{"id":774,"date":"2023-02-06T09:34:47","date_gmt":"2023-02-06T09:34:47","guid":{"rendered":"https:\/\/jommwellness.co.za\/?page_id=774"},"modified":"2023-02-06T09:47:25","modified_gmt":"2023-02-06T09:47:25","slug":"enquiry-form","status":"publish","type":"page","link":"https:\/\/jommwellness.co.za\/index.php\/enquiry-form\/","title":{"rendered":"Enquiry Form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"774\" class=\"elementor elementor-774\">\n\t\t\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-64dc934 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"64dc934\" data-element_type=\"section\" 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class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-68e69cc\" data-id=\"68e69cc\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"jupiter-tooltip-widget elementor-element elementor-element-c96fb91 elementor-widget elementor-widget-spacer\" data-jupiter-tooltip-settings=\"{&quot;tooltip&quot;:&quot;false&quot;,&quot;tooltipDescription&quot;:&quot;This is Tooltip!&quot;,&quot;tooltipPlacement&quot;:&quot;top&quot;,&quot;tooltipArrow&quot;:true,&quot;xOffset&quot;:0,&quot;yOffset&quot;:0,&quot;tooltipAnimation&quot;:&quot;fade&quot;,&quot;tooltipTrigger&quot;:&quot;mouseenter&quot;,&quot;zIndex&quot;:999,&quot;customSelector&quot;:&quot;&quot;,&quot;delay&quot;:0}\" data-id=\"c96fb91\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.7.8 - 02-10-2022 *\/\n.elementor-column .elementor-spacer-inner{height:var(--spacer-size)}.e-container{--container-widget-width:100%}.e-container>.elementor-widget-spacer{width:var(--container-widget-width,var(--spacer-size));-ms-flex-item-align:stretch;align-self:stretch;-ms-flex-negative:0;flex-shrink:0}.e-container>.elementor-widget-spacer>.elementor-widget-container,.e-container>.elementor-widget-spacer>.elementor-widget-container>.elementor-spacer{height:100%}.e-container>.elementor-widget-spacer>.elementor-widget-container>.elementor-spacer>.elementor-spacer-inner{height:var(--container-widget-height,var(--spacer-size))}<\/style>\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"jupiter-tooltip-widget elementor-element elementor-element-88627f0 elementor-align-center elementor-widget elementor-widget-raven-heading\" data-jupiter-tooltip-settings=\"{&quot;tooltip&quot;:&quot;false&quot;,&quot;tooltipDescription&quot;:&quot;This is Tooltip!&quot;,&quot;tooltipPlacement&quot;:&quot;top&quot;,&quot;tooltipArrow&quot;:true,&quot;xOffset&quot;:0,&quot;yOffset&quot;:0,&quot;tooltipAnimation&quot;:&quot;fade&quot;,&quot;tooltipTrigger&quot;:&quot;mouseenter&quot;,&quot;zIndex&quot;:999,&quot;customSelector&quot;:&quot;&quot;,&quot;delay&quot;:0}\" data-id=\"88627f0\" data-element_type=\"widget\" data-widget_type=\"raven-heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"raven-widget-wrapper\"><h2 class=\"raven-heading raven-heading-h2\"><span class=\"raven-heading-title\">Enquiry Form<\/span><\/h2><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"jupiter-tooltip-widget elementor-element elementor-element-b7c796c elementor-widget elementor-widget-spacer\" data-jupiter-tooltip-settings=\"{&quot;tooltip&quot;:&quot;false&quot;,&quot;tooltipDescription&quot;:&quot;This is Tooltip!&quot;,&quot;tooltipPlacement&quot;:&quot;top&quot;,&quot;tooltipArrow&quot;:true,&quot;xOffset&quot;:0,&quot;yOffset&quot;:0,&quot;tooltipAnimation&quot;:&quot;fade&quot;,&quot;tooltipTrigger&quot;:&quot;mouseenter&quot;,&quot;zIndex&quot;:999,&quot;customSelector&quot;:&quot;&quot;,&quot;delay&quot;:0}\" data-id=\"b7c796c\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"jupiter-tooltip-widget elementor-element elementor-element-60fa0aa elementor-widget elementor-widget-wpforms\" data-jupiter-tooltip-settings=\"{&quot;tooltip&quot;:&quot;false&quot;,&quot;tooltipDescription&quot;:&quot;This is Tooltip!&quot;,&quot;tooltipPlacement&quot;:&quot;top&quot;,&quot;tooltipArrow&quot;:true,&quot;xOffset&quot;:0,&quot;yOffset&quot;:0,&quot;tooltipAnimation&quot;:&quot;fade&quot;,&quot;tooltipTrigger&quot;:&quot;mouseenter&quot;,&quot;zIndex&quot;:999,&quot;customSelector&quot;:&quot;&quot;,&quot;delay&quot;:0}\" data-id=\"60fa0aa\" data-element_type=\"widget\" data-widget_type=\"wpforms.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<div class=\"wpforms-container wpforms-container-full\" id=\"wpforms-752\"><form id=\"wpforms-form-752\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"752\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/index.php\/wp-json\/wp\/v2\/pages\/774\" data-token=\"47efdf711e208994bf450349a9322801\"><div class=\"wpforms-head-container\"><div class=\"wpforms-title\">JOMM wellness enquiry form<\/div><\/div><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-752-field_0-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"0\"><label class=\"wpforms-field-label\" for=\"wpforms-752-field_0\">Name <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-752-field_0\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][0][first]\" required><label for=\"wpforms-752-field_0\" class=\"wpforms-field-sublabel after \">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-752-field_0-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][0][last]\" required><label