{"id":3926,"date":"2021-04-13T10:39:13","date_gmt":"2021-04-13T18:39:13","guid":{"rendered":"https:\/\/healthyfuturesak.org\/?page_id=3926"},"modified":"2021-10-22T12:16:59","modified_gmt":"2021-10-22T20:16:59","slug":"game-changer-application","status":"publish","type":"page","link":"https:\/\/healthyfuturesak.org\/game-changer-application\/","title":{"rendered":"Game Changer Application"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.6.0&#8243; _module_preset=&#8221;default&#8221; background_image=&#8221;https:\/\/healthyfuturesak.org\/wp-content\/uploads\/2021\/04\/Sports.png&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.6.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.6.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text admin_label=&#8221;Challenges that make it hard for you or your team to participate in a sport or recreational activity you love?&#8221; _builder_version=&#8221;4.11.3&#8243; _module_preset=&#8221;default&#8221; text_font=&#8221;Rubik||||||||&#8221; text_text_color=&#8221;#E09900&#8243; text_font_size=&#8221;15px&#8221; text_line_height=&#8221;2em&#8221; background_color=&#8221;RGBA(0,0,0,0)&#8221; background_enable_image=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h4 style=\"text-align: center;\"><b>Challenges that make it hard for you or your team to participate in a sport or recreational activity you love?<\/b><\/h4>\n<p>&nbsp;<\/p>\n<h4 style=\"text-align: center;\"><b>Maybe you qualify for a Healthy Futures Game Changer Scholarship:<\/b><\/h4>\n<p>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.11.3&#8243; _module_preset=&#8221;default&#8221; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; admin_label=&#8221;*Recipients will be chosen and announced every two weeks after a board review of submitted applications*&#8221; sticky_enabled=&#8221;0&#8243;]<\/p>\n<p style=\"text-align: center;\">*Recipients will be chosen and announced every two weeks after a board review of submitted applications*<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=&#8221;4.9.4&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.9.4&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text admin_label=&#8221;Game Changer Application Form&#8221; module_id=&#8221;Individual&#8221; _builder_version=&#8221;4.11.3&#8243; _module_preset=&#8221;default&#8221; text_line_height=&#8221;2em&#8221; background_color=&#8221;#d1f794&#8243; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h3>Game Changer Scholarship Application:<\/h3>\n<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var 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class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_11_2\" class=\"gfield gfield--type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_2\" ><label class='gfield_label gform-field-label' for='input_11_2'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_2' id='input_11_2' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_11_3\" class=\"gfield gfield--type-phone gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_3\" ><label class='gfield_label gform-field-label' for='input_11_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_11_3' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_34\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_34\" ><label class='gfield_label gform-field-label' for='input_11_34'>Mailing Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_34' id='input_11_34' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_11_24\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_24\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Is this for an individual or team\/group?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_11_24'><div class='gchoice gchoice_11_24_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.1' type='checkbox'  value='Individual'  id='choice_11_24_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_24_1' id='label_11_24_1' class='gform-field-label gform-field-label--type-inline'>Individual<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_24_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.2' type='checkbox'  value='Team\/Group'  id='choice_11_24_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_24_2' id='label_11_24_2' class='gform-field-label gform-field-label--type-inline'>Team\/Group<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_11_25\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_25\" ><label class='gfield_label gform-field-label' for='input_11_25'>Name of team\/group<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_25' id='input_11_25' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_11_26\" class=\"gfield gfield--type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_26\" ><label class='gfield_label gform-field-label' for='input_11_26'>I am currently between the age of 5 and 18<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_26' id='input_11_26' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/div><div id=\"field_11_11\" class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_11\" ><label class='gfield_label gform-field-label' for='input_11_11'>Members of team\/group are currently between the age of 5 and 18<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_11' id='input_11_11' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/div><div id=\"field_11_37\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_37\" ><label class='gfield_label gform-field-label' for='input_11_37'>Age<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_37' id='input_11_37' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_11_41\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_41\" ><label class='gfield_label gform-field-label' for='input_11_41'>Age range of team\/group<\/label><div class='ginput_container ginput_container_text'><input name='input_41' id='input_11_41' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_11_12\" class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_12\" ><label class='gfield_label gform-field-label' for='input_11_12'>I have at least a C average (2.0 GPA) in School<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_12' id='input_11_12' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/div><div id=\"field_11_27\" class=\"gfield gfield--type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_27\" ><label class='gfield_label gform-field-label' for='input_11_27'>Members of team\/group have at least a C average (2.0 GPA) in School<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_27' id='input_11_27' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/div><div id=\"field_11_6\" class=\"gfield gfield--type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_6\" ><label class='gfield_label gform-field-label' for='input_11_6'>Grade<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_6' id='input_11_6' type='number' step='any'   value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_11_28\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_28\" ><label class='gfield_label gform-field-label' for='input_11_28'>Name of school in attendance<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_11_28' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_11_13\" class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_13\" ><label class='gfield_label gform-field-label' for='input_11_13'>Members of team\/group are having financial challenges<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_13' id='input_11_13' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/div><div id=\"field_11_29\" class=\"gfield gfield--type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_29\" ><label class='gfield_label gform-field-label' for='input_11_29'>My family is having financial challenges<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_29' id='input_11_29' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/div><div id=\"field_11_38\" class=\"gfield gfield--type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_38\" ><label class='gfield_label gform-field-label' for='input_11_38'>Do you qualify for free\/reduced lunches at school?