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Submitted URL: http://periwinkleservice.com/xterra-nepal/
Effective URL: https://periwinkleservice.com/xterra-nepal/
Submission: On July 18 via api from US — Scanned from CA
Effective URL: https://periwinkleservice.com/xterra-nepal/
Submission: On July 18 via api from US — Scanned from CA
Form analysis 1 forms found in the DOM
POST /xterra-nepal/#gf_2
<form method="post" enctype="multipart/form-data" target="gform_ajax_frame_2" id="gform_2" action="/xterra-nepal/#gf_2" data-formid="2" novalidate="">
<div id="gf_progressbar_wrapper_2" class="gf_progressbar_wrapper" data-start-at-zero="">
<p class="gf_progressbar_title">Step <span class="gf_step_current_page">1</span> of <span class="gf_step_page_count">6</span></p>
<div class="gf_progressbar gf_progressbar_green" aria-hidden="true">
<div class="gf_progressbar_percentage percentbar_green percentbar_16" style="width:16%;"><span>16%</span></div>
</div>
</div>
<div class="gform-body gform_body">
<div id="gform_page_2_1" class="gform_page " data-js="page-field-id-1">
<div class="gform_page_fields">
<div id="gform_fields_2" class="gform_fields top_label form_sublabel_above description_above validation_below">
<div id="field_2_13" class="gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_2_13">
<h3 class="gsection_title">Personal information</h3>
</div>
<fieldset id="field_2_133"
class="gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_133">
<legend class="gfield_label gform-field-label gfield_label_before_complex">Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row" id="input_2_133">
<span id="input_2_133_3_container" class="name_first gform-grid-col gform-grid-col--size-auto">
<label for="input_2_133_3" class="gform-field-label gform-field-label--type-sub ">First</label>
<input type="text" name="input_133.3" id="input_2_133_3" value="" aria-required="true">
</span>
<span id="input_2_133_6_container" class="name_last gform-grid-col gform-grid-col--size-auto">
<label for="input_2_133_6" class="gform-field-label gform-field-label--type-sub ">Last</label>
<input type="text" name="input_133.6" id="input_2_133_6" value="" aria-required="true">
</span>
</div>
</fieldset>
<div id="field_2_17"
class="gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_17"><label class="gfield_label gform-field-label" for="input_2_17">Date of Birth<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_date">
<input name="input_17" id="input_2_17" type="text" value="" class="datepicker gform-datepicker ymd_dash datepicker_no_icon gdatepicker-no-icon hasDatepicker initialized" placeholder="yyyy-mm-dd" aria-describedby="input_2_17_date_format"
aria-invalid="false" aria-required="true">
<span id="input_2_17_date_format" class="screen-reader-text">YYYY dash MM dash DD</span>
</div>
<input type="hidden" id="gforms_calendar_icon_input_2_17" class="gform_hidden" value="https://periwinkleservice.com/wp-content/plugins/gravityforms/images/datepicker/datepicker.svg">
</div>
<div id="field_2_90"
class="gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_90"><label class="gfield_label gform-field-label" for="input_2_90">Gender<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_90" id="input_2_90" class="large gfield_select" aria-required="true" aria-invalid="false">
<option value="" selected="selected" class="gf_placeholder">Select one</option>
<option value="Male">Male</option>
<option value="Female">Female</option>
<option value="Other">Other</option>
</select></div>
</div>
<div id="field_2_3"
class="gfield gfield--type-phone gfield--input-type-phone gfield--width-half margin-right-10px gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_3"><label class="gfield_label gform-field-label" for="input_2_3">Phone<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_phone"><input name="input_3" id="input_2_3" type="tel" value="" class="large" aria-required="true" aria-invalid="false"></div>
</div>
<div id="field_2_4" class="gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_4"><label class="gfield_label gform-field-label" for="input_2_4">Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_email">
<input name="input_4" id="input_2_4" type="email" value="" class="large" aria-required="true" aria-invalid="false">
</div>
</div>
<fieldset id="field_2_110"
class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_110">
<legend class="gfield_label gform-field-label">Are you a Nepali citizen?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_2_110">
<div class="gchoice gchoice_2_110_0">
<input class="gfield-choice-input" name="input_110" type="radio" value="Yes" id="choice_2_110_0" onchange="gformToggleRadioOther( this )">
<label for="choice_2_110_0" id="label_2_110_0" class="gform-field-label gform-field-label--type-inline">Yes</label>
</div>
<div class="gchoice gchoice_2_110_1">
<input class="gfield-choice-input" name="input_110" type="radio" value="No" id="choice_2_110_1" onchange="gformToggleRadioOther( this )">
<label for="choice_2_110_1" id="label_2_110_1" class="gform-field-label gform-field-label--type-inline">No</label>
</div>
</div>
</div>
</fieldset>
<div id="field_2_23" class="gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_23" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label" for="input_2_23">Nationality<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_23" id="input_2_23" type="text" value="" class="large" aria-required="true" aria-invalid="false" disabled="disabled"></div>
</div>
<div id="field_2_134" class="gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_134" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label" for="input_2_134">Passport no.<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_134" id="input_2_134" type="text" value="" class="large" aria-required="true" aria-invalid="false" disabled="disabled"></div>
</div>
<div id="field_2_135" class="gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_135" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label" for="input_2_135">Citizenship no.<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_135" id="input_2_135" type="text" value="" class="large" aria-required="true" aria-invalid="false" disabled="disabled"></div>
</div>
<fieldset id="field_2_24"
class="gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_24">
<legend class="gfield_label gform-field-label gfield_label_before_complex">Residential Address<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="ginput_complex ginput_container has_street has_city has_state has_zip has_country ginput_container_address gform-grid-row" id="input_2_24">
<span class="ginput_full address_line_1 ginput_address_line_1 gform-grid-col" id="input_2_24_1_container">
<label for="input_2_24_1" id="input_2_24_1_label" class="gform-field-label gform-field-label--type-sub ">Street Address</label>
<input type="text" name="input_24.1" id="input_2_24_1" value="" aria-required="true">
</span><span class="ginput_left address_city ginput_address_city gform-grid-col" id="input_2_24_3_container">
<label for="input_2_24_3" id="input_2_24_3_label" class="gform-field-label gform-field-label--type-sub ">City</label>
<input type="text" name="input_24.3" id="input_2_24_3" value="" aria-required="true">
</span><span class="ginput_right address_state ginput_address_state gform-grid-col" id="input_2_24_4_container">
<label for="input_2_24_4" id="input_2_24_4_label" class="gform-field-label gform-field-label--type-sub ">State / Province / Region</label>
<input type="text" name="input_24.4" id="input_2_24_4" value="" aria-required="true">
</span><span class="ginput_left address_zip ginput_address_zip gform-grid-col" id="input_2_24_5_container">
<label for="input_2_24_5" id="input_2_24_5_label" class="gform-field-label gform-field-label--type-sub ">ZIP / Postal Code</label>
<input type="text" name="input_24.5" id="input_2_24_5" value="" aria-required="true">
</span><span class="ginput_right address_country ginput_address_country gform-grid-col" id="input_2_24_6_container">
<label for="input_2_24_6" id="input_2_24_6_label" class="gform-field-label gform-field-label--type-sub ">Country</label>
<select name="input_24.6" id="input_2_24_6" aria-required="true">
<option value="" selected="selected"></option>
<option value="Afghanistan">Afghanistan</option>
<option value="Albania">Albania</option>
<option value="Algeria">Algeria</option>
<option value="American Samoa">American Samoa</option>
<option value="Andorra">Andorra</option>
<option value="Angola">Angola</option>
<option value="Anguilla">Anguilla</option>
<option value="Antarctica">Antarctica</option>
<option value="Antigua and Barbuda">Antigua and Barbuda</option>
<option value="Argentina">Argentina</option>
<option value="Armenia">Armenia</option>
<option value="Aruba">Aruba</option>
<option value="Australia">Australia</option>
<option value="Austria">Austria</option>
<option value="Azerbaijan">Azerbaijan</option>
<option value="Bahamas">Bahamas</option>
<option value="Bahrain">Bahrain</option>
<option value="Bangladesh">Bangladesh</option>
<option value="Barbados">Barbados</option>
<option value="Belarus">Belarus</option>
<option value="Belgium">Belgium</option>
<option value="Belize">Belize</option>
<option value="Benin">Benin</option>
<option value="Bermuda">Bermuda</option>
<option value="Bhutan">Bhutan</option>
<option value="Bolivia">Bolivia</option>
<option value="Bonaire, Sint Eustatius and Saba">Bonaire, Sint Eustatius and Saba</option>
<option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option>
<option value="Botswana">Botswana</option>
<option value="Bouvet Island">Bouvet Island</option>
<option value="Brazil">Brazil</option>
<option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
<option value="Brunei Darussalam">Brunei Darussalam</option>
<option value="Bulgaria">Bulgaria</option>
<option value="Burkina Faso">Burkina Faso</option>
<option value="Burundi">Burundi</option>
<option value="Cabo Verde">Cabo Verde</option>
<option value="Cambodia">Cambodia</option>
<option value="Cameroon">Cameroon</option>
<option value="Canada">Canada</option>
<option value="Cayman Islands">Cayman Islands</option>
<option value="Central African Republic">Central African Republic</option>
<option value="Chad">Chad</option>
<option value="Chile">Chile</option>
<option value="China">China</option>
<option value="Christmas Island">Christmas Island</option>
<option value="Cocos Islands">Cocos Islands</option>
<option value="Colombia">Colombia</option>
<option value="Comoros">Comoros</option>
<option value="Congo">Congo</option>
<option value="Congo, Democratic Republic of the">Congo, Democratic Republic of the</option>
<option value="Cook Islands">Cook Islands</option>
<option value="Costa Rica">Costa Rica</option>
<option value="Croatia">Croatia</option>
<option value="Cuba">Cuba</option>
<option value="Curaçao">Curaçao</option>
<option value="Cyprus">Cyprus</option>
<option value="Czechia">Czechia</option>
<option value="Côte d'Ivoire">Côte d'Ivoire</option>
<option value="Denmark">Denmark</option>
<option value="Djibouti">Djibouti</option>
<option value="Dominica">Dominica</option>
<option value="Dominican Republic">Dominican Republic</option>
<option value="Ecuador">Ecuador</option>
<option value="Egypt">Egypt</option>
<option value="El Salvador">El Salvador</option>
<option value="Equatorial Guinea">Equatorial Guinea</option>
<option value="Eritrea">Eritrea</option>
<option value="Estonia">Estonia</option>
<option value="Eswatini">Eswatini</option>
<option value="Ethiopia">Ethiopia</option>
<option value="Falkland Islands">Falkland Islands</option>
<option value="Faroe Islands">Faroe Islands</option>
<option value="Fiji">Fiji</option>
<option value="Finland">Finland</option>
<option value="France">France</option>
<option value="French Guiana">French Guiana</option>
<option value="French Polynesia">French Polynesia</option>
<option value="French Southern Territories">French Southern Territories</option>
<option value="Gabon">Gabon</option>
<option value="Gambia">Gambia</option>
<option value="Georgia">Georgia</option>
<option value="Germany">Germany</option>
<option value="Ghana">Ghana</option>
<option value="Gibraltar">Gibraltar</option>
<option value="Greece">Greece</option>
<option value="Greenland">Greenland</option>
<option value="Grenada">Grenada</option>
<option value="Guadeloupe">Guadeloupe</option>
<option value="Guam">Guam</option>
<option value="Guatemala">Guatemala</option>
<option value="Guernsey">Guernsey</option>
<option value="Guinea">Guinea</option>
