{"id":11483,"date":"2026-04-06T19:04:59","date_gmt":"2026-04-07T01:04:59","guid":{"rendered":"https:\/\/grassfieldrc.org\/?page_id=11483"},"modified":"2026-04-06T19:04:59","modified_gmt":"2026-04-07T01:04:59","slug":"grassfield-incident-form","status":"publish","type":"page","link":"https:\/\/grassfieldrc.org\/?page_id=11483","title":{"rendered":"Grassfield Incident Form"},"content":{"rendered":"<div id=\"bitforms_11_11483_1\" class=\"b11-bit-form bCQ11 bCR11 bDU11 _frm-bg-b11 bit-form bf-form-wrapper\">\n      \n          <form novalidate id=\"form-bitforms_11_11483_1\" class=\"bBt11 bBu11 _frm-b11 bf-form\" enctype=\"multipart\/form-data\" method=\"post\">\n              <input type=\"text\" class=\"d-none\" name=\"csrf\" value=\"dBtzSJO4A7KHdk0BWsxEN84QcZRgdtKIIsA7XjfysKQ=\">\n              <input type=\"text\" class=\"d-none\" name=\"t_identity\" value=\"lJjPjr+kn+5Uhsi+duGIioPwI49v+4j5Io+KrnbKGbs=\">\n              \n              <input type=\"text\" class=\"d-none\" name=\"bitforms_id\" value=\"bitforms_11\">\n                  \n      <div class=\"bBx11 _frm-b11-stp-cntnr _frm-b-stp-cntnr\">\n        <div class=\"_frm-b11-stp-hdr-cntnr _frm-b-stp-hdr-cntnr\">\n        <div class=\"bA11 bH11 bCE11 _frm-b11-stp-hdr-wrpr _frm-b-stp-hdr-wrpr\" role=\"tablist\" aria-label=\"Form steps navigation\">\n      <div class=\"bD11 bf11 bj11 bk11 bl11 bm11 bCB11 bCF11 bCG11 bCH11 bCI11 bCJ11 bCK11 bCL11 bCM11 bDP11 bDQ11 bDR11 bDS11 bDT11 _frm-b11-stp-hdr _frm-b-stp-hdr active \" data-step=\"1\" role=\"tab\" aria-selected=\"true\" aria-controls=\"step-11-1-panel\" id=\"step-11-1-tab\" tabindex=\"0\">\n        <div class=\"bH11 be11 _frm-b11-stp-hdr-cntnt _frm-b-stp-hdr-cntnt\">\n          <div class=\"bA11 bH11 bn11 _frm-b11-stp-hdr-icn-wrp _frm-b-stp-hdr-icn-wrp\">\n          <div class=\"bA11 bG11 bH11 bL11 bf11 bp11 bq11 br11 bs11 bt11 bu11 bv11 bCN11 bCu11 bCv11 _frm-b11-stp-icn-cntn _frm-b-stp-icn-cntn\">\n            <span class=\"_frm-b11-stp-num\">1<\/span>\n          <\/div>\n        <\/div>\n          <span class=\"bH11 be11 bCD11 _frm-b11-stp-hdr-titl-wrpr _frm-b-stp-hdr-titl-wrpr\">\n            <span class=\"bA11 bG11 bH11 bn11 bCC11 _frm-b11-stp-hdr-lbl _frm-b-stp-hdr-lbl\">\n              \n              Page 1\n              \n      <\/span>\n            <span class=\"bA11 bH11 bn11 bo11 _frm-b11-stp-hdr-sub-titl _frm-b-stp-hdr-sub-titl\">\n              \n              of 2\n              \n      <\/span>\n          <\/span>\n        <\/div>\n      <\/div>\n      <div class=\"bD11 bf11 bj11 bk11 bl11 bm11 bCB11 bCF11 bCG11 bCH11 bCI11 bCJ11 bCK11 bCL11 bCM11 bDP11 bDQ11 