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Submitted URL: https://qrco.de/beiim9
Effective URL: https://redcap.musc.edu/surveys/?s=7WXELJXRCYPDEENE
Submission: On February 01 via manual from SG — Scanned from DE
Effective URL: https://redcap.musc.edu/surveys/?s=7WXELJXRCYPDEENE
Submission: On February 01 via manual from SG — Scanned from DE
Form analysis 1 forms found in the DOM
Name: form — POST /surveys/index.php?s=7WXELJXRCYPDEENE
<form action="/surveys/index.php?s=7WXELJXRCYPDEENE" enctype="multipart/form-data" target="_self" method="post" name="form" id="form"><input type="hidden" name="redcap_csrf_token" value="">
<div>
<script type="text/javascript">
if (typeof lang == 'undefined') {
var lang = {}
};
lang.global_143 = 'Checked';
lang.global_144 = 'Unchecked';
</script>
<script type="text/javascript">
var missing_data_replacement_js = '______';
var piping_receiver_class_field_js = '.piping_receiver.piperec-';
</script>
<span id="maxchecked_tag_label" class="" style="display:none;z-index:1000;" data-rc-lang="data_entry_421">Cannot select choice! The maximum number of choices has been selected.</span><span id="matrix_rank_remove_label" class="opacity75"
style="display:none;" data-rc-lang="data_entry_203">Value removed!</span>
<div id="questiontable_loading" style="display: none; visibility: visible;">
<img alt="Loading..." src="/redcap_v13.4.13/Resources/images/progress_circle.gif"> <span data-rc-lang="data_entry_64">Loading...</span>
</div>
<script type="text/javascript">
setTimeout(function() {
document.getElementById('questiontable_loading').style.visibility = 'visible';
}, 750);
</script>
<table role="presentation" class="form_border container-fluid" style="display: table;" id="questiontable">
<tbody class="formtbody">
<tr id="name-tr" sq_id="name" req="1">
<td class="labelrc questionnum col-1" valign="top">1)</td>
<td class="labelrc col-6"><label class="fl" id="label-name">
<div data-kind="field-label">
<div data-mlm-field="name" data-mlm-type="label"> Name </div>
<div class="requiredlabel" aria-label="Question required.">* <span data-rc-lang="data_entry_39">must provide value</span></div>
</div>
</label></td>
<td class="data col-5"><span data-kind="field-value"><input autocomplete="new-password" aria-required="true" aria-labelledby="label-name" class="x-form-text x-form-field " type="text" name="name" value="" tabindex="0"></span>
<div id="name_MDLabel" class="MDLabel" style="display:none" code="" label=""></div>
</td>
</tr>
<tr id="birthday-tr" sq_id="birthday" req="1">
<td class="labelrc questionnum col-1" valign="top">2)</td>
<td class="labelrc col-6"><label class="fl" id="label-birthday">
<div data-kind="field-label">
<div data-mlm-field="birthday" data-mlm-type="label"> Date of Birth </div>
<div class="requiredlabel" aria-label="Question required.">* <span data-rc-lang="data_entry_39">must provide value</span></div>
</div>
</label></td>
<td class="data col-5"><span data-kind="field-value"><input autocomplete="new-password" aria-required="true" aria-labelledby="label-birthday" class="x-form-text x-form-field " type="text" name="birthday" value="" tabindex="0"></span>
<div id="birthday_MDLabel" class="MDLabel" style="display:none" code="" label=""></div>
</td>
</tr>
<tr id="email-tr" sq_id="email" req="1">
<td class="labelrc questionnum col-1" valign="top">3)</td>
<td class="labelrc col-6"><label class="fl" id="label-email">
<div data-kind="field-label">
<div data-mlm-field="email" data-mlm-type="label"> Email</div>
<div class="requiredlabel" aria-label="Question required.">* <span data-rc-lang="data_entry_39">must provide value</span></div>
</div>
</label></td>
<td class="data col-5"><span data-kind="field-value"><input autocomplete="new-password" aria-required="true" aria-labelledby="label-email" class="x-form-text x-form-field " type="text" name="email" value="" tabindex="0"></span>