<option value="Guinea-Bissau">Guinea-Bissau</option>
<option value="Guyana">Guyana</option>
<option value="Haiti">Haiti</option>
<option value="Heard Island and McDonald Islands">Heard Island and McDonald Islands</option>
<option value="Holy See">Holy See</option>
<option value="Honduras">Honduras</option>
<option value="Hong Kong">Hong Kong</option>
<option value="Hungary">Hungary</option>
<option value="Iceland">Iceland</option>
<option value="India">India</option>
<option value="Indonesia">Indonesia</option>
<option value="Iran">Iran</option>
<option value="Iraq">Iraq</option>
<option value="Ireland">Ireland</option>
<option value="Isle of Man">Isle of Man</option>
<option value="Israel">Israel</option>
<option value="Italy">Italy</option>
<option value="Jamaica">Jamaica</option>
<option value="Japan">Japan</option>
<option value="Jersey">Jersey</option>
<option value="Jordan">Jordan</option>
<option value="Kazakhstan">Kazakhstan</option>
<option value="Kenya">Kenya</option>
<option value="Kiribati">Kiribati</option>
<option value="Korea, Democratic People's Republic of">Korea, Democratic People's Republic of</option>
<option value="Korea, Republic of">Korea, Republic of</option>
<option value="Kuwait">Kuwait</option>
<option value="Kyrgyzstan">Kyrgyzstan</option>
<option value="Lao People's Democratic Republic">Lao People's Democratic Republic</option>
<option value="Latvia">Latvia</option>
<option value="Lebanon">Lebanon</option>
<option value="Lesotho">Lesotho</option>
<option value="Liberia">Liberia</option>
<option value="Libya">Libya</option>
<option value="Liechtenstein">Liechtenstein</option>
<option value="Lithuania">Lithuania</option>
<option value="Luxembourg">Luxembourg</option>
<option value="Macao">Macao</option>
<option value="Madagascar">Madagascar</option>
<option value="Malawi">Malawi</option>
<option value="Malaysia">Malaysia</option>
<option value="Maldives">Maldives</option>
<option value="Mali">Mali</option>
<option value="Malta">Malta</option>
<option value="Marshall Islands">Marshall Islands</option>
<option value="Martinique">Martinique</option>
<option value="Mauritania">Mauritania</option>
<option value="Mauritius">Mauritius</option>
<option value="Mayotte">Mayotte</option>
<option value="Mexico">Mexico</option>
<option value="Micronesia">Micronesia</option>
<option value="Moldova">Moldova</option>
<option value="Monaco">Monaco</option>
<option value="Mongolia">Mongolia</option>
<option value="Montenegro">Montenegro</option>
<option value="Montserrat">Montserrat</option>
<option value="Morocco">Morocco</option>
<option value="Mozambique">Mozambique</option>
<option value="Myanmar">Myanmar</option>
<option value="Namibia">Namibia</option>
<option value="Nauru">Nauru</option>
<option value="Nepal">Nepal</option>
<option value="Netherlands">Netherlands</option>
<option value="New Caledonia">New Caledonia</option>
<option value="New Zealand">New Zealand</option>
<option value="Nicaragua">Nicaragua</option>
<option value="Niger">Niger</option>
<option value="Nigeria">Nigeria</option>
<option value="Niue">Niue</option>
<option value="Norfolk Island">Norfolk Island</option>
<option value="North Macedonia">North Macedonia</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Norway">Norway</option>
<option value="Oman">Oman</option>
<option value="Pakistan">Pakistan</option>
<option value="Palau">Palau</option>
<option value="Palestine, State of">Palestine, State of</option>
<option value="Panama">Panama</option>
<option value="Papua New Guinea">Papua New Guinea</option>
<option value="Paraguay">Paraguay</option>
<option value="Peru">Peru</option>
<option value="Philippines">Philippines</option>
<option value="Pitcairn">Pitcairn</option>
<option value="Poland">Poland</option>
<option value="Portugal">Portugal</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Qatar">Qatar</option>
<option value="Romania">Romania</option>
<option value="Russian Federation">Russian Federation</option>
<option value="Rwanda">Rwanda</option>
<option value="Réunion">Réunion</option>
<option value="Saint Barthélemy">Saint Barthélemy</option>
<option value="Saint Helena, Ascension and Tristan da Cunha">Saint Helena, Ascension and Tristan da Cunha</option>
<option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
<option value="Saint Lucia">Saint Lucia</option>
<option value="Saint Martin">Saint Martin</option>
<option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option>
<option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option>
<option value="Samoa">Samoa</option>
<option value="San Marino">San Marino</option>
<option value="Sao Tome and Principe">Sao Tome and Principe</option>
<option value="Saudi Arabia">Saudi Arabia</option>
<option value="Senegal">Senegal</option>
<option value="Serbia">Serbia</option>
<option value="Seychelles">Seychelles</option>
<option value="Sierra Leone">Sierra Leone</option>
<option value="Singapore">Singapore</option>
<option value="Sint Maarten">Sint Maarten</option>
<option value="Slovakia">Slovakia</option>
<option value="Slovenia">Slovenia</option>
<option value="Solomon Islands">Solomon Islands</option>
<option value="Somalia">Somalia</option>
<option value="South Africa">South Africa</option>
<option value="South Georgia and the South Sandwich Islands">South Georgia and the South Sandwich Islands</option>
<option value="South Sudan">South Sudan</option>
<option value="Spain">Spain</option>
<option value="Sri Lanka">Sri Lanka</option>
<option value="Sudan">Sudan</option>
<option value="Suriname">Suriname</option>
<option value="Svalbard and Jan Mayen">Svalbard and Jan Mayen</option>
<option value="Sweden">Sweden</option>
<option value="Switzerland">Switzerland</option>
<option value="Syria Arab Republic">Syria Arab Republic</option>
<option value="Taiwan">Taiwan</option>
<option value="Tajikistan">Tajikistan</option>
<option value="Tanzania, the United Republic of">Tanzania, the United Republic of</option>
<option value="Thailand">Thailand</option>
<option value="Timor-Leste">Timor-Leste</option>
<option value="Togo">Togo</option>
<option value="Tokelau">Tokelau</option>
<option value="Tonga">Tonga</option>
<option value="Trinidad and Tobago">Trinidad and Tobago</option>
<option value="Tunisia">Tunisia</option>
<option value="Turkmenistan">Turkmenistan</option>
<option value="Turks and Caicos Islands">Turks and Caicos Islands</option>
<option value="Tuvalu">Tuvalu</option>
<option value="Türkiye">Türkiye</option>
<option value="US Minor Outlying Islands">US Minor Outlying Islands</option>
<option value="Uganda">Uganda</option>
<option value="Ukraine">Ukraine</option>
<option value="United Arab Emirates">United Arab Emirates</option>
<option value="United Kingdom">United Kingdom</option>
<option value="United States">United States</option>
<option value="Uruguay">Uruguay</option>
<option value="Uzbekistan">Uzbekistan</option>
<option value="Vanuatu">Vanuatu</option>
<option value="Venezuela">Venezuela</option>
<option value="Viet Nam">Viet Nam</option>
<option value="Virgin Islands, British">Virgin Islands, British</option>
<option value="Virgin Islands, U.S.">Virgin Islands, U.S.</option>
<option value="Wallis and Futuna">Wallis and Futuna</option>
<option value="Western Sahara">Western Sahara</option>
<option value="Yemen">Yemen</option>
<option value="Zambia">Zambia</option>
<option value="Zimbabwe">Zimbabwe</option>
<option value="Åland Islands">Åland Islands</option>
</select>
</span>
<div class="gf_clear gf_clear_complex"></div>
</div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_next_button_2_15" class="gform_next_button gform-theme-button button" value="Next"
onclick="jQuery("#gform_target_page_number_2").val("2"); jQuery("#gform_2").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_2").val("2"); jQuery("#gform_2").trigger("submit",[true]); } "> <button type="button" id="gform_save_2_2_link"
class="gform_save_link gform-theme-button gform-theme-button--secondary button"
onclick="if(window["gf_submitting_2"]){return false;} if( !jQuery("#gform_2")[0].checkValidity || jQuery("#gform_2")[0].checkValidity()){window["gf_submitting_2"]=true;} jQuery("#gform_save_2").val(1); jQuery("#gform_2").trigger("submit",[true]);"
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_2"]){return false;} if( !jQuery("#gform_2")[0].checkValidity || jQuery("#gform_2")[0].checkValidity()){window["gf_submitting_2"]=true;} jQuery("#gform_save_2").val(1); jQuery("#gform_2").trigger("submit",[true]); }"><svg
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fill="#6B7280"></path>
</svg> Save & Continue</button>
</div>
</div>
<div id="gform_page_2_2" class="gform_page" data-js="page-field-id-15" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_2_2" class="gform_fields top_label form_sublabel_above description_above validation_below">
<div id="field_2_16" class="gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_2_16">
<h3 class="gsection_title">Emergency Contact</h3>
</div>
<div id="field_2_28" class="gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_28"><label class="gfield_label gform-field-label" for="input_2_28">Full Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_28" id="input_2_28" type="text" value="" class="large" aria-required="true" aria-invalid="false"></div>
</div>
<div id="field_2_29" class="gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_29"><label class="gfield_label gform-field-label" for="input_2_29">Relationship<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_29" id="input_2_29" type="text" value="" class="large" aria-required="true" aria-invalid="false"></div>
</div>
<div id="field_2_30" class="gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_30"><label class="gfield_label gform-field-label" for="input_2_30">Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_email">
<input name="input_30" id="input_2_30" type="email" value="" class="large" aria-required="true" aria-invalid="false">
</div>
</div>
<div id="field_2_31" class="gfield gfield--type-phone gfield--input-type-phone gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_31"><label class="gfield_label gform-field-label" for="input_2_31">Phone<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_phone"><input name="input_31" id="input_2_31" type="tel" value="" class="large" aria-required="true" aria-invalid="false"></div>
</div>
</div>
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<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_2_12" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_2").val("1"); jQuery("#gform_2").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_2").val("1"); jQuery("#gform_2").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_2_12"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_2").val("3"); jQuery("#gform_2").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_2").val("3"); jQuery("#gform_2").trigger("submit",[true]); } "> <button type="button" id="gform_save_2_3_link"
class="gform_save_link gform-theme-button gform-theme-button--secondary button"
onclick="if(window["gf_submitting_2"]){return false;} if( !jQuery("#gform_2")[0].checkValidity || jQuery("#gform_2")[0].checkValidity()){window["gf_submitting_2"]=true;} jQuery("#gform_save_2").val(1); jQuery("#gform_2").trigger("submit",[true]);"
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_2"]){return false;} if( !jQuery("#gform_2")[0].checkValidity || jQuery("#gform_2")[0].checkValidity()){window["gf_submitting_2"]=true;} jQuery("#gform_save_2").val(1); jQuery("#gform_2").trigger("submit",[true]); }"><svg
aria-hidden="true" focusable="false" width="16" height="16" fill="none" xmlns="http://www.w3.org/2000/svg">
<path fill-rule="evenodd" clip-rule="evenodd" d="M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z"
fill="#6B7280"></path>
</svg> Save & Continue</button>
</div>
</div>
<div id="gform_page_2_3" class="gform_page" data-js="page-field-id-12" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_2_3" class="gform_fields top_label form_sublabel_above description_above validation_below">
<div id="field_2_5" class="gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_2_5">
<h3 class="gsection_title">Medical Certificates</h3>
</div>
<div id="field_2_92"
class="gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_92">
<h5>NOTE:</h5>
<ul>
<li>• Please email us any relevant medical certificates, if applicable.</li>
<li>• Please Mention any pre-existing conditions along with your doctor’s clearance for participation.</li>
</ul>