for=\"wpforms-752-field_0-last\" class=\"wpforms-field-sublabel after \">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-752-field_3-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"3\"><label class=\"wpforms-field-label\" for=\"wpforms-752-field_3\">Gender<\/label><select id=\"wpforms-752-field_3\" class=\"wpforms-field-medium\" name=\"wpforms[fields][3]\"><option value=\"Male\" >Male<\/option><option value=\"Female\" >Female<\/option><option value=\"Other\" >Other<\/option><option value=\"Prefer not to say\" >Prefer not to say<\/option><\/select><\/div><div id=\"wpforms-752-field_5-container\" class=\"wpforms-field wpforms-field-number-slider\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-752-field_5\">Age<\/label>\n<input\n\ttype=\"range\"\n\tid=\"wpforms-752-field_5\" class=\"wpforms-field-medium\" name=\"wpforms[fields][5]\" value=\"0\"\t\tvalue=\"0\"\n\tmin=\"0\"\n\tmax=\"100\"\n\tstep=\"1\">\n\n<div class=\"wpforms-field-number-slider-hint\"\n\tdata-hint=\"Selected Value: {value}\">\n\tSelected Value: <b>0<\/b><\/div>\n<\/div><div id=\"wpforms-752-field_6-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-752-field_6\">I would Like to Join the JOMM community for<\/label><ul id=\"wpforms-752-field_6\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-752-field_6_1\" name=\"wpforms[fields][6][]\" value=\"Fitness\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-752-field_6_1\">Fitness<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-752-field_6_2\" name=\"wpforms[fields][6][]\" value=\"Nutrition\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-752-field_6_2\">Nutrition<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-752-field_6_3\" name=\"wpforms[fields][6][]\" value=\"Hiking and Mindfulness experiences \"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-752-field_6_3\">Hiking and Mindfulness experiences <\/label><\/li><\/ul><\/div><div id=\"wpforms-752-field_1-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"1\"><label class=\"wpforms-field-label\" for=\"wpforms-752-field_1\">Email <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-752-field_1\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][1]\" required><\/div><div id=\"wpforms-752-field_7-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"7\"><label class=\"wpforms-field-label\" for=\"wpforms-752-field_7\">Phone Numbers<\/label><input type=\"number\" pattern=\"\\d*\" id=\"wpforms-752-field_7\" class=\"wpforms-field-medium\" name=\"wpforms[fields][7]\" ><\/div><div id=\"wpforms-752-field_8-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"8\"><label class=\"wpforms-field-label\" for=\"wpforms-752-field_8\">I prefer to be contacted via<\/label><select id=\"wpforms-752-field_8\" class=\"wpforms-field-medium\" name=\"wpforms[fields][8]\"><option value=\"Email\" >Email<\/option><option value=\"Whatsapp\" >Whatsapp<\/option><option value=\"SMS\" >SMS<\/option><option value=\"Phone\" >Phone<\/option><\/select><\/div><\/div><div class=\"wpforms-recaptcha-container wpforms-is-recaptcha\"><div class=\"g-recaptcha\" data-sitekey=\"6Ld0sFckAAAAAIldyuECBuvlBVMIp1ky6jsdFGrE\"><\/div><input type=\"text\" name=\"g-recaptcha-hidden\" class=\"wpforms-recaptcha-hidden\" style=\"position:absolute!important;clip:rect(0,0,0,0)!important;height:1px!important;width:1px!important;border:0!important;overflow:hidden!important;padding:0!important;margin:0!important;\" required><\/div><div class=\"wpforms-submit-container\"><input type=\"hidden\" name=\"wpforms[id]\" value=\"752\"><input type=\"hidden\" name=\"wpforms[author]\" value=\"1\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-752\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\" aria-live=\"assertive\" value=\"wpforms-submit\">Submit<\/button><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/jommwellness.co.za\/wp-content\/plugins\/wpforms-lite\/assets\/images\/submit-spin.svg\" class=\"wpforms-submit-spinner\" style=\"display: none;\" width=\"26\" height=\"26\" alt=\"Loading\"><\/div><\/form><\/div>  <!-- .wpforms-container -->\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Enquiry Form<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"full-width.php","meta":{"footnotes":""},"class_list":["post-774","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/jommwellness.co.za\/index.php\/wp-json\/wp\/v2\/pages\/774","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jommwellness.co.za\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/jommwellness.co.za\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/jommwellness.co.za\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/jommwellness.co.za\/index.php\/wp-json\/wp\/v2\/comments?post=774"}],"version-history":[{"count":7,"href":"https:\/\/jommwellness.co.za\/index.php\/wp-json\/wp\/v2\/pages\/774\/revisions"}],"predecessor-version":[{"id":784,"href":"https:\/\/jommwellness.co.za\/index.php\/wp-json\/wp\/v2\/pages\/774\/revisions\/784"}],"wp:attachment":[{"href":"https:\/\/jommwellness.co.za\/index.php\/wp-json\/wp\/v2\/media?parent=774"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}