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_38' id='input_11_38' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><option value='' ><\/option><\/select><\/div><\/div><fieldset id=\"field_11_15\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_15\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >What my team\/group needs help with (select all that apply):<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_11_15'><div class='gchoice gchoice_11_15_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_15.1' type='checkbox'  value='Participation Fees'  id='choice_11_15_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_15_1' id='label_11_15_1' class='gform-field-label gform-field-label--type-inline'>Participation Fees<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_15_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_15.2' type='checkbox'  value='Equipment'  id='choice_11_15_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_15_2' id='label_11_15_2' class='gform-field-label gform-field-label--type-inline'>Equipment<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_15_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_15.3' type='checkbox'  value='Transportation Support'  id='choice_11_15_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_15_3' id='label_11_15_3' class='gform-field-label gform-field-label--type-inline'>Transportation Support<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_15_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_15.4' type='checkbox'  value='Other (specify below)'  id='choice_11_15_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_15_4' id='label_11_15_4' class='gform-field-label gform-field-label--type-inline'>Other (specify below)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_11_30\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_30\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >What I need help with (select all that apply):<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_11_30'><div class='gchoice gchoice_11_30_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.1' type='checkbox'  value='Participation Fees'  id='choice_11_30_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_30_1' id='label_11_30_1' class='gform-field-label gform-field-label--type-inline'>Participation Fees<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_30_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.2' type='checkbox'  value='Equipment'  id='choice_11_30_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_30_2' id='label_11_30_2' class='gform-field-label gform-field-label--type-inline'>Equipment<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_30_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.3' type='checkbox'  value='Transportation Support'  id='choice_11_30_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_30_3' id='label_11_30_3' class='gform-field-label gform-field-label--type-inline'>Transportation Support<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_30_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.4' type='checkbox'  value='Other (specify below)'  id='choice_11_30_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_30_4' id='label_11_30_4' class='gform-field-label gform-field-label--type-inline'>Other (specify below)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_11_16\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_16\" ><label class='gfield_label gform-field-label' for='input_11_16'>Other Explanation<\/label><div class='ginput_container ginput_container_text'><input name='input_16' id='input_11_16' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_11_8\" class=\"gfield gfield--type-number gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_8\" ><label class='gfield_label gform-field-label' for='input_11_8'>Total amount of funds needed<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_8' id='input_11_8' type='number' step='any'  max='500' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_instruction_11_8\" \/><div class='gfield_description instruction ' id='gfield_instruction_11_8'>Please enter a number less than or equal to <strong>500<\/strong>.<\/div><\/div><\/div><div id=\"field_11_36\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_36\" ><label class='gfield_label gform-field-label' for='input_11_36'>Referral Source<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_36' id='input_11_36' type='text' value='' class='large'  aria-describedby=\"gfield_description_11_36\"   aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><div class='gfield_description' id='gfield_description_11_36'>How did you hear about Healthy Futures Game Changer?<\/div><\/div><div id=\"field_11_9\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_9\" ><label class='gfield_label gform-field-label' for='input_11_9'>Summary of need<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_9' id='input_11_9' class='textarea medium'  aria-describedby=\"gfield_description_11_9\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><div class='gfield_description' id='gfield_description_11_9'>Why are these funds needed? How will they be used? <\/div><\/div><div id=\"field_11_23\" class=\"gfield gfield--type-select gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_23\" ><label class='gfield_label gform-field-label' for='input_11_23'>Our team\/group is willing to share their story with Alaska&#039;s News Source<\/label><div class='ginput_container ginput_container_select'><select name='input_23' id='input_11_23' class='large gfield_select'     aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/div><div id=\"field_11_31\" class=\"gfield gfield--type-select gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_31\" ><label class='gfield_label gform-field-label' for='input_11_31'>I am willing to share my story with Alaska&#039;s News Source<\/label><div class='ginput_container ginput_container_select'><select name='input_31' id='input_11_31' class='large gfield_select'     aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/div><div id=\"field_11_40\" class=\"gfield gfield--type-select gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_40\" ><label class='gfield_label gform-field-label' for='input_11_40'>Our team\/group is willing to anonymously share testimonial of award experience<\/label><div