</div>
<fieldset id="field_2_130"
class="gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_130">
<legend class="gfield_label gform-field-label gfield_label_before_complex">Please indicate here if you have any allergies</legend>
<div class="ginput_container ginput_container_checkbox">
<div class="gfield_checkbox" id="input_2_130">
<div class="gchoice gchoice_2_130_1">
<input class="gfield-choice-input" name="input_130.1" type="checkbox" value="Food" id="choice_2_130_1">
<label for="choice_2_130_1" id="label_2_130_1" class="gform-field-label gform-field-label--type-inline">Food</label>
</div>
<div class="gchoice gchoice_2_130_2">
<input class="gfield-choice-input" name="input_130.2" type="checkbox" value="Insect stings" id="choice_2_130_2">
<label for="choice_2_130_2" id="label_2_130_2" class="gform-field-label gform-field-label--type-inline">Insect stings</label>
</div>
<div class="gchoice gchoice_2_130_3">
<input class="gfield-choice-input" name="input_130.3" type="checkbox" value="Medicines" id="choice_2_130_3">
<label for="choice_2_130_3" id="label_2_130_3" class="gform-field-label gform-field-label--type-inline">Medicines</label>
</div>
<div class="gchoice gchoice_2_130_4">
<input class="gfield-choice-input" name="input_130.4" type="checkbox" value="Other" id="choice_2_130_4">
<label for="choice_2_130_4" id="label_2_130_4" class="gform-field-label gform-field-label--type-inline">Other</label>
</div>
</div>
</div>
</fieldset>
<div id="field_2_132" class="gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_132" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label" for="input_2_132">Please specify</label>
<div class="gfield_description" id="gfield_description_2_132">Please give more details about any relevant allergies, or dietary restrictions that you may have.</div>
<div class="ginput_container ginput_container_textarea"><textarea name="input_132" id="input_2_132" class="textarea small" aria-describedby="gfield_description_2_132" aria-invalid="false" rows="10" cols="50"
disabled="disabled"></textarea></div>
</div>
<fieldset id="field_2_33"
class="gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_33">
<legend class="gfield_label gform-field-label gfield_label_before_complex">Consent<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="ginput_container ginput_container_consent"><input name="input_33.1" id="input_2_33_1" type="checkbox" value="1" aria-required="true" aria-invalid="false"> <label
class="gform-field-label gform-field-label--type-inline gfield_consent_label" for="input_2_33_1">I confirm I am in good health and fit to take part in an endurance event on alpine terrain.</label><input type="hidden" name="input_33.2"
value="I confirm I am in good health and fit to take part in an endurance event on alpine terrain." class="gform_hidden"><input type="hidden" name="input_33.3" value="4" class="gform_hidden"></div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_2_37" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_2").val("2"); jQuery("#gform_2").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_2").val("2"); jQuery("#gform_2").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_2_37"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_2").val("4"); jQuery("#gform_2").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_2").val("4"); jQuery("#gform_2").trigger("submit",[true]); } "> <button type="button" id="gform_save_2_4_link"
class="gform_save_link gform-theme-button gform-theme-button--secondary button"
onclick="if(window["gf_submitting_2"]){return false;} if( !jQuery("#gform_2")[0].checkValidity || jQuery("#gform_2")[0].checkValidity()){window["gf_submitting_2"]=true;} jQuery("#gform_save_2").val(1); jQuery("#gform_2").trigger("submit",[true]);"
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_2"]){return false;} if( !jQuery("#gform_2")[0].checkValidity || jQuery("#gform_2")[0].checkValidity()){window["gf_submitting_2"]=true;} jQuery("#gform_save_2").val(1); jQuery("#gform_2").trigger("submit",[true]); }"><svg
aria-hidden="true" focusable="false" width="16" height="16" fill="none" xmlns="http://www.w3.org/2000/svg">
<path fill-rule="evenodd" clip-rule="evenodd" d="M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z"
fill="#6B7280"></path>
</svg> Save & Continue</button>
</div>
</div>
<div id="gform_page_2_4" class="gform_page" data-js="page-field-id-37" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_2_4" class="gform_fields top_label form_sublabel_above description_above validation_below">
<div id="field_2_112" class="gfield gfield--type-select gfield--input-type-select gfield--width-full gf_invisible field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_112"><label class="gfield_label gform-field-label" for="input_2_112">Offer</label>
<div class="ginput_container ginput_container_select"><select name="input_112" id="input_2_112" class="small gfield_select" aria-invalid="false">
<option value="Early Bird" selected="selected">Early Bird</option>
<option value="Normal">Normal</option>
</select></div>
</div>
<div id="field_2_38" class="gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_2_38">
<h3 class="gsection_title">Event Races</h3>
</div>
<div id="field_2_70"
class="gfield gfield--type-product gfield--input-type-singleproduct gfield--width-third gf_invisible gfield_price gfield_price_2_70 gfield_product_2_70 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_70" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_2_70_1">Full Distance Triathlon</label>
<div class="ginput_container ginput_container_singleproduct">
<input type="hidden" name="input_70.1" value="Full Distance Triathlon" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_2_70" class="ginput_product_price_wrapper">
<label for="ginput_base_price_2_70" class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</label>
<input type="text" readonly="" class="ginput_product_price gform-text-input-reset" name="input_70.2" id="ginput_base_price_2_70" value="$200.00" aria-label="Full Distance Triathlon Price" disabled="disabled">
</div>
<input type="hidden" name="input_70.3" value="1" class="ginput_quantity_2_70 gform_hidden" disabled="disabled">
</div>
</div>
<div id="field_2_72"
class="gfield gfield--type-product gfield--input-type-singleproduct gfield--width-third gf_invisible gfield_price gfield_price_2_72 gfield_product_2_72 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_72" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_2_72_1">Sprint Distance Triathlon</label>
<div class="ginput_container ginput_container_singleproduct">
<input type="hidden" name="input_72.1" value="Sprint Distance Triathlon" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_2_72" class="ginput_product_price_wrapper">
<label for="ginput_base_price_2_72" class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</label>
<input type="text" readonly="" class="ginput_product_price gform-text-input-reset" name="input_72.2" id="ginput_base_price_2_72" value="$100.00" aria-label="Sprint Distance Triathlon Price" disabled="disabled">
</div>
<input type="hidden" name="input_72.3" value="1" class="ginput_quantity_2_72 gform_hidden" disabled="disabled">
</div>
</div>
<div id="field_2_71"
class="gfield gfield--type-product gfield--input-type-singleproduct gfield--width-third gf_invisible gfield_price gfield_price_2_71 gfield_product_2_71 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_71" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_2_71_1">Duathlon</label>
<div class="ginput_container ginput_container_singleproduct">
<input type="hidden" name="input_71.1" value="Duathlon" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_2_71" class="ginput_product_price_wrapper">
<label for="ginput_base_price_2_71" class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</label>
<input type="text" readonly="" class="ginput_product_price gform-text-input-reset" name="input_71.2" id="ginput_base_price_2_71" value="$150.00" aria-label="Duathlon Price" disabled="disabled">
</div>
<input type="hidden" name="input_71.3" value="1" class="ginput_quantity_2_71 gform_hidden" disabled="disabled">
</div>
</div>
<fieldset id="field_2_81"
class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_81" data-conditional-logic="hidden" style="display: none;">
<legend class="gfield_label gform-field-label screen-reader-text">Early Bird Offer</legend>
<div class="gfield_description" id="gfield_description_2_81">Early Bird Offer</div>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_2_81">
<div class="gchoice gchoice_2_81_0">
<input class="gfield-choice-input" name="input_81" type="radio" value="Full Distance Triathlon (Early Bird)(Int)" id="choice_2_81_0" onchange="gformToggleRadioOther( this )" aria-describedby="gfield_description_2_81"
disabled="disabled">
<label for="choice_2_81_0" id="label_2_81_0" class="gform-field-label gform-field-label--type-inline">Full Distance Triathlon | $200</label>
</div>
<div class="gchoice gchoice_2_81_1">
<input class="gfield-choice-input" name="input_81" type="radio" value="Duathlon (Early Bird)(Int)" id="choice_2_81_1" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_2_81_1" id="label_2_81_1" class="gform-field-label gform-field-label--type-inline">Duathlon | $150</label>
</div>
<div class="gchoice gchoice_2_81_2">
<input class="gfield-choice-input" name="input_81" type="radio" value="Sprint Distance Triathlon (Early Bird)(Int)" id="choice_2_81_2" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_2_81_2" id="label_2_81_2" class="gform-field-label gform-field-label--type-inline">Sprint Distance Triathlon | $100</label>
</div>
</div>
</div>
</fieldset>
<div id="field_2_122"
class="gfield gfield--type-product gfield--input-type-singleproduct gfield--width-third gf_invisible gfield_price gfield_price_2_122 gfield_product_2_122 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_122" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_2_122_1">Full Distance Triathlon</label>
<div class="ginput_container ginput_container_singleproduct">
<input type="hidden" name="input_122.1" value="Full Distance Triathlon" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_2_122" class="ginput_product_price_wrapper">
<label for="ginput_base_price_2_122" class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</label>
<input type="text" readonly="" class="ginput_product_price gform-text-input-reset" name="input_122.2" id="ginput_base_price_2_122" value="$10,000.00" aria-label="Full Distance Triathlon Price" disabled="disabled">
</div>
<input type="hidden" name="input_122.3" value="1" class="ginput_quantity_2_122 gform_hidden" disabled="disabled">
</div>
</div>
<div id="field_2_123"
class="gfield gfield--type-product gfield--input-type-singleproduct gfield--width-third gf_invisible gfield_price gfield_price_2_123 gfield_product_2_123 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_123" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_2_123_1">Duathlon</label>
<div class="ginput_container ginput_container_singleproduct">
<input type="hidden" name="input_123.1" value="Duathlon" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_2_123" class="ginput_product_price_wrapper">
<label for="ginput_base_price_2_123" class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</label>
<input type="text" readonly="" class="ginput_product_price gform-text-input-reset" name="input_123.2" id="ginput_base_price_2_123" value="$8,000.00" aria-label="Duathlon Price" disabled="disabled">
</div>
<input type="hidden" name="input_123.3" value="1" class="ginput_quantity_2_123 gform_hidden" disabled="disabled">
</div>
</div>
<div id="field_2_124"
class="gfield gfield--type-product gfield--input-type-singleproduct gfield--width-third gf_invisible gfield_price gfield_price_2_124 gfield_product_2_124 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_124" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_2_124_1">Sprint Distance Triathlon</label>
<div class="ginput_container ginput_container_singleproduct">
<input type="hidden" name="input_124.1" value="Sprint Distance Triathlon" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_2_124" class="ginput_product_price_wrapper">
<label for="ginput_base_price_2_124" class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</label>
<input type="text" readonly="" class="ginput_product_price gform-text-input-reset" name="input_124.2" id="ginput_base_price_2_124" value="$8,000.00" aria-label="Sprint Distance Triathlon Price" disabled="disabled">
</div>