bDR11 bDS11 bDT11 _frm-b11-stp-hdr _frm-b-stp-hdr  disabled\" data-step=\"2\" role=\"tab\" aria-selected=\"false\" aria-controls=\"step-11-2-panel\" id=\"step-11-2-tab\" tabindex=\"-1\" aria-disabled=\"true\">\n        <div class=\"bH11 be11 _frm-b11-stp-hdr-cntnt _frm-b-stp-hdr-cntnt\">\n          <div class=\"bA11 bH11 bn11 _frm-b11-stp-hdr-icn-wrp _frm-b-stp-hdr-icn-wrp\">\n          <div class=\"bA11 bG11 bH11 bL11 bf11 bp11 bq11 br11 bs11 bt11 bu11 bv11 bCN11 bCu11 bCv11 _frm-b11-stp-icn-cntn _frm-b-stp-icn-cntn\">\n            <span class=\"_frm-b11-stp-num\">2<\/span>\n          <\/div>\n        <\/div>\n          <span class=\"bH11 be11 bCD11 _frm-b11-stp-hdr-titl-wrpr _frm-b-stp-hdr-titl-wrpr\">\n            <span class=\"bA11 bG11 bH11 bn11 bCC11 _frm-b11-stp-hdr-lbl _frm-b-stp-hdr-lbl\">\n              \n              Page 2\n              \n      <\/span>\n            <span class=\"bA11 bH11 bn11 bo11 _frm-b11-stp-hdr-sub-titl _frm-b-stp-hdr-sub-titl\">\n              \n              of 2\n              \n      <\/span>\n          <\/span>\n        <\/div>\n      <\/div>\n      <\/div>\n    <\/div>\n        <div class=\"bz11 bCP11 _frm-b11-stp-wrpr _frm-b-stp-wrpr\">\n        \n    <div class=\"bh11 _frm-b11-stp-progress-wrpr\">\n      <div class=\"_frm-b11-stp-progress\">\n        <div class=\"bH11 bp11 bw11 bCO11 bCu11 _frm-b11-stp-progress-bar\" role=\"progressbar\" aria-label=\"Form completion progress: Step 1 of 2\">\n          <div class=\"bF11 bH11 bL11 be11 bf11 bBv11 bDO11 _frm-b11-progress-fill\" style=\"width: 0%\">\n            0%\n          <\/div>\n        <\/div>\n      <\/div>\n    <\/div>\n          <div class=\"bH11 bg11 _frm-b11-stp-cntnt-wrpr _frm-b-stp-cntnt-wrpr\">\n\n          <div class=\"bH11 be11 bi11 bBy11 bBz11 bCA11 _frm-b11-stp-cntnt _frm-b-stp-cntnt \" data-step=\"1\" role=\"tabpanel\" id=\"step-11-1-panel\" aria-labelledby=\"step-11-1-tab\">\n            <div class=\"_frm-b11 _frm-b\">\n              <div class=\"btcd-fld-itm b11-9 \"><div class=\"bh11 bm11 bAA11 bAF11  b11-9-fld-wrp b11-fld-wrp bf-fld-wrp bf-field-wrapper \">\n        <p style=\"text-align: center\"><strong>Accident\/Incident Reporting Form<\/strong><\/p>\n<p style=\"text-align: center\"><strong>Grassfield RC Model Aircraft Club<\/strong><\/p>\n<p>Accident\/Incident Details<\/p>\n<p>Please complete this form to report any accident or incident related to model aircraft activities at our club. Your report helps us maintain safety and improve our practices. All submissions are non-jeopardy and confidential.