=\"section-input_8 address-level1\" placeholder=\"ON\" data-component=\"state\" aria-labelledby=\"label_8 sublabel_8_state\" value=\"\" \/><label class=\"form-sub-label\" for=\"input_8_state\" id=\"sublabel_8_state\" style=\"min-height:13px\">Province<\/label><\/span><\/span><\/div> <div class=\"form-address-line-wrapper jsTest-address-line-wrapperField\"><span class=\"form-address-line form-address-zip-line jsTest-address-lineField \"><span class=\"form-sub-label-container\" style=\"vertical-align:top\"><input type=\"text\" id=\"input_8_postal\" name=\"q8_homeAddress8[postal]\" class=\"form-textbox form-address-postal\" data-defaultvalue=\"\" autoComplete=\"section-input_8 postal-code\" placeholder=\"A#A #A#\" data-component=\"zip\" aria-labelledby=\"label_8 sublabel_8_postal\" value=\"\" \/><label class=\"form-sub-label\" for=\"input_8_postal\" id=\"sublabel_8_postal\" style=\"min-height:13px\">Postal Code<\/label><\/span><\/span><\/div> <\/div> <\/div> <\/li> <li id=\"cid_114\" class=\"form-input-wide\" data-type=\"control_pagebreak\"> <div class=\"form-pagebreak\" data-component=\"pagebreak\"> <div class=\"form-pagebreak-back-container\"><button id=\"form-pagebreak-back_114\" type=\"button\" class=\"form-pagebreak-back jf-form-buttons\" data-component=\"pagebreak-back\">Back<\/button><\/div> <div class=\"form-pagebreak-next-container\"><button id=\"form-pagebreak-next_114\" type=\"button\" class=\"form-pagebreak-next jf-form-buttons\" data-component=\"pagebreak-next\">Next<\/button><\/div> <div style=\"clear:both\" class=\"pageInfo form-sub-label\" id=\"pageInfo_114\"><\/div> <\/div> <\/li> <\/ul> <ul class=\"form-section page-section\" style=\"display:none;\"> <li class=\"form-line jf-required\" data-type=\"control_fullname\" id=\"id_11\"><label class=\"form-label form-label-top\" id=\"label_11\" for=\"first_11\" aria-hidden=\"false\"> Student Name<span class=\"form-required\">*<\/span> <\/label> <div id=\"cid_11\" class=\"form-input-wide jf-required\"> <div data-wrapper-react=\"true\"><span class=\"form-sub-label-container\" style=\"vertical-align:top\" data-input-type=\"first\"><input type=\"text\" id=\"first_11\" name=\"q11_studentName[first]\" class=\"form-textbox validate[required]\" data-defaultvalue=\"\" autoComplete=\"section-input_11 given-name\" size=\"10\" data-component=\"first\" aria-labelledby=\"label_11 sublabel_11_first\" required=\"\" value=\"\" \/><label class=\"form-sub-label\" for=\"first_11\" id=\"sublabel_11_first\" style=\"min-height:13px\">First Name<\/label><\/span><span class=\"form-sub-label-container\" style=\"vertical-align:top\" data-input-type=\"last\"><input type=\"text\" id=\"last_11\" name=\"q11_studentName[last]\" class=\"form-textbox validate[required]\" data-defaultvalue=\"\" autoComplete=\"section-input_11 family-name\" size=\"15\" data-component=\"last\" aria-labelledby=\"label_11 sublabel_11_last\" required=\"\" value=\"\" \/><label class=\"form-sub-label\" for=\"last_11\" id=\"sublabel_11_last\" style=\"min-height:13px\">Last Name<\/label><\/span><\/div> <\/div> <\/li> <li class=\"form-line form-line-column form-col-1 jf-required\" data-type=\"control_textbox\" id=\"id_68\"><label class=\"form-label form-label-top\" id=\"label_68\" for=\"input_68\" aria-hidden=\"false\"> Age<span class=\"form-required\">*<\/span> <\/label> <div id=\"cid_68\" class=\"form-input-wide jf-required\"> <input type=\"text\" id=\"input_68\" name=\"q68_age\" data-type=\"input-textbox\" class=\"form-textbox validate[required]\" data-defaultvalue=\"\" size=\"20\" data-component=\"textbox\" aria-labelledby=\"label_68\" required=\"\" value=\"\" \/> <\/div> <\/li> <li class=\"form-line jf-required\" data-type=\"control_dropdown\" id=\"id_110\"><label class=\"form-label form-label-top form-label-auto\" id=\"label_110\" for=\"input_110\" aria-hidden=\"false\"> Which instrument would you like to sign up for?<span class=\"form-required\">*<\/span> <\/label> <div id=\"cid_110\" class=\"form-input-wide jf-required\"> <select class=\"form-dropdown validate[required]\" id=\"input_110\" name=\"q110_whichInstrument110\" style=\"width:250px\" data-component=\"dropdown\" required=\"\" aria-label=\"Which instrument would you like to sign up for?