<input type="hidden" name="input_124.3" value="1" class="ginput_quantity_2_124 gform_hidden" disabled="disabled">
</div>
</div>
<fieldset id="field_2_125"
class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_125" data-conditional-logic="hidden" style="display: none;">
<legend class="gfield_label gform-field-label screen-reader-text">Early Bird Offer</legend>
<div class="gfield_description" id="gfield_description_2_125">Early Bird Offer</div>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_2_125">
<div class="gchoice gchoice_2_125_0">
<input class="gfield-choice-input" name="input_125" type="radio" value="Full Distance Triathlon(Early Bird)(Nep)" id="choice_2_125_0" onchange="gformToggleRadioOther( this )" aria-describedby="gfield_description_2_125"
disabled="disabled">
<label for="choice_2_125_0" id="label_2_125_0" class="gform-field-label gform-field-label--type-inline">Full Distance Triathlon | NPR 10,000</label>
</div>
<div class="gchoice gchoice_2_125_1">
<input class="gfield-choice-input" name="input_125" type="radio" value="Duathlon(Early Bird)(Nep)" id="choice_2_125_1" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_2_125_1" id="label_2_125_1" class="gform-field-label gform-field-label--type-inline">Duathlon | NPR 8,000</label>
</div>
<div class="gchoice gchoice_2_125_2">
<input class="gfield-choice-input" name="input_125" type="radio" value="Sprint Distance Triathlon(Early Bird)(Nep)" id="choice_2_125_2" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_2_125_2" id="label_2_125_2" class="gform-field-label gform-field-label--type-inline">Sprint Distance Triathlon | NPR 8,000</label>
</div>
</div>
</div>
</fieldset>
<div id="field_2_113"
class="gfield gfield--type-product gfield--input-type-singleproduct gfield--width-third gf_invisible gfield_price gfield_price_2_113 gfield_product_2_113 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_113" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_2_113_1">Full Distance Triathlon</label>
<div class="ginput_container ginput_container_singleproduct">
<input type="hidden" name="input_113.1" value="Full Distance Triathlon" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_2_113" class="ginput_product_price_wrapper">
<label for="ginput_base_price_2_113" class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</label>
<input type="text" readonly="" class="ginput_product_price gform-text-input-reset" name="input_113.2" id="ginput_base_price_2_113" value="$225.00" aria-label="Full Distance Triathlon Price" disabled="disabled">
</div>
<input type="hidden" name="input_113.3" value="1" class="ginput_quantity_2_113 gform_hidden" disabled="disabled">
</div>
</div>
<div id="field_2_115"
class="gfield gfield--type-product gfield--input-type-singleproduct gfield--width-third gf_invisible gfield_price gfield_price_2_115 gfield_product_2_115 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_115" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_2_115_1">Sprint Distance Triathlon</label>
<div class="ginput_container ginput_container_singleproduct">
<input type="hidden" name="input_115.1" value="Sprint Distance Triathlon" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_2_115" class="ginput_product_price_wrapper">
<label for="ginput_base_price_2_115" class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</label>
<input type="text" readonly="" class="ginput_product_price gform-text-input-reset" name="input_115.2" id="ginput_base_price_2_115" value="$125.00" aria-label="Sprint Distance Triathlon Price" disabled="disabled">
</div>
<input type="hidden" name="input_115.3" value="1" class="ginput_quantity_2_115 gform_hidden" disabled="disabled">
</div>
</div>
<div id="field_2_114"
class="gfield gfield--type-product gfield--input-type-singleproduct gfield--width-third gf_invisible gfield_price gfield_price_2_114 gfield_product_2_114 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_114" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_2_114_1">Duathlon</label>
<div class="ginput_container ginput_container_singleproduct">
<input type="hidden" name="input_114.1" value="Duathlon" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_2_114" class="ginput_product_price_wrapper">
<label for="ginput_base_price_2_114" class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</label>
<input type="text" readonly="" class="ginput_product_price gform-text-input-reset" name="input_114.2" id="ginput_base_price_2_114" value="$175.00" aria-label="Duathlon Price" disabled="disabled">
</div>
<input type="hidden" name="input_114.3" value="1" class="ginput_quantity_2_114 gform_hidden" disabled="disabled">
</div>
</div>
<fieldset id="field_2_116"
class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_116" data-conditional-logic="hidden" style="display: none;">
<legend class="gfield_label gform-field-label screen-reader-text">Normal Offer</legend>
<div class="gfield_description" id="gfield_description_2_116">Normal Offer</div>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_2_116">
<div class="gchoice gchoice_2_116_0">
<input class="gfield-choice-input" name="input_116" type="radio" value="Full Distance Triathlon(Normal)(Int)" id="choice_2_116_0" onchange="gformToggleRadioOther( this )" aria-describedby="gfield_description_2_116"
disabled="disabled">
<label for="choice_2_116_0" id="label_2_116_0" class="gform-field-label gform-field-label--type-inline">Full Distance Triathlon | $225</label>
</div>
<div class="gchoice gchoice_2_116_1">
<input class="gfield-choice-input" name="input_116" type="radio" value="Duathlon (Normal)(Int)" id="choice_2_116_1" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_2_116_1" id="label_2_116_1" class="gform-field-label gform-field-label--type-inline">Duathlon | $175</label>
</div>
<div class="gchoice gchoice_2_116_2">
<input class="gfield-choice-input" name="input_116" type="radio" value="Sprint Distance Triathlon (Normal)(Int)" id="choice_2_116_2" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_2_116_2" id="label_2_116_2" class="gform-field-label gform-field-label--type-inline">Sprint Distance Triathlon | $125</label>
</div>
</div>
</div>
</fieldset>
<div id="field_2_126"
class="gfield gfield--type-product gfield--input-type-singleproduct gfield--width-third gf_invisible gfield_price gfield_price_2_126 gfield_product_2_126 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_126" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_2_126_1">Full Distance Triathlon</label>
<div class="ginput_container ginput_container_singleproduct">
<input type="hidden" name="input_126.1" value="Full Distance Triathlon" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_2_126" class="ginput_product_price_wrapper">
<label for="ginput_base_price_2_126" class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</label>
<input type="text" readonly="" class="ginput_product_price gform-text-input-reset" name="input_126.2" id="ginput_base_price_2_126" value="$12,500.00" aria-label="Full Distance Triathlon Price" disabled="disabled">
</div>
<input type="hidden" name="input_126.3" value="1" class="ginput_quantity_2_126 gform_hidden" disabled="disabled">
</div>
</div>
<div id="field_2_127"
class="gfield gfield--type-product gfield--input-type-singleproduct gfield--width-third gf_invisible gfield_price gfield_price_2_127 gfield_product_2_127 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_127" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_2_127_1">Duathlon</label>
<div class="ginput_container ginput_container_singleproduct">
<input type="hidden" name="input_127.1" value="Duathlon" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_2_127" class="ginput_product_price_wrapper">
<label for="ginput_base_price_2_127" class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</label>
<input type="text" readonly="" class="ginput_product_price gform-text-input-reset" name="input_127.2" id="ginput_base_price_2_127" value="$10,000.00" aria-label="Duathlon Price" disabled="disabled">
</div>
<input type="hidden" name="input_127.3" value="1" class="ginput_quantity_2_127 gform_hidden" disabled="disabled">
</div>
</div>
<div id="field_2_128"
class="gfield gfield--type-product gfield--input-type-singleproduct gfield--width-third gf_invisible gfield_price gfield_price_2_128 gfield_product_2_128 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_128" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_2_128_1">Sprint Distance Triathlon</label>
<div class="ginput_container ginput_container_singleproduct">
<input type="hidden" name="input_128.1" value="Sprint Distance Triathlon" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_2_128" class="ginput_product_price_wrapper">
<label for="ginput_base_price_2_128" class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</label>
<input type="text" readonly="" class="ginput_product_price gform-text-input-reset" name="input_128.2" id="ginput_base_price_2_128" value="$10,000.00" aria-label="Sprint Distance Triathlon Price" disabled="disabled">
</div>
<input type="hidden" name="input_128.3" value="1" class="ginput_quantity_2_128 gform_hidden" disabled="disabled">
</div>
</div>
<fieldset id="field_2_129"
class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_129" data-conditional-logic="hidden" style="display: none;">
<legend class="gfield_label gform-field-label screen-reader-text">Normal Offer</legend>
<div class="gfield_description" id="gfield_description_2_129">Normal Offer</div>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_2_129">
<div class="gchoice gchoice_2_129_0">
<input class="gfield-choice-input" name="input_129" type="radio" value="Full Distance Triathlon(Normal)(Nep)" id="choice_2_129_0" onchange="gformToggleRadioOther( this )" aria-describedby="gfield_description_2_129"
disabled="disabled">
<label for="choice_2_129_0" id="label_2_129_0" class="gform-field-label gform-field-label--type-inline">Full Distance Triathlon | NPR 12,500</label>
</div>
<div class="gchoice gchoice_2_129_1">
<input class="gfield-choice-input" name="input_129" type="radio" value="Duathlon(Normal)(Nep)" id="choice_2_129_1" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_2_129_1" id="label_2_129_1" class="gform-field-label gform-field-label--type-inline">Duathlon | NPR 10,000</label>
</div>
<div class="gchoice gchoice_2_129_2">
<input class="gfield-choice-input" name="input_129" type="radio" value="Sprint Distance Triathlon(Normal)(Nep)" id="choice_2_129_2" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_2_129_2" id="label_2_129_2" class="gform-field-label gform-field-label--type-inline">Sprint Distance Triathlon | NPR 10,000</label>
</div>
</div>
</div>
</fieldset>
<div id="field_2_151" class="gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_2_151">
<h3 class="gsection_title">Trail Run</h3>
</div>
<div id="field_2_155"
class="gfield gfield--type-product gfield--input-type-singleproduct gfield--width-quarter gf_invisible gfield_price gfield_price_2_155 gfield_product_2_155 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_155" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_2_155_1">25 K</label>
<div class="ginput_container ginput_container_singleproduct">
<input type="hidden" name="input_155.1" value="25 K" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_2_155" class="ginput_product_price_wrapper">
<label for="ginput_base_price_2_155" class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</label>
<input type="text" readonly="" class="ginput_product_price gform-text-input-reset" name="input_155.2" id="ginput_base_price_2_155" value="$45.00" aria-label="25 K Price" disabled="disabled">
</div>
<input type="hidden" name="input_155.3" value="1" class="ginput_quantity_2_155 gform_hidden" disabled="disabled">
</div>
</div>
<div id="field_2_156"
class="gfield gfield--type-product gfield--input-type-singleproduct gfield--width-quarter gf_invisible gfield_price gfield_price_2_156 gfield_product_2_156 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_156" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_2_156_1">12 K</label>
<div class="ginput_container ginput_container_singleproduct">
<input type="hidden" name="input_156.1" value="12 K" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_2_156" class="ginput_product_price_wrapper">
<label for="ginput_base_price_2_156" class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</label>
<input type="text" readonly="" class="ginput_product_price gform-text-input-reset" name="input_156.2" id="ginput_base_price_2_156" value="$35.00" aria-label="12 K Price" disabled="disabled">