<\/p>\n<p>&nbsp;<\/p>\n<p>Reporter information:<\/p>\n      <\/div><\/div><div class=\"btcd-fld-itm b11-2 \"><div class=\"bh11 bm11 bAA11 bAE11  b11-2-fld-wrp b11-fld-wrp bf-fld-wrp bf-field-wrapper \">\n  <div class=\"bi11 bBj11 bBl11  b11-2-lbl-wrp b11-lbl-wrp bf-lbl-wrp bf-label-wrapper \"><label id=\"b11-2-1-lbl\" class=\"bA11 bH11 bi11 bu11 bAt11 bBj11 bBk11 bDC11  b11-2-lbl b11-lbl bf-lbl bf-label \" for=\"b11-2-1\">\n          \n          \n          Name:\n          \n          <span class=\"bBE11 bBF11  b11-2-req-smbl b11-req-smbl bf-req-smbl bf-asterisk-symbol \" aria-hidden=\"true\">*<\/span>\n        <\/label><\/div>\n  <div class=\"b11-2-inp-wrp b11-inp-wrp bf-inp-wrp bf-input-wrapper \">\n    <div class=\"bl11 bm11  b11-2-inp-fld-wrp b11-inp-fld-wrp bf-inp-fld-wrp bf-input-field-wrapper \">\n        <input id=\"b11-2-1\" class=\"bC11 bI11 bJ11 bq11 bs11 bt11 bBJ11 bBK11 bBL11 bBN11 bBO11 bBQ11 bBR11 bBS11 bBU11 bBV11 bBW11 bBX11 bBY11 bBZ11 bBa11 bBb11 bBc11 bBd11 bBe11 bBf11 bBg11 bBh11 bBi11 bBm11 bBn11 bCv11 bDE11 bDF11 bDG11 bDH11 bDI11 bDJ11 bDK11 bDL11 bDM11 bDN11  b11-2-fld b11-fld bf-fld bf-field \" type=\"text\" required aria-required=\"true\" aria-describedby=\"b11-2-err-txt\" autocomplete=\"name\" name=\"text-b11-2\" \/>\n        \n        \n      <\/div>\n      \n    \n    <div class=\"bAB11 bAC11 bAD11  b11-2-err-wrp b11-err-wrp bf-err-wrp bf-error-wrapper\" role=\"alert\" aria-live=\"assertive\" style=\"opacity: 0 !important;height: 0px !important\">\n        <div class=\"bw11  b11-2-err-inner b11-err-inner bf-err-inner bf-error-inner\">\n          \n          \n          <div id=\"b11-2-err-txt\" class=\"bA11 bH11 bo11 bAH11 bAw11 bAx11 bAy11 bAz11 bBA11 bBB11 bBC11 bBD11  b11-2-err-msg b11-err-msg bf-err-msg bf-error-messages-container  bAA11  b11-2-err-txt b11-err-txt bf-err-txt bf-error-text  \" style=\"display: none !important\">\n            \n          <\/div>\n          \n          \n        <\/div>\n      <\/div>\n  <\/div>\n<\/div><\/div><div class=\"btcd-fld-itm b11-28 \"><div class=\"bh11 bm11 bAA11 bAE11  b11-28-fld-wrp b11-fld-wrp bf-fld-wrp bf-field-wrapper \">\n  <div class=\"bi11 bBj11 bBl11  b11-28-lbl-wrp b11-lbl-wrp bf-lbl-wrp bf-label-wrapper \"><label id=\"b11-28-1-lbl\" class=\"bA11 bH11 bi11 bu11 bAt11 bBj11 bBk11 bDC11  b11-28-lbl b11-lbl bf-lbl bf-label \" for=\"b11-28-1\">\n          \n          \n          Contact Information\n          \n          <span class=\"bBE11 bBF11  b11-28-req-smbl b11-req-smbl bf-req-smbl bf-asterisk-symbol \" aria-hidden=\"true\">*<\/span>\n        <\/label><\/div>\n  <div class=\"b11-28-inp-wrp b11-inp-wrp bf-inp-wrp bf-input-wrapper \">\n    <div class=\"bl11 bm11  