<div id="email_MDLabel" class="MDLabel" style="display:none" code="" label=""></div>
</td>
</tr>
<tr id="phone_number-tr" sq_id="phone_number" req="1">
<td class="labelrc questionnum col-1" valign="top">4)</td>
<td class="labelrc col-6"><label class="fl" id="label-phone_number">
<div data-kind="field-label">
<div data-mlm-field="phone_number" data-mlm-type="label"> Phone Number </div>
<div class="requiredlabel" aria-label="Question required.">* <span data-rc-lang="data_entry_39">must provide value</span></div>
</div>
</label></td>
<td class="data col-5"><span data-kind="field-value"><input autocomplete="new-password" aria-required="true" aria-labelledby="label-phone_number" class="x-form-text x-form-field " type="text" name="phone_number" value=""
tabindex="0"></span>
<div id="phone_number_MDLabel" class="MDLabel" style="display:none" code="" label=""></div>
</td>
</tr>
<tr id="address-tr" sq_id="address" req="1">
<td class="labelrc questionnum col-1" valign="top">5)</td>
<td class="labelrc col-6"><label class="fl" id="label-address">
<div data-kind="field-label">
<div data-mlm-field="address" data-mlm-type="label"> Address (street, city, zip code)</div>
<div class="requiredlabel" aria-label="Question required.">* <span data-rc-lang="data_entry_39">must provide value</span></div>
</div>
</label></td>
<td class="data col-5"><span data-kind="field-value"><input autocomplete="new-password" aria-required="true" aria-labelledby="label-address" class="x-form-text x-form-field " type="text" name="address" value="" tabindex="0"></span>
<div id="address_MDLabel" class="MDLabel" style="display:none" code="" label=""></div>
</td>
</tr>
<tr id="class_selection-tr" sq_id="class_selection" req="1">
<td class="labelrc questionnum col-1" valign="top">6)</td>
<td class="labelrc col-6"><label class="fl" id="label-class_selection">
<div data-kind="field-label">
<div data-mlm-field="class_selection" data-mlm-type="label"> Please choose from the following session options</div>
<div class="requiredlabel" aria-label="Question required.">* <span data-rc-lang="data_entry_39">must provide value</span></div>
</div>
</label></td>
<td class="data col-5"><span data-kind="field-value"><input name="class_selection" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-class_selection">
<div class="choicevert hidden"><input type="radio" id="opt-class_selection_1" tabindex="-1" name="class_selection___radio" aria-labelledby="label-class_selection label-class_selection-1"
onclick="document.forms['form'].class_selection.value=this.value;" value="1"> <label data-mlm-field="class_selection" data-mlm-type="enum" data-mlm-value="1" id="label-class_selection-1" for="opt-class_selection_1"
class="mc">Monday/ Wednesday/ Friday - 6:30-7:30am</label></div>
<div class="choicevert hidden"><input type="radio" id="opt-class_selection_2" tabindex="-1" name="class_selection___radio" aria-labelledby="label-class_selection label-class_selection-2"
onclick="document.forms['form'].class_selection.value=this.value;" value="2"> <label data-mlm-field="class_selection" data-mlm-type="enum" data-mlm-value="2" id="label-class_selection-2" for="opt-class_selection_2"
class="mc">Tuesday/ Thursday- 4:30-5:30pm and Saturday 9-10am</label></div>
<div class="enhancedchoice_wrapper">
<div class="enhancedchoice col-12 col-md-12 "><label tabindex="0" for="opt-class_selection_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }" onclick="enhanceChoiceSelect(this,event,null);"
comps="class_selection,value,1" class="hover "><span class="ec" aria-labelledby="label-class_selection label-class_selection-1" data-mlm-field="class_selection" data-mlm-type="enum" data-mlm-value="1">Monday/ Wednesday/ Friday -
6:30-7:30am</span></label></div>