</div>
<input type="hidden" name="input_156.3" value="1" class="ginput_quantity_2_156 gform_hidden" disabled="disabled">
</div>
</div>
<div id="field_2_157"
class="gfield gfield--type-product gfield--input-type-singleproduct gfield--width-quarter gf_invisible gfield_price gfield_price_2_157 gfield_product_2_157 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_157" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_2_157_1">6 K</label>
<div class="ginput_container ginput_container_singleproduct">
<input type="hidden" name="input_157.1" value="6 K" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_2_157" class="ginput_product_price_wrapper">
<label for="ginput_base_price_2_157" class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</label>
<input type="text" readonly="" class="ginput_product_price gform-text-input-reset" name="input_157.2" id="ginput_base_price_2_157" value="$30.00" aria-label="6 K Price" disabled="disabled">
</div>
<input type="hidden" name="input_157.3" value="1" class="ginput_quantity_2_157 gform_hidden" disabled="disabled">
</div>
</div>
<div id="field_2_158"
class="gfield gfield--type-product gfield--input-type-singleproduct gfield--width-quarter gf_invisible gfield_price gfield_price_2_158 gfield_product_2_158 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_158" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_2_158_1">2 K</label>
<div class="ginput_container ginput_container_singleproduct">
<input type="hidden" name="input_158.1" value="2 K" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_2_158" class="ginput_product_price_wrapper">
<label for="ginput_base_price_2_158" class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</label>
<input type="text" readonly="" class="ginput_product_price gform-text-input-reset" name="input_158.2" id="ginput_base_price_2_158" value="$15.00" aria-label="2 K Price" disabled="disabled">
</div>
<input type="hidden" name="input_158.3" value="1" class="ginput_quantity_2_158 gform_hidden" disabled="disabled">
</div>
</div>
<fieldset id="field_2_161"
class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_161" data-conditional-logic="hidden" style="display: none;">
<legend class="gfield_label gform-field-label screen-reader-text">Early Bird Offer</legend>
<div class="gfield_description" id="gfield_description_2_161">Early Bird Offer</div>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_2_161">
<div class="gchoice gchoice_2_161_0">
<input class="gfield-choice-input" name="input_161" type="radio" value="25 K (Early Bird)(Int)" id="choice_2_161_0" onchange="gformToggleRadioOther( this )" aria-describedby="gfield_description_2_161" disabled="disabled">
<label for="choice_2_161_0" id="label_2_161_0" class="gform-field-label gform-field-label--type-inline">25K | $45</label>
</div>
<div class="gchoice gchoice_2_161_1">
<input class="gfield-choice-input" name="input_161" type="radio" value="12 K (Early Bird)(Int)" id="choice_2_161_1" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_2_161_1" id="label_2_161_1" class="gform-field-label gform-field-label--type-inline">12K | $35</label>
</div>
<div class="gchoice gchoice_2_161_2">
<input class="gfield-choice-input" name="input_161" type="radio" value="6 K (Early Bird)(Int)" id="choice_2_161_2" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_2_161_2" id="label_2_161_2" class="gform-field-label gform-field-label--type-inline">6K | $30</label>
</div>
<div class="gchoice gchoice_2_161_3">
<input class="gfield-choice-input" name="input_161" type="radio" value="2 K (Early Bird)(Int)" id="choice_2_161_3" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_2_161_3" id="label_2_161_3" class="gform-field-label gform-field-label--type-inline">2K (Kids Run) | $15</label>
</div>
</div>
</div>
</fieldset>
<div id="field_2_162"
class="gfield gfield--type-product gfield--input-type-singleproduct gfield--width-quarter gf_invisible gfield_price gfield_price_2_162 gfield_product_2_162 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_162" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_2_162_1">25 K</label>
<div class="ginput_container ginput_container_singleproduct">
<input type="hidden" name="input_162.1" value="25 K" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_2_162" class="ginput_product_price_wrapper">
<label for="ginput_base_price_2_162" class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</label>
<input type="text" readonly="" class="ginput_product_price gform-text-input-reset" name="input_162.2" id="ginput_base_price_2_162" value="$4,000.00" aria-label="25 K Price" disabled="disabled">
</div>
<input type="hidden" name="input_162.3" value="1" class="ginput_quantity_2_162 gform_hidden" disabled="disabled">
</div>
</div>
<div id="field_2_163"
class="gfield gfield--type-product gfield--input-type-singleproduct gfield--width-quarter gf_invisible gfield_price gfield_price_2_163 gfield_product_2_163 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_163" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_2_163_1">12 K</label>
<div class="ginput_container ginput_container_singleproduct">
<input type="hidden" name="input_163.1" value="12 K" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_2_163" class="ginput_product_price_wrapper">
<label for="ginput_base_price_2_163" class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</label>
<input type="text" readonly="" class="ginput_product_price gform-text-input-reset" name="input_163.2" id="ginput_base_price_2_163" value="$3,000.00" aria-label="12 K Price" disabled="disabled">
</div>
<input type="hidden" name="input_163.3" value="1" class="ginput_quantity_2_163 gform_hidden" disabled="disabled">
</div>
</div>
<div id="field_2_164"
class="gfield gfield--type-product gfield--input-type-singleproduct gfield--width-quarter gf_invisible gfield_price gfield_price_2_164 gfield_product_2_164 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_164" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_2_164_1">6 K</label>
<div class="ginput_container ginput_container_singleproduct">
<input type="hidden" name="input_164.1" value="6 K" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_2_164" class="ginput_product_price_wrapper">
<label for="ginput_base_price_2_164" class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</label>
<input type="text" readonly="" class="ginput_product_price gform-text-input-reset" name="input_164.2" id="ginput_base_price_2_164" value="$2,500.00" aria-label="6 K Price" disabled="disabled">
</div>
<input type="hidden" name="input_164.3" value="1" class="ginput_quantity_2_164 gform_hidden" disabled="disabled">
</div>
</div>
<div id="field_2_165"
class="gfield gfield--type-product gfield--input-type-singleproduct gfield--width-quarter gf_invisible gfield_price gfield_price_2_165 gfield_product_2_165 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_165" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_2_165_1">2 K</label>
<div class="ginput_container ginput_container_singleproduct">
<input type="hidden" name="input_165.1" value="2 K" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_2_165" class="ginput_product_price_wrapper">
<label for="ginput_base_price_2_165" class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</label>
<input type="text" readonly="" class="ginput_product_price gform-text-input-reset" name="input_165.2" id="ginput_base_price_2_165" value="$1,500.00" aria-label="2 K Price" disabled="disabled">
</div>
<input type="hidden" name="input_165.3" value="1" class="ginput_quantity_2_165 gform_hidden" disabled="disabled">
</div>
</div>
<fieldset id="field_2_166"
class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_166" data-conditional-logic="hidden" style="display: none;">
<legend class="gfield_label gform-field-label screen-reader-text">Early Bird Offer</legend>
<div class="gfield_description" id="gfield_description_2_166">Early Bird Offer</div>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_2_166">
<div class="gchoice gchoice_2_166_0">
<input class="gfield-choice-input" name="input_166" type="radio" value="25 K(Early Bird)(Nep)" id="choice_2_166_0" onchange="gformToggleRadioOther( this )" aria-describedby="gfield_description_2_166" disabled="disabled">
<label for="choice_2_166_0" id="label_2_166_0" class="gform-field-label gform-field-label--type-inline">25K | NPR 4,000</label>
</div>
<div class="gchoice gchoice_2_166_1">
<input class="gfield-choice-input" name="input_166" type="radio" value="12 K(Early Bird)(Nep)" id="choice_2_166_1" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_2_166_1" id="label_2_166_1" class="gform-field-label gform-field-label--type-inline">12K | NPR 3,000</label>
</div>
<div class="gchoice gchoice_2_166_2">
<input class="gfield-choice-input" name="input_166" type="radio" value="6 K(Early Bird)(Nep)" id="choice_2_166_2" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_2_166_2" id="label_2_166_2" class="gform-field-label gform-field-label--type-inline">6K | NPR 2,500</label>
</div>
<div class="gchoice gchoice_2_166_3">
<input class="gfield-choice-input" name="input_166" type="radio" value="2 K(Early Bird)(Nep)" id="choice_2_166_3" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_2_166_3" id="label_2_166_3" class="gform-field-label gform-field-label--type-inline">2K (Kids Run) | NPR 1,500</label>
</div>
</div>
</div>
</fieldset>
<div id="field_2_167"
class="gfield gfield--type-product gfield--input-type-singleproduct gfield--width-quarter gf_invisible gfield_price gfield_price_2_167 gfield_product_2_167 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_167" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_2_167_1">25 K</label>
<div class="ginput_container ginput_container_singleproduct">
<input type="hidden" name="input_167.1" value="25 K" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_2_167" class="ginput_product_price_wrapper">
<label for="ginput_base_price_2_167" class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</label>
<input type="text" readonly="" class="ginput_product_price gform-text-input-reset" name="input_167.2" id="ginput_base_price_2_167" value="$55.00" aria-label="25 K Price" disabled="disabled">
</div>
<input type="hidden" name="input_167.3" value="1" class="ginput_quantity_2_167 gform_hidden" disabled="disabled">
</div>
</div>
<div id="field_2_168"
class="gfield gfield--type-product gfield--input-type-singleproduct gfield--width-quarter gf_invisible gfield_price gfield_price_2_168 gfield_product_2_168 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_168" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_2_168_1">12 K</label>
<div class="ginput_container ginput_container_singleproduct">
<input type="hidden" name="input_168.1" value="12 K" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_2_168" class="ginput_product_price_wrapper">
<label for="ginput_base_price_2_168" class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</label>
<input type="text" readonly="" class="ginput_product_price gform-text-input-reset" name="input_168.2" id="ginput_base_price_2_168" value="$45.00" aria-label="12 K Price" disabled="disabled">
</div>
<input type="hidden" name="input_168.3" value="1" class="ginput_quantity_2_168 gform_hidden" disabled="disabled">
</div>
</div>
<div id="field_2_169"
class="gfield gfield--type-product gfield--input-type-singleproduct gfield--width-quarter gf_invisible gfield_price gfield_price_2_169 gfield_product_2_169 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_169" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_2_169_1">6 K</label>
<div class="ginput_container ginput_container_singleproduct">
<input type="hidden" name="input_169.1" value="6 K" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_2_169" class="ginput_product_price_wrapper">
<label for="ginput_base_price_2_169" class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</label>
<input type="text" readonly="" class="ginput_product_price gform-text-input-reset" name="input_169.2" id="ginput_base_price_2_169" value="$40.00" aria-label="6 K Price" disabled="disabled">
</div>
<input type="hidden" name="input_169.3" value="1" class="ginput_quantity_2_169 gform_hidden" disabled="disabled">
</div>
</div>
<div id="field_2_170"
class="gfield gfield--type-product gfield--input-type-singleproduct gfield--width-quarter gf_invisible gfield_price gfield_price_2_170 gfield_product_2_170 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_170" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_2_170_1">2 K</label>