b11-28-inp-fld-wrp b11-inp-fld-wrp bf-inp-fld-wrp bf-input-field-wrapper \">\n        <input id=\"b11-28-1\" class=\"bC11 bI11 bJ11 bq11 bs11 bt11 bBJ11 bBK11 bBL11 bBN11 bBO11 bBQ11 bBR11 bBS11 bBU11 bBV11 bBW11 bBX11 bBY11 bBZ11 bBa11 bBb11 bBc11 bBd11 bBe11 bBf11 bBg11 bBh11 bBi11 bBm11 bBn11 bCv11 bDE11 bDF11 bDG11 bDH11 bDI11 bDJ11 bDK11 bDL11 bDM11 bDN11  b11-28-fld b11-fld bf-fld bf-field \" type=\"text\" required aria-required=\"true\" aria-describedby=\"b11-28-err-txt\" name=\"text-11-28\" \/>\n        \n        \n      <\/div>\n      \n    \n    <div class=\"bAB11 bAC11 bAD11  b11-28-err-wrp b11-err-wrp bf-err-wrp bf-error-wrapper\" role=\"alert\" aria-live=\"assertive\" style=\"opacity: 0 !important;height: 0px !important\">\n        <div class=\"bw11  b11-28-err-inner b11-err-inner bf-err-inner bf-error-inner\">\n          \n          \n          <div id=\"b11-28-err-txt\" class=\"bA11 bH11 bo11 bAH11 bAw11 bAx11 bAy11 bAz11 bBA11 bBB11 bBC11 bBD11  b11-28-err-msg b11-err-msg bf-err-msg bf-error-messages-container  bAA11  b11-28-err-txt b11-err-txt bf-err-txt bf-error-text  \" style=\"display: none !important\">\n            \n          <\/div>\n          \n          \n        <\/div>\n      <\/div>\n  <\/div>\n<\/div><\/div><div class=\"btcd-fld-itm b11-5 \"><div class=\"bh11 bm11 bAA11 bAE11  b11-5-fld-wrp b11-fld-wrp bf-fld-wrp bf-field-wrapper \">\n  <div class=\"bi11 bBj11 bBl11  b11-5-lbl-wrp b11-lbl-wrp bf-lbl-wrp bf-label-wrapper \"><label id=\"b11-5-1-lbl\" class=\"bA11 bH11 bi11 bu11 bAt11 bBj11 bBk11 bDC11  b11-5-lbl b11-lbl bf-lbl bf-label \" for=\"b11-5-1\">\n          \n          \n          Email\n          \n          <span class=\"bBE11 bBF11  b11-5-req-smbl b11-req-smbl bf-req-smbl bf-asterisk-symbol \" aria-hidden=\"true\">*<\/span>\n        <\/label><\/div>\n  <div class=\"b11-5-inp-wrp b11-inp-wrp bf-inp-wrp bf-input-wrapper \">\n    <div class=\"bl11 bm11  b11-5-inp-fld-wrp b11-inp-fld-wrp bf-inp-fld-wrp bf-input-field-wrapper \">\n        <input id=\"b11-5-1\" class=\"bC11 bI11 bJ11 bq11 bs11 bt11 bBJ11 bBK11 bBL11 bBN11 bBO11 bBQ11 bBR11 bBS11 bBU11 bBV11 bBW11 bBX11 bBY11 bBZ11 bBa11 bBb11 bBc11 bBd11 bBe11 bBf11 bBg11 bBh11 bBi11 bBm11 bBn11 bCv11 bDE11 bDF11 bDG11 bDH11 bDI11 bDJ11 bDK11 bDL11 bDM11 bDN11  b11-5-fld b11-fld bf-fld bf-field \" type=\"email\" required aria-required=\"true\" aria-describedby=\"b11-5-err-txt\" placeholder=\"example@mail.com\" autocomplete=\"email\" name=\"email-b11-5\" \/>\n        \n        \n      <\/div>\n      \n    \n    <div class=\"bAB11 bAC11 bAD11  b11-5-err-wrp b11-err-wrp bf-err-wrp