<div class="enhancedchoice col-12 col-md-12 "><label tabindex="0" for="opt-class_selection_2" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }" onclick="enhanceChoiceSelect(this,event,null);"
comps="class_selection,value,2" class="hover "><span class="ec" aria-labelledby="label-class_selection label-class_selection-2" data-mlm-field="class_selection" data-mlm-type="enum" data-mlm-value="2">Tuesday/ Thursday-
4:30-5:30pm and Saturday 9-10am</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('class_selection','form');return false;"><span data-rc-lang="form_renderer_20">reset</span></a></div>
<div id="class_selection_MDLabel" class="MDLabel" style="display:none" code="" label=""></div>
</td>
</tr>
<input type="hidden" name="submit-action" id="submit-action" value="<span data-rc-lang="data_entry_206">Save Record</span>">
<input type="hidden" name="__start_time__" id="__start_time__" value="2024-01-31 20:02:33">
<input type="hidden" name="record_id" id="record_id" value="1">
<input type="hidden" name="__page__" value="1">
<input type="hidden" name="__page_hash__" value="db1761d6c10b3b3e864a2d50c414a750">
<input type="hidden" name="__response_hash__" value="">
<input type="hidden" name="boxing_club_registration_complete" value="">
<tr class="surveysubmit">
<td class="labelrc col-12" style="padding:5px;" colspan="3">
<table cellspacing="0">
<tbody>
<tr>
<td colspan="2" style="text-align:center;padding:15px 0;">
<button name="submit-btn-saverecord" tabindex="0" class="jqbutton nowrap ui-button ui-corner-all ui-widget" style="color:#800000;min-width:140px;"
onclick="$(this).button("disable");dataEntrySubmit(this);return false;"><span data-rc-lang="survey_200">Submit</span></button>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
</div><input type="hidden" name="external-modules-temporary-record-id" value="external-modules-temporary-record-id-1706749355-185919226">
</form>Text Content
The code block below illustrates how one might use # and // as comments in your logic and calculations. # Text can be put here to explain what the logic/calculation does and why. if ([field1] = '1' and [field2] > 7, // This comment can explain what the next line does. [score] * [factor], // Return '0' if the condition is False. 0 ) Working... 0% means 50% means 100% means This value you provided is not a number. Please try again. This value you provided is not an integer. Please try again. The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again. The value you provided must be within the suggested range The value you provided is outside the suggested range This value is admissible, but you may wish to double check it. The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19). This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now. This field must be a 10 digit U.S. phone number (like 415 555 1212). Please re-enter it now. This field must be a valid email address (like joe@user.com). Please re-enter it now. The value you provided could not be validated because it does not follow the expected format. Please try again. Required format: w8dbfEmIJSVFqPdW2crETGxdBgbpDvucsRLjGNjMFuqAgze3YtypaZc4WWD8WMsT9DmxX244n BOXING CLUB REGISTRATION A A A Please complete the survey below. Thank you! Cannot select choice! The maximum number of choices has been selected.Value removed! Loading... 1) Name * must provide value 2) Date of Birth * must provide value 3) Email * must provide value 4) Phone Number * must provide value 5) Address (street, city, zip code) * must provide value 6) Please choose from the following session options * must provide value Monday/ Wednesday/ Friday - 6:30-7:30am Tuesday/ Thursday- 4:30-5:30pm and Saturday 9-10am Monday/ Wednesday/ Friday - 6:30-7:30am Tuesday/ Thursday- 4:30-5:30pm and Saturday 9-10am reset Submit YOU HAVE SELECTED AN OPTION THAT TRIGGERS THIS SURVEY TO END RIGHT NOW. To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button. Powered by REDCap