<div class="ginput_container ginput_container_singleproduct">
<input type="hidden" name="input_170.1" value="2 K" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_2_170" class="ginput_product_price_wrapper">
<label for="ginput_base_price_2_170" class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</label>
<input type="text" readonly="" class="ginput_product_price gform-text-input-reset" name="input_170.2" id="ginput_base_price_2_170" value="$25.00" aria-label="2 K Price" disabled="disabled">
</div>
<input type="hidden" name="input_170.3" value="1" class="ginput_quantity_2_170 gform_hidden" disabled="disabled">
</div>
</div>
<fieldset id="field_2_171"
class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_171" data-conditional-logic="hidden" style="display: none;">
<legend class="gfield_label gform-field-label screen-reader-text">Normal Offer</legend>
<div class="gfield_description" id="gfield_description_2_171">Normal Offer</div>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_2_171">
<div class="gchoice gchoice_2_171_0">
<input class="gfield-choice-input" name="input_171" type="radio" value="25 K (Normal)(Int)" id="choice_2_171_0" onchange="gformToggleRadioOther( this )" aria-describedby="gfield_description_2_171" disabled="disabled">
<label for="choice_2_171_0" id="label_2_171_0" class="gform-field-label gform-field-label--type-inline">25K | $ 55</label>
</div>
<div class="gchoice gchoice_2_171_1">
<input class="gfield-choice-input" name="input_171" type="radio" value="12 K (Normal)(Int)" id="choice_2_171_1" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_2_171_1" id="label_2_171_1" class="gform-field-label gform-field-label--type-inline">12K | $45</label>
</div>
<div class="gchoice gchoice_2_171_2">
<input class="gfield-choice-input" name="input_171" type="radio" value="6 K (Normal)(Int)" id="choice_2_171_2" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_2_171_2" id="label_2_171_2" class="gform-field-label gform-field-label--type-inline">6K | $40</label>
</div>
<div class="gchoice gchoice_2_171_3">
<input class="gfield-choice-input" name="input_171" type="radio" value="2 K (Normal)(Int)" id="choice_2_171_3" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_2_171_3" id="label_2_171_3" class="gform-field-label gform-field-label--type-inline">2K (Kids Run) | $ 25</label>
</div>
</div>
</div>
</fieldset>
<div id="field_2_172"
class="gfield gfield--type-product gfield--input-type-singleproduct gfield--width-quarter gf_invisible gfield_price gfield_price_2_172 gfield_product_2_172 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_172" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_2_172_1">25 K</label>
<div class="ginput_container ginput_container_singleproduct">
<input type="hidden" name="input_172.1" value="25 K" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_2_172" class="ginput_product_price_wrapper">
<label for="ginput_base_price_2_172" class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</label>
<input type="text" readonly="" class="ginput_product_price gform-text-input-reset" name="input_172.2" id="ginput_base_price_2_172" value="$5,000.00" aria-label="25 K Price" disabled="disabled">
</div>
<input type="hidden" name="input_172.3" value="1" class="ginput_quantity_2_172 gform_hidden" disabled="disabled">
</div>
</div>
<div id="field_2_173"
class="gfield gfield--type-product gfield--input-type-singleproduct gfield--width-quarter gf_invisible gfield_price gfield_price_2_173 gfield_product_2_173 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_173" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_2_173_1">12 K</label>
<div class="ginput_container ginput_container_singleproduct">
<input type="hidden" name="input_173.1" value="12 K" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_2_173" class="ginput_product_price_wrapper">
<label for="ginput_base_price_2_173" class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</label>
<input type="text" readonly="" class="ginput_product_price gform-text-input-reset" name="input_173.2" id="ginput_base_price_2_173" value="$4,000.00" aria-label="12 K Price" disabled="disabled">
</div>
<input type="hidden" name="input_173.3" value="1" class="ginput_quantity_2_173 gform_hidden" disabled="disabled">
</div>
</div>
<div id="field_2_174"
class="gfield gfield--type-product gfield--input-type-singleproduct gfield--width-quarter gf_invisible gfield_price gfield_price_2_174 gfield_product_2_174 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_174" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_2_174_1">6 K</label>
<div class="ginput_container ginput_container_singleproduct">
<input type="hidden" name="input_174.1" value="6 K" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_2_174" class="ginput_product_price_wrapper">
<label for="ginput_base_price_2_174" class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</label>
<input type="text" readonly="" class="ginput_product_price gform-text-input-reset" name="input_174.2" id="ginput_base_price_2_174" value="$3,500.00" aria-label="6 K Price" disabled="disabled">
</div>
<input type="hidden" name="input_174.3" value="1" class="ginput_quantity_2_174 gform_hidden" disabled="disabled">
</div>
</div>
<div id="field_2_175"
class="gfield gfield--type-product gfield--input-type-singleproduct gfield--width-quarter gf_invisible gfield_price gfield_price_2_175 gfield_product_2_175 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_175" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_2_175_1">2 K</label>
<div class="ginput_container ginput_container_singleproduct">
<input type="hidden" name="input_175.1" value="2 K" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_2_175" class="ginput_product_price_wrapper">
<label for="ginput_base_price_2_175" class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</label>
<input type="text" readonly="" class="ginput_product_price gform-text-input-reset" name="input_175.2" id="ginput_base_price_2_175" value="$2,000.00" aria-label="2 K Price" disabled="disabled">
</div>
<input type="hidden" name="input_175.3" value="1" class="ginput_quantity_2_175 gform_hidden" disabled="disabled">
</div>
</div>
<fieldset id="field_2_176"
class="gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_176" data-conditional-logic="hidden" style="display: none;">
<legend class="gfield_label gform-field-label screen-reader-text">Normal Offer</legend>
<div class="gfield_description" id="gfield_description_2_176">Normal Offer</div>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_2_176">
<div class="gchoice gchoice_2_176_0">
<input class="gfield-choice-input" name="input_176" type="radio" value="25 K (Normal)(Nep)" id="choice_2_176_0" onchange="gformToggleRadioOther( this )" aria-describedby="gfield_description_2_176" disabled="disabled">
<label for="choice_2_176_0" id="label_2_176_0" class="gform-field-label gform-field-label--type-inline">25K | NPR 5,000</label>
</div>
<div class="gchoice gchoice_2_176_1">
<input class="gfield-choice-input" name="input_176" type="radio" value="12 K (Normal)(Nep)" id="choice_2_176_1" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_2_176_1" id="label_2_176_1" class="gform-field-label gform-field-label--type-inline">12K | NPR 4,000</label>
</div>
<div class="gchoice gchoice_2_176_2">
<input class="gfield-choice-input" name="input_176" type="radio" value="6 K (Normal)(Nep)" id="choice_2_176_2" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_2_176_2" id="label_2_176_2" class="gform-field-label gform-field-label--type-inline">6K | NPR 3,500</label>
</div>
<div class="gchoice gchoice_2_176_3">
<input class="gfield-choice-input" name="input_176" type="radio" value="2 K (Normal)(Nep)" id="choice_2_176_3" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_2_176_3" id="label_2_176_3" class="gform-field-label gform-field-label--type-inline">2K (Kids Run) | NPR 2,000</label>
</div>
</div>
</div>
</fieldset>
<div id="field_2_40" class="gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_2_40">
<h3 class="gsection_title">Merchandise (Euro Sizes)</h3>
</div>
<div id="field_2_144" class="gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_144" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label" for="input_2_144">T-shirt | $25</label>
<div class="ginput_container ginput_container_select"><select name="input_144" id="input_2_144" class="large gfield_select" aria-invalid="false" disabled="disabled">
<option value="" selected="selected" class="gf_placeholder">Select your size</option>
<option value="XS">XS</option>
<option value="S">S</option>
<option value="M">M</option>
<option value="L">L</option>
<option value="XL">XL</option>
<option value="XXL">XXL</option>
<option value="XXXL">XXXL</option>
</select></div>
</div>
<div id="field_2_145" class="gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_145" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label" for="input_2_145">Hoodie | $35</label>
<div class="ginput_container ginput_container_select"><select name="input_145" id="input_2_145" class="large gfield_select" aria-invalid="false" disabled="disabled">
<option value="" selected="selected" class="gf_placeholder">Select your size</option>
<option value="XS">XS</option>
<option value="S">S</option>
<option value="M">M</option>
<option value="L">L</option>
<option value="XL">XL</option>
<option value="XXL">XXL</option>
<option value="XXXL">XXXL</option>
</select></div>
</div>
<fieldset id="field_2_146"
class="gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_146" data-conditional-logic="hidden" style="display: none;">
<legend class="gfield_label gform-field-label screen-reader-text gfield_label_before_complex">You can select multiple. Please follow the notes below.</legend>
<div class="gfield_description" id="gfield_description_2_146">You can select multiple. Please follow the notes below.</div>
<div class="ginput_container ginput_container_checkbox">
<div class="gfield_checkbox" id="input_2_146">
<div class="gchoice gchoice_2_146_1">
<input class="gfield-choice-input" name="input_146.1" type="checkbox" value="Buff | $10" id="choice_2_146_1" aria-describedby="gfield_description_2_146" disabled="disabled">
<label for="choice_2_146_1" id="label_2_146_1" class="gform-field-label gform-field-label--type-inline">Buff | $10</label>
</div>
<div class="gchoice gchoice_2_146_2">
<input class="gfield-choice-input" name="input_146.2" type="checkbox" value="Snapback | $25" id="choice_2_146_2" disabled="disabled">
<label for="choice_2_146_2" id="label_2_146_2" class="gform-field-label gform-field-label--type-inline">Snapback | $25</label>
</div>
</div>
</div>
</fieldset>
<div id="field_2_147" class="gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_147" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label" for="input_2_147">T-shirt | NPR 2500</label>
<div class="ginput_container ginput_container_select"><select name="input_147" id="input_2_147" class="large gfield_select" aria-invalid="false" disabled="disabled">
<option value="" selected="selected" class="gf_placeholder">Select your size</option>
<option value="XS">XS</option>
<option value="S">S</option>
<option value="M">M</option>
<option value="L">L</option>
<option value="XL">XL</option>
<option value="XXL">XXL</option>
<option value="XXXL">XXXL</option>
</select></div>
</div>
<div id="field_2_148" class="gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_148" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label" for="input_2_148">Hoodie | NPR 3500</label>
<div class="ginput_container ginput_container_select"><select name="input_148" id="input_2_148" class="large gfield_select" aria-invalid="false" disabled="disabled">
<option value="" selected="selected" class="gf_placeholder">Select your size</option>
<option value="XS">XS</option>
<option value="S">S</option>
<option value="M">M</option>
<option value="L">L</option>
<option value="XL">XL</option>
<option value="XXL">XXL</option>
<option value="XXXL">XXXL</option>
</select></div>
</div>
<fieldset id="field_2_149"
class="gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_149" data-conditional-logic="hidden" style="display: none;">
<legend class="gfield_label gform-field-label screen-reader-text gfield_label_before_complex">You can select multiple. Please follow the notes below.</legend>
<div class="gfield_description" id="gfield_description_2_149">You can select multiple. Please follow the notes below.</div>