\"> <option value=\"\"><\/option> <option selected=\"\" value=\"Piano\">Piano<\/option> <option value=\"Guitar \/ Ukulele\">Guitar \/ Ukulele<\/option> <option value=\"Voice\">Voice<\/option> <option value=\"Woodwinds\">Woodwinds<\/option> <option value=\"Brass\">Brass<\/option> <option value=\"Theory\">Theory<\/option> <\/select> <\/div> <\/li> <li class=\"form-line\" data-type=\"control_textarea\" id=\"id_111\"><label class=\"form-label form-label-top form-label-auto\" id=\"label_111\" for=\"input_111\" aria-hidden=\"false\"> Please tell us about this student's music experience, their goals or any other relevant information <\/label> <div id=\"cid_111\" class=\"form-input-wide\"> <textarea id=\"input_111\" class=\"form-textarea\" name=\"q111_pleaseTell111\" cols=\"40\" rows=\"6\" data-component=\"textarea\" aria-labelledby=\"label_111\"><\/textarea> <\/div> <\/li> <li class=\"form-line\" data-type=\"control_text\" id=\"id_54\"> <div id=\"cid_54\" class=\"form-input-wide\"> <div id=\"text_54\" class=\"form-html\" data-component=\"text\" tabindex=\"0\"> <p>Students must have an instrument at home to be able to practice. All extra materials (books, accessories) required are to be paid by the family as needed. <\/p> <p>The administrator will contact you after the trial lesson has been booked to confirm your availability and any time changes that may be required for lessons going forward such as longer lessons or multiple student households. <\/p> <\/div> <\/div> <\/li> <li class=\"form-line\" data-type=\"control_button\" id=\"id_2\"> <div id=\"cid_2\" class=\"form-input-wide\"> <div data-align=\"center\" class=\"form-buttons-wrapper form-buttons-center jsTest-button-wrapperField\"><button id=\"input_2\" type=\"submit\" class=\"form-submit-button submit-button jf-form-buttons jsTest-submitField\" data-component=\"button\" data-content=\"\">Submit<\/button><\/div> <\/div> <\/li> <li style=\"clear:both\"><\/li> <li style=\"display:none\">Should be Empty: <input type=\"text\" name=\"website\" value=\"\" type=\"hidden\" \/><\/li> <\/ul> <\/div> <script> JotForm.showJotFormPowered = \"new_footer\"; <\/script> <script> JotForm.poweredByText = \"Powered by Jotform\"; <\/script><input type=\"hidden\" class=\"simple_spc\" id=\"simple_spc\" name=\"simple_spc\" value=\"201526217098252\" \/> <script type=\"text\/javascript\"> var all_spc = document.querySelectorAll(\"form[id='201526217098252'] .si\" + \"mple\" + \"_spc\"); for (var i = 0; i < all_spc.length; i++) { all_spc[i].value = \"201526217098252-201526217098252\"; } <\/script> <\/form><script type=\"text\/javascript\">JotForm.ownerView=true;<\/script><script type=\"text\/javascript\">JotForm.isNewSACL=true;<\/script>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Trial Music Lesson Registration Form Parent \/ Guardian Name First NameLast Name E-mail Address* Phone Number Where would you prefer lessons to be held? At homeOnline Home Address Street Address Unit Number CityProvince Postal Code Back Next Student Name* First NameLast Name Age* Which instrument would you like to sign up for?* PianoGuitar \/ UkuleleVoiceWoodwindsBrassTheory &hellip;<\/p>\n<p class=\"read-more\"> <a class=\"\" href=\"https:\/\/edwardcockerton.com\/?page_id=1110\"> <span class=\"screen-reader-text\">Trial Lesson Registration Form<\/span> Read More &raquo;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/edwardcockerton.com\/index.php?rest_route=\/wp\/v2\/pages\/1110"}],"collection":[{"href":"https:\/\/edwardcockerton.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/edwardcockerton.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/edwardcockerton.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/edwardcockerton.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1110"}],"version-history":[{"count":11,"href":"https:\/\/edwardcockerton.com\/index.php?rest_route=\/wp\/v2\/pages\/1110\/revisions"}],"predecessor-version":[{"id":1394,"href":"https:\/\/edwardcockerton.com\/index.php?rest_route=\/wp\/v2\/pages\/1110\/revisions\/1394"}],"wp:attachment":[{"href":"https:\/\/edwardcockerton.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1110"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}