class='ginput_container ginput_container_select'><select name='input_40' id='input_11_40' class='large gfield_select'     aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><option value='' ><\/option><\/select><\/div><\/div><div id=\"field_11_39\" class=\"gfield gfield--type-select gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_39\" ><label class='gfield_label gform-field-label' for='input_11_39'>I am willing to anonymously share testimonial of my  award experience<\/label><div class='ginput_container ginput_container_select'><select name='input_39' id='input_11_39' class='large gfield_select'     aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><option value='' ><\/option><\/select><\/div><\/div><fieldset id=\"field_11_17\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_17\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Parent\/Guardian 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_11_17'>\n                            \n                            <span id='input_11_17_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_17.3' id='input_11_17_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_11_17_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_11_17_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_17.6' id='input_11_17_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_11_17_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_11_18\" class=\"gfield gfield--type-phone gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_18\" ><label class='gfield_label gform-field-label' for='input_11_18'>Parent\/Guardian 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_18' id='input_11_18' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_11_19\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_hidden_label gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_19\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Reference 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_11_19'>\n                            \n                            <span id='input_11_19_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_19.3' id='input_11_19_3' value=''   aria-required='true'   placeholder='First'  \/>\n                                                    <label for='input_11_19_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_11_19_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_19.6' id='input_11_19_6' value=''   aria-required='true'   placeholder='Last'  \/>\n                                                    <label for='input_11_19_6' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><div class='gfield_description' id='gfield_description_11_19'>Preferably NOT a family member\n\n<\/div><\/fieldset><div id=\"field_11_32\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_32\" ><label class='gfield_label gform-field-label' for='input_11_32'>Relationship to Reference<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_32' id='input_11_32' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_11_20\" class=\"gfield gfield--type-phone gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_20\" ><label class='gfield_label gform-field-label' for='input_11_20'>Reference 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_20' id='input_11_20' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_10\" class=\"gfield gfield--type-captcha field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_10\" ><label class='gfield_label gform-field-label' for='input_11_10'>CAPTCHA<\/label><div id='input_11_10' class='ginput_container ginput_recaptcha' data-sitekey='6LfTZQ8TAAAAABqhZyW6f4m67AD-Ykf-T6Eoofav'  data-theme='light' data-tabindex='0'  data-badge=''><\/div><\/div><div id=\"field_11_42\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_42\" ><label class='gfield_label gform-field-label' for='input_11_42'>Name<\/label><div class='ginput_container'><input name='input_42' id='input_11_42' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_11_42'>This field is for validation purposes and should be left unchanged.<\/div><\/div><\/div><\/div>\n        <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_11' class='gform_button button' value='Submit'  onclick='if(window[\"gf_submitting_11\"]){return false;}  if( !jQuery(\"#gform_11\")[0].checkValidity || jQuery(\"#gform_11\")[0].checkValidity()){window[\"gf_submitting_11\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_11\"]){return false;} if( !jQuery(\"#gform_11\")[0].checkValidity || jQuery(\"#gform_11\")[0].checkValidity()){window[\"gf_submitting_11\"]=true;}  jQuery(\"#gform_11\").trigger(\"submit\",[true]); }' \/> \n            <input type='hidden' class='gform_hidden' name='is_submit_11' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='11' \/>\n            \n            <input type='hidden' class='gform_hidden' 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<\/div><script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\n gform.initializeOnLoaded( function() {gformInitSpinner( 11, 'https:\/\/healthyfuturesak.org\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery('#gform_ajax_frame_11').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_11');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_11').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 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color=&#8221;#0C71C3&#8243; _builder_version=&#8221;4.9.4&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_divider][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Challenges that make it hard for you or your team to participate in a sport or recreational activity you love? &nbsp; Maybe you qualify for a Healthy Futures Game Changer Scholarship:*Recipients will be chosen and announced every two weeks after a board review of submitted applications*Game Changer Scholarship Application: \n                <div class='gf_browser_safari gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='1' id='gform_wrapper_11' style='display:none'>\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_11'  action='\/wp-json\/wp\/v2\/pages\/3926' data-formid='11' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_11' class='gform_fields top_label form_sublabel_below description_below'><fieldset id=\"field_11_1\" class=\"gfield gfield--type-name gfield--width-full gfield_contains_required field_sublabel_hidden_label gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_1\" ><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_11_1'>\n                            \n                            <span id='input_11_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_11_1_3' value=''   aria-required='true'   placeholder='First'  \/>\n                                                    <label for='input_11_1_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_11_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_11_1_6' value=''   aria-required='true'   placeholder='Last'  \/>\n                                                    <label for='input_11_1_6' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_11_2\" class=\"gfield gfield--type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_2\" ><label class='gfield_label gform-field-label' for='input_11_2'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_2' id='input_11_2' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_11_3\" class=\"gfield gfield--type-phone gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_3\" ><label class='gfield_label gform-field-label' for='input_11_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_11_3' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_34\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_34\" ><label class='gfield_label gform-field-label' for='input_11_34'>Mailing Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_34' id='input_11_34' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_11_24\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_24\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Is this for an individual or team\/group?