<div class="ginput_container ginput_container_checkbox">
<div class="gfield_checkbox" id="input_2_149">
<div class="gchoice gchoice_2_149_1">
<input class="gfield-choice-input" name="input_149.1" type="checkbox" value="Buff | NPR 1000" id="choice_2_149_1" aria-describedby="gfield_description_2_149" disabled="disabled">
<label for="choice_2_149_1" id="label_2_149_1" class="gform-field-label gform-field-label--type-inline">Buff | NPR 1000</label>
</div>
<div class="gchoice gchoice_2_149_2">
<input class="gfield-choice-input" name="input_149.2" type="checkbox" value="Snapback | NPR 2500" id="choice_2_149_2" disabled="disabled">
<label for="choice_2_149_2" id="label_2_149_2" class="gform-field-label gform-field-label--type-inline">Snapback | NPR 2500</label>
</div>
</div>
</div>
</fieldset>
<div id="field_2_95"
class="gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_95">
<h5>NOTE:</h5>
<ul>
<li>• All the merchandise will be available at the event venue.</li>
<li> • Prior booking can be done via emails or social handles.</li>
</ul>
</div>
<div id="field_2_67"
class="gfield gfield--type-total gfield--input-type-total gfield--width-full gfield_price gfield_price_2_ gfield_total gfield_total_2_ field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
aria-atomic="true" aria-live="polite" data-js-reload="field_2_67" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label" for="input_2_67">Total</label>
<div class="ginput_container ginput_container_total">
<input type="text" readonly="" name="input_67" id="input_2_67" value="$0.00" class="gform-text-input-reset ginput_total ginput_total_2" disabled="disabled">
</div>
</div>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_2_105" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_2").val("3"); jQuery("#gform_2").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_2").val("3"); jQuery("#gform_2").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_2_105"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_2").val("5"); jQuery("#gform_2").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_2").val("5"); jQuery("#gform_2").trigger("submit",[true]); } "> <button type="button" id="gform_save_2_5_link"
class="gform_save_link gform-theme-button gform-theme-button--secondary button"
onclick="if(window["gf_submitting_2"]){return false;} if( !jQuery("#gform_2")[0].checkValidity || jQuery("#gform_2")[0].checkValidity()){window["gf_submitting_2"]=true;} jQuery("#gform_save_2").val(1); jQuery("#gform_2").trigger("submit",[true]);"
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_2"]){return false;} if( !jQuery("#gform_2")[0].checkValidity || jQuery("#gform_2")[0].checkValidity()){window["gf_submitting_2"]=true;} jQuery("#gform_save_2").val(1); jQuery("#gform_2").trigger("submit",[true]); }"><svg
aria-hidden="true" focusable="false" width="16" height="16" fill="none" xmlns="http://www.w3.org/2000/svg">
<path fill-rule="evenodd" clip-rule="evenodd" d="M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z"
fill="#6B7280"></path>
</svg> Save & Continue</button>
</div>
</div>
<div id="gform_page_2_5" class="gform_page" data-js="page-field-id-105" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_2_5" class="gform_fields top_label form_sublabel_above description_above validation_below">
<div id="field_2_137" class="gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_2_137">
<h3 class="gsection_title">Waiver Form</h3>
</div>
<div id="field_2_140"
class="gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_140">
<h4>ATTENTION PARTICIPANTS</h4>
<p>Your safety is our priority! Before embarking on the Race , it’s crucial for all participants to disclose any pertinent medical history to our team. Your well-being matters, and this information enables us to ensure a safe and
enjoyable experience for everyone. This important step allows our team to be fully aware of any medical conditions you may have. It empowers us to remind participants about their regular medications if necessary, ensuring that everyone
can maintain their health throughout period of the race. We’re committed to creating a secure environment for all, and your cooperation in sharing medical information plays a pivotal role in achieving this goal.</p>
<h5>WAIVER</h5>
<p>I, [Participant’s Full Name], hereby acknowledge that my participation in the XTERRA Nepal event involves certain risks and hazards. In consideration of being permitted to participate in this event, I agree to assume all risks
associated with my participation. I understand and agree that neither the organizers of XTERRA Nepal nor any sponsors, volunteers, or affiliated entities shall be liable for any injury, loss, or damage to myself or my property that may
arise directly or indirectly from my participation in the event.</p>
<p>I understand that participation in XTERRA Nepal may involve physical exertion and potential exposure to natural elements and other hazards, including but not limited to:</p>
<ul>
<li>• Trail running and hiking on rugged terrain.</li>
<li>• Mountain biking on challenging trails.</li>
<li>• Swimming in open water.</li>
<li>• Risks associated with wildlife encounters.</li>
<li>• Weather-related hazards such as extreme temperatures, rain, wind, and lightning.</li>
<li>• Risks associated with transportation to and from event locations.</li>
</ul>
<p>I hereby release, waive, discharge, and covenant not to sue the organizers of XTERRA Nepal, their respective officers, directors, employees, agents, volunteers, sponsors, and affiliates from any and all liability, claims, demands,
actions, or rights of action arising out of or related to any loss, damage, injury, or death that may be sustained by me during my participation in the event, regardless of whether such injury, loss, or damage is caused by the
negligence of the organizers or others.</p>
<p>I further agree to indemnify and hold harmless the organizers of XTERRA Nepal, their respective officers, directors, employees, agents, volunteers, sponsors, and affiliates from any and all liabilities or claims made by third parties
arising out of my participation in the event.</p>
<p>I understand that this waiver and release is intended to be as broad and inclusive as permitted by the laws of Nepal and agree that if any portion of this agreement is held to be invalid, the remainder shall continue in full force and
effect.</p>
<p>I have carefully read this waiver and release and fully understand its contents. I am aware that by signing this document, I am waiving certain legal rights which I or my heirs, executors, administrators, or assigns may have against
the organizers of XTERRA Nepal.</p>
<h5>MANDATORY:</h5>
<p>All participants are required to physically sign this waiver form prior to the commencement of the race.</p>
</div>
<fieldset id="field_2_141"
class="gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_141">
<legend class="gfield_label gform-field-label gfield_label_before_complex">Consent<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="ginput_container ginput_container_consent"><input name="input_141.1" id="input_2_141_1" type="checkbox" value="1" aria-required="true" aria-invalid="false"> <label
class="gform-field-label gform-field-label--type-inline gfield_consent_label" for="input_2_141_1">I agree.</label><input type="hidden" name="input_141.2" value="I agree." class="gform_hidden"><input type="hidden" name="input_141.3"
value="4" class="gform_hidden"></div>
</fieldset>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_previous_button_2_136" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="jQuery("#gform_target_page_number_2").val("4"); jQuery("#gform_2").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_2").val("4"); jQuery("#gform_2").trigger("submit",[true]); } "> <input type="button" id="gform_next_button_2_136"
class="gform_next_button gform-theme-button button" value="Next" onclick="jQuery("#gform_target_page_number_2").val("6"); jQuery("#gform_2").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_2").val("6"); jQuery("#gform_2").trigger("submit",[true]); } "> <button type="button" id="gform_save_2_6_link"
class="gform_save_link gform-theme-button gform-theme-button--secondary button"
onclick="if(window["gf_submitting_2"]){return false;} if( !jQuery("#gform_2")[0].checkValidity || jQuery("#gform_2")[0].checkValidity()){window["gf_submitting_2"]=true;} jQuery("#gform_save_2").val(1); jQuery("#gform_2").trigger("submit",[true]);"
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_2"]){return false;} if( !jQuery("#gform_2")[0].checkValidity || jQuery("#gform_2")[0].checkValidity()){window["gf_submitting_2"]=true;} jQuery("#gform_save_2").val(1); jQuery("#gform_2").trigger("submit",[true]); }"><svg
aria-hidden="true" focusable="false" width="16" height="16" fill="none" xmlns="http://www.w3.org/2000/svg">
<path fill-rule="evenodd" clip-rule="evenodd" d="M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z"
fill="#6B7280"></path>
</svg> Save & Continue</button>
</div>
</div>
<div id="gform_page_2_6" class="gform_page" data-js="page-field-id-136" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_2_6" class="gform_fields top_label form_sublabel_above description_above validation_below">
<div id="field_2_108" class="gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_2_108"
data-conditional-logic="hidden" style="display: none;">
<h3 class="gsection_title">Payment</h3>
</div>
<div id="field_2_109"
class="gfield gfield--type-total gfield--input-type-total gfield--width-full gfield_price gfield_price_2_ gfield_total gfield_total_2_ field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
aria-atomic="true" aria-live="polite" data-js-reload="field_2_109" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label" for="input_2_109">Total</label>
<div class="ginput_container ginput_container_total">
<input type="text" readonly="" name="input_109" id="input_2_109" value="$0.00" class="gform-text-input-reset ginput_total ginput_total_2" disabled="disabled">
</div>
</div>
<div id="field_2_94"
class="gfield gfield--type-stripe_creditcard gfield--input-type-stripe_creditcard gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--type-stripe_creditcard-payment-element"
data-js-reload="field_2_94" data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gfield_label_before_complex gform-field-label" for="input_2_94_1">Credit Card<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_complex ginput_container ginput_container_creditcard ginput_stripe_creditcard gform-grid-row" id="input_2_94">
<div class="ginput_full gform-grid-col" id="input_2_94_1_container" data-payment-element="true">
<div id="input_2_94_1" class="StripeElement--payment-element"></div>
<div class="gfield_description validation_message gfield_validation_message">The credit card field will initiate once the payment condition is met.</div>
</div>
</div>
</div>
<div id="field_2_107" class="gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_2_107">
<h3 class="gsection_title">Privacy and Policy</h3>
</div>
<div id="field_2_93"
class="gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_93">
<center>
<h4>Transportation Convenience : Let us Handle Your Travel Needs for XTERRA Nepal</h4>
<h6>For further assistance & queries, please reach us at <span style="color:blue;">xterra.nepal@periwinkleservice.com</span></h6>
</center>
</div>
<fieldset id="field_2_36"
class="gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible"
data-js-reload="field_2_36">
<legend class="gfield_label gform-field-label gfield_label_before_complex">Your privacy is important. We collect your name & email for event communication. Your data is secure & confidential. We may use event photos for
promotions, with respect to individual privacy.<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="gfield_description gfield_consent_description" id="gfield_consent_description_2_36">By submitting this registration form, I acknowledge that all information provided is accurate and consent to the processing of my personal
data in accordance with XTERRA’s privacy policy.</div>
<div class="ginput_container ginput_container_consent"><input name="input_36.1" id="input_2_36_1" type="checkbox" value="1" aria-describedby="gfield_consent_description_2_36" aria-required="true" aria-invalid="false"> <label
class="gform-field-label gform-field-label--type-inline gfield_consent_label" for="input_2_36_1">I agree to the privacy policy.</label><input type="hidden" name="input_36.2" value="I agree to the privacy policy."
class="gform_hidden"><input type="hidden" name="input_36.3" value="4" class="gform_hidden"></div>
</fieldset>
<div id="field_2_177" class="gfield gfield--type-honeypot gform_validation_container field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible" data-js-reload="field_2_177"><label
class="gfield_label gform-field-label" for="input_2_177">Email</label>
<div class="gfield_description" id="gfield_description_2_177">This field is for validation purposes and should be left unchanged.</div>
<div class="ginput_container"><input name="input_177" id="input_2_177" type="text" value="" autocomplete="new-password"></div>
</div>
</div>
</div>
<div class="gform_page_footer top_label"><input type="submit" id="gform_previous_button_2" class="gform_previous_button gform-theme-button gform-theme-button--secondary button" value="Previous"
onclick="if(window["gf_submitting_2"]){return false;} if( !jQuery("#gform_2")[0].checkValidity || jQuery("#gform_2")[0].checkValidity()){window["gf_submitting_2"]=true;} "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_2"]){return false;} if( !jQuery("#gform_2")[0].checkValidity || jQuery("#gform_2")[0].checkValidity()){window["gf_submitting_2"]=true;} jQuery("#gform_2").trigger("submit",[true]); }">
<input type="submit" id="gform_submit_button_2" class="gform_button button" value="Submit"
onclick="if(window["gf_submitting_2"]){return false;} if( !jQuery("#gform_2")[0].checkValidity || jQuery("#gform_2")[0].checkValidity()){window["gf_submitting_2"]=true;} "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_2"]){return false;} if( !jQuery("#gform_2")[0].checkValidity || jQuery("#gform_2")[0].checkValidity()){window["gf_submitting_2"]=true;} jQuery("#gform_2").trigger("submit",[true]); }">
<button type="button" id="gform_save_2_footer_link" class="gform_save_link gform-theme-button gform-theme-button--secondary button"
onclick="if(window["gf_submitting_2"]){return false;} if( !jQuery("#gform_2")[0].checkValidity || jQuery("#gform_2")[0].checkValidity()){window["gf_submitting_2"]=true;} jQuery("#gform_save_2").val(1); jQuery("#gform_2").trigger("submit",[true]);"
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_2"]){return false;} if( !jQuery("#gform_2")[0].checkValidity || jQuery("#gform_2")[0].checkValidity()){window["gf_submitting_2"]=true;} jQuery("#gform_save_2").val(1); jQuery("#gform_2").trigger("submit",[true]); }"><svg
aria-hidden="true" focusable="false" width="16" height="16" fill="none" xmlns="http://www.w3.org/2000/svg">
<path fill-rule="evenodd" clip-rule="evenodd" d="M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z"
fill="#6B7280"></path>
</svg> Save & Continue</button><input type="hidden" name="gform_ajax" value="form_id=2&title=&description=&tabindex=0&theme=orbital">
<input type="hidden" class="gform_hidden" name="is_submit_2" value="1">
<input type="hidden" class="gform_hidden" name="gform_submit" value="2">
<input type="hidden" class="gform_hidden" name="gform_save" id="gform_save_2" value="">
<input type="hidden" class="gform_hidden" name="gform_resume_token" id="gform_resume_token_2" value="">
<input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
<input type="hidden" class="gform_hidden" name="state_2"
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Nov 15 – 17, 2024 REGISTRATION OPEN Rules and Regulations -------------------------------------------------------------------------------- "*" indicates required fields Step 1 of 6 16% PERSONAL INFORMATION Name* First Last Date of Birth* YYYY dash MM dash DD Gender* Select oneMaleFemaleOther Phone* Email* Are you a Nepali citizen?* Yes No Nationality* Passport no.* Citizenship no.* Residential Address* Street Address City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Save & Continue EMERGENCY CONTACT Full Name* Relationship* Email* Phone* Save & Continue MEDICAL CERTIFICATES NOTE: * • Please email us any relevant medical certificates, if applicable. * • Please Mention any pre-existing conditions along with your doctor’s clearance for participation. Please indicate here if you have any allergies Food Insect stings Medicines Other Please specify Please give more details about any relevant allergies, or dietary restrictions that you may have. Consent* I confirm I am in good health and fit to take part in an endurance event on alpine terrain. Save & Continue Offer Early BirdNormal EVENT RACES Full Distance Triathlon Price: Sprint Distance Triathlon Price: Duathlon Price: Early Bird Offer Early Bird Offer Full Distance Triathlon | $200 Duathlon | $150 Sprint Distance Triathlon | $100 Full Distance Triathlon Price: Duathlon Price: Sprint Distance Triathlon Price: Early Bird Offer Early Bird Offer Full Distance Triathlon | NPR 10,000 Duathlon | NPR 8,000 Sprint Distance Triathlon | NPR 8,000 Full Distance Triathlon Price: Sprint Distance Triathlon Price: Duathlon Price: Normal Offer Normal Offer Full Distance Triathlon | $225 Duathlon | $175 Sprint Distance Triathlon | $125 Full Distance Triathlon Price: Duathlon Price: Sprint Distance Triathlon Price: Normal Offer Normal Offer Full Distance Triathlon | NPR 12,500 Duathlon | NPR 10,000 Sprint Distance Triathlon | NPR 10,000 TRAIL RUN 25 K Price: 12 K Price: 6 K Price: 2 K Price: Early Bird Offer Early Bird Offer 25K | $45 12K | $35 6K | $30 2K (Kids Run) | $15 25 K Price: 12 K Price: 6 K Price: 2 K Price: Early Bird Offer Early Bird Offer 25K | NPR 4,000 12K | NPR 3,000 6K | NPR 2,500 2K (Kids Run) | NPR 1,500 25 K Price: 12 K Price: 6 K Price: 2 K Price: Normal Offer Normal Offer 25K | $ 55 12K | $45 6K | $40 2K (Kids Run) | $ 25 25 K Price: 12 K Price: 6 K Price: 2 K Price: Normal Offer Normal Offer 25K | NPR 5,000 12K | NPR 4,000 6K | NPR 3,500 2K (Kids Run) | NPR 2,000 MERCHANDISE (EURO SIZES) T-shirt | $25 Select your sizeXSSMLXLXXLXXXL Hoodie | $35 Select your sizeXSSMLXLXXLXXXL You can select multiple. Please follow the notes below. You can select multiple. Please follow the notes below. Buff | $10 Snapback | $25 T-shirt | NPR 2500 Select your sizeXSSMLXLXXLXXXL Hoodie | NPR 3500 Select your sizeXSSMLXLXXLXXXL You can select multiple. Please follow the notes below. You can select multiple. Please follow the notes below. Buff | NPR 1000 Snapback | NPR 2500 NOTE: * • All the merchandise will be available at the event venue. * • Prior booking can be done via emails or social handles. Total Save & Continue WAIVER FORM ATTENTION PARTICIPANTS Your safety is our priority! Before embarking on the Race , it’s crucial for all participants to disclose any pertinent medical history to our team. Your well-being matters, and this information enables us to ensure a safe and enjoyable experience for everyone. This important step allows our team to be fully aware of any medical conditions you may have. It empowers us to remind participants about their regular medications if necessary, ensuring that everyone can maintain their health throughout period of the race. We’re committed to creating a secure environment for all, and your cooperation in sharing medical information plays a pivotal role in achieving this goal. WAIVER I, [Participant’s Full Name], hereby acknowledge that my participation in the XTERRA Nepal event involves certain risks and hazards. In consideration of being permitted to participate in this event, I agree to assume all risks associated with my participation. I understand and agree that neither the organizers of XTERRA Nepal nor any sponsors, volunteers, or affiliated entities shall be liable for any injury, loss, or damage to myself or my property that may arise directly or indirectly from my participation in the event. I understand that participation in XTERRA Nepal may involve physical exertion and potential exposure to natural elements and other hazards, including but not limited to: * • Trail running and hiking on rugged terrain. * • Mountain biking on challenging trails. * • Swimming in open water. * • Risks associated with wildlife encounters. * • Weather-related hazards such as extreme temperatures, rain, wind, and lightning. * • Risks associated with transportation to and from event locations. I hereby release, waive, discharge, and covenant not to sue the organizers of XTERRA Nepal, their respective officers, directors, employees, agents, volunteers, sponsors, and affiliates from any and all liability, claims, demands, actions, or rights of action arising out of or related to any loss, damage, injury, or death that may be sustained by me during my participation in the event, regardless of whether such injury, loss, or damage is caused by the negligence of the organizers or others. I further agree to indemnify and hold harmless the organizers of XTERRA Nepal, their respective officers, directors, employees, agents, volunteers, sponsors, and affiliates from any and all liabilities or claims made by third parties arising out of my participation in the event. I understand that this waiver and release is intended to be as broad and inclusive as permitted by the laws of Nepal and agree that if any portion of this agreement is held to be invalid, the remainder shall continue in full force and effect. I have carefully read this waiver and release and fully understand its contents. I am aware that by signing this document, I am waiving certain legal rights which I or my heirs, executors, administrators, or assigns may have against the organizers of XTERRA Nepal. MANDATORY: All participants are required to physically sign this waiver form prior to the commencement of the race. Consent* I agree. Save & Continue PAYMENT Total Credit Card* The credit card field will initiate once the payment condition is met. PRIVACY AND POLICY TRANSPORTATION CONVENIENCE : LET US HANDLE YOUR TRAVEL NEEDS FOR XTERRA NEPAL FOR FURTHER ASSISTANCE & QUERIES, PLEASE REACH US AT XTERRA.NEPAL@PERIWINKLESERVICE.COM Your privacy is important. We collect your name & email for event communication. Your data is secure & confidential. We may use event photos for promotions, with respect to individual privacy.* By submitting this registration form, I acknowledge that all information provided is accurate and consent to the processing of my personal data in accordance with XTERRA’s privacy policy. I agree to the privacy policy. Email This field is for validation purposes and should be left unchanged. Save & Continue EVENT VENUE Begnas Lake, Lekhnath, Pokhara, Nepal CORPORATE OFFICE XTERRA Nepal, Periwinkle Service Pvt. Ltd., Kamaladi, Kathmandu, Nepal REACH US xterra.nepal@periwinkleservice.com FOLLOW US * * Notifications The credit card field will initiate once the payment condition is met.