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_11_24'><div class='gchoice gchoice_11_24_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.1' type='checkbox'  value='Individual'  id='choice_11_24_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_24_1' id='label_11_24_1' class='gform-field-label gform-field-label--type-inline'>Individual<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_24_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.2' type='checkbox'  value='Team\/Group'  id='choice_11_24_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_24_2' id='label_11_24_2' class='gform-field-label gform-field-label--type-inline'>Team\/Group<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_11_25\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_25\" ><label class='gfield_label gform-field-label' for='input_11_25'>Name of team\/group<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_25' id='input_11_25' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_11_26\" class=\"gfield gfield--type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_26\" ><label class='gfield_label gform-field-label' for='input_11_26'>I am currently between the age of 5 and 18<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_26' id='input_11_26' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/div><div id=\"field_11_11\" class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_11\" ><label class='gfield_label gform-field-label' for='input_11_11'>Members of team\/group are currently between the age of 5 and 18<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_11' id='input_11_11' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/div><div id=\"field_11_37\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_37\" ><label class='gfield_label gform-field-label' for='input_11_37'>Age<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_37' id='input_11_37' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_11_41\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_41\" ><label class='gfield_label gform-field-label' for='input_11_41'>Age range of team\/group<\/label><div class='ginput_container ginput_container_text'><input name='input_41' id='input_11_41' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_11_12\" class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_12\" ><label class='gfield_label gform-field-label' for='input_11_12'>I have at least a C average (2.0 GPA) in School<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_12' id='input_11_12' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/div><div id=\"field_11_27\" class=\"gfield gfield--type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_27\" ><label class='gfield_label gform-field-label' for='input_11_27'>Members of team\/group have at least a C average (2.0 GPA) in School<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_27' id='input_11_27' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/div><div id=\"field_11_6\" class=\"gfield gfield--type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_6\" ><label class='gfield_label gform-field-label' for='input_11_6'>Grade<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_6' id='input_11_6' type='number' step='any'   value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_11_28\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_28\" ><label class='gfield_label gform-field-label' for='input_11_28'>Name of school in attendance<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_11_28' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_11_13\" class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_13\" ><label class='gfield_label gform-field-label' for='input_11_13'>Members of team\/group are having financial challenges<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_13' id='input_11_13' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/div><div id=\"field_11_29\" class=\"gfield gfield--type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_29\" ><label class='gfield_label gform-field-label' for='input_11_29'>My family is having financial challenges<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_29' id='input_11_29' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/div><div id=\"field_11_38\" class=\"gfield gfield--type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_38\" ><label class='gfield_label gform-field-label' for='input_11_38'>Do you qualify for free\/reduced lunches at school?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_38' id='input_11_38' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><option value='' ><\/option><\/select><\/div><\/div><fieldset id=\"field_11_15\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_15\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >What my team\/group needs help with (select all that apply):<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_11_15'><div class='gchoice gchoice_11_15_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_15.1' type='checkbox'  value='Participation Fees'  id='choice_11_15_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_15_1' id='label_11_15_1' class='gform-field-label gform-field-label--type-inline'>Participation Fees<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_15_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_15.2' type='checkbox'  value='Equipment'  id='choice_11_15_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_15_2' id='label_11_15_2' class='gform-field-label gform-field-label--type-inline'>Equipment<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_15_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_15.3' type='checkbox'  value='Transportation Support'  id='choice_11_15_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_15_3' id='label_11_15_3' class='gform-field-label gform-field-label--type-inline'>Transportation Support<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_15_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_15.4' type='checkbox'  value='Other (specify below)'  id='choice_11_15_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_15_4' id='label_11_15_4' class='gform-field-label gform-field-label--type-inline'>Other (specify below)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_11_30\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_30\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >What I need help with (select all that apply):<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_11_30'><div class='gchoice gchoice_11_30_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.1' type='checkbox'  value='Participation Fees'  id='choice_11_30_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_30_1' id='label_11_30_1' class='gform-field-label gform-field-label--type-inline'>Participation Fees<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_30_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.2' type='checkbox'  value='Equipment'  id='choice_11_30_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_30_2' id='label_11_30_2' class='gform-field-label gform-field-label--type-inline'>Equipment<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_30_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.3' type='checkbox'  value='Transportation Support'  id='choice_11_30_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_30_3' id='label_11_30_3' class='gform-field-label gform-field-label--type-inline'>Transportation Support<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_30_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.4' type='checkbox'  value='Other (specify below)'  id='choice_11_30_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_30_4' id='label_11_30_4' class='gform-field-label gform-field-label--type-inline'>Other (specify below)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_11_16\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_16\" ><label class='gfield_label gform-field-label' for='input_11_16'>Other Explanation<\/label><div class='ginput_container ginput_container_text'><input name='input_16' id='input_11_16' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_11_8\" class=\"gfield gfield--type-number gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_8\" ><label class='gfield_label gform-field-label' for='input_11_8'>Total amount of funds needed<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_8' id='input_11_8' type='number' step='any'  max='500' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_instruction_11_8\" \/><div class='gfield_description instruction ' id='gfield_instruction_11_8'>Please enter a number less than or equal to <strong>500<\/strong>.<\/div><\/div><\/div><div id=\"field_11_36\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_36\" ><label class='gfield_label gform-field-label' for='input_11_36'>Referral Source<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_36' id='input_11_36' type='text' value='' class='large'  aria-describedby=\"gfield_description_11_36\"   aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><div class='gfield_description' id='gfield_description_11_36'>How did you hear about Healthy Futures Game Changer?<\/div><\/div><div id=\"field_11_9\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_9\" ><label class='gfield_label gform-field-label' for='input_11_9'>Summary of need<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_9' id='input_11_9' class='textarea medium'  aria-describedby=\"gfield_description_11_9\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><div class='gfield_description' id='gfield_description_11_9'>Why are these funds needed? How will they be used? <\/div><\/div><div id=\"field_11_23\" class=\"gfield gfield--type-select gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_23\" ><label class='gfield_label gform-field-label' for='input_11_23'>Our team\/group is willing to share their story with Alaska&#039;s News Source<\/label><div class='ginput_container ginput_container_select'><select name='input_23' id='input_11_23' class='large gfield_select'     aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/div><div id=\"field_11_31\" class=\"gfield gfield--type-select gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_31\" ><label class='gfield_label gform-field-label' for='input_11_31'>I am willing to share my story with Alaska&#039;s News Source<\/label><div class='ginput_container ginput_container_select'><select name='input_31' id='input_11_31' class='large gfield_select'     aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/div><div id=\"field_11_40\" class=\"gfield gfield--type-select gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_40\" ><label class='gfield_label gform-field-label' for='input_11_40'>Our team\/group is willing to anonymously share testimonial of award experience<\/label><div class='ginput_container ginput_container_select'><select name='input_40' id='input_11_40' class='large gfield_select'     aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><option value='' ><\/option><\/select><\/div><\/div><div id=\"field_11_39\" class=\"gfield gfield--type-select gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_39\" ><label class='gfield_label gform-field-label' for='input_11_39'>I am willing to anonymously share testimonial of my  award experience<\/label><div class='ginput_container ginput_container_select'><select name='input_39' id='input_11_39' class='large gfield_select'     aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><option value='' ><\/option><\/select><\/div><\/div><fieldset id=\"field_11_17\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_17\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Parent\/Guardian 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_11_17'>\n                            \n                            <span id='input_11_17_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_17.3' id='input_11_17_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_11_17_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_11_17_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_17.6' id='input_11_17_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_11_17_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_11_18\" class=\"gfield gfield--type-phone gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_18\" ><label class='gfield_label gform-field-label' for='input_11_18'>Parent\/Guardian 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_18' id='input_11_18' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_11_19\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_hidden_label gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_11_19\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Reference 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_11_19'>\n                            \n                            <span id='input_11_19_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_19.3' id='input_11_19_3' value=''   aria-required='true'   placeholder='First'  \/>\n                                                    <label for='input_11_19_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_11_19_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_19.6' id='input_11_19_6' value=''   aria-required='true'   placeholder='Last'  \/>\n                                                    <label for='input_11_19_6' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><div class='gfield_description' id='gfield_description_11_19'>Preferably NOT a family member\n\n<\/div><\/fieldset><div id=\"field_11_32\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description 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