bf-error-wrapper\" role=\"alert\" aria-live=\"assertive\" style=\"opacity: 0 !important;height: 0px !important\">\n        <div class=\"bw11  b11-5-err-inner b11-err-inner bf-err-inner bf-error-inner\">\n          \n          \n          <div id=\"b11-5-err-txt\" class=\"bA11 bH11 bo11 bAH11 bAw11 bAx11 bAy11 bAz11 bBA11 bBB11 bBC11 bBD11  b11-5-err-msg b11-err-msg bf-err-msg bf-error-messages-container  bAA11  b11-5-err-txt b11-err-txt bf-err-txt bf-error-text  \" style=\"display: none !important\">\n            \n          <\/div>\n          \n          \n        <\/div>\n      <\/div>\n  <\/div>\n<\/div><\/div><div class=\"btcd-fld-itm b11-6 \"><div class=\"bh11 bm11 bAA11 bAE11  b11-6-fld-wrp b11-fld-wrp bf-fld-wrp bf-field-wrapper \">\n  <div class=\"bi11 bBj11 bBl11  b11-6-lbl-wrp b11-lbl-wrp bf-lbl-wrp bf-label-wrapper \"><label id=\"b11-6-1-lbl\" class=\"bA11 bH11 bi11 bu11 bAt11 bBj11 bBk11 bDC11  b11-6-lbl b11-lbl bf-lbl bf-label \" for=\"b11-6-1\">\n          \n          \n          Date\n          \n          <span class=\"bBE11 bBF11  b11-6-req-smbl b11-req-smbl bf-req-smbl bf-asterisk-symbol \" aria-hidden=\"true\">*<\/span>\n        <\/label><\/div>\n  <div class=\"b11-6-inp-wrp b11-inp-wrp bf-inp-wrp bf-input-wrapper \">\n    <div class=\"bl11 bm11  b11-6-inp-fld-wrp b11-inp-fld-wrp bf-inp-fld-wrp bf-input-field-wrapper \">\n        <input id=\"b11-6-1\" class=\"bC11 bI11 bJ11 bq11 bs11 bt11 bBJ11 bBK11 bBL11 bBN11 bBO11 bBQ11 bBR11 bBS11 bBU11 bBV11 bBW11 bBX11 bBY11 bBZ11 bBa11 bBb11 bBc11 bBd11 bBe11 bBf11 bBg11 bBh11 bBi11 bBm11 bBn11 bCv11 bDE11 bDF11 bDG11 bDH11 bDI11 bDJ11 bDK11 bDL11 bDM11 bDN11  b11-6-fld b11-fld bf-fld bf-field \" type=\"date\" required aria-required=\"true\" aria-describedby=\"b11-6-err-txt\" name=\"date-9-6\" data-bf-show-picker=\"1\" \/>\n        \n        \n      <\/div>\n      \n    \n    <div class=\"bAB11 bAC11 bAD11  b11-6-err-wrp b11-err-wrp bf-err-wrp bf-error-wrapper\" role=\"alert\" aria-live=\"assertive\" style=\"opacity: 0 !important;height: 0px !important\">\n        <div class=\"bw11  b11-6-err-inner b11-err-inner bf-err-inner bf-error-inner\">\n          \n          \n          <div id=\"b11-6-err-txt\" class=\"bA11 bH11 bo11 bAH11 bAw11 bAx11 bAy11 bAz11 bBA11 bBB11 bBC11 bBD11  b11-6-err-msg b11-err-msg bf-err-msg bf-error-messages-container  bAA11  b11-6-err-txt b11-err-txt bf-err-txt bf-error-text  \" style=\"display: none !important\">\n            \n          <\/div>\n          \n          \n        <\/div>\n      <\/div>\n  <\/div>\n<\/div><\/div><div class=\"btcd-fld-itm b11-7 \"><div class=\"bh11 bm11 bAA11 bAE11  b11-7-fld-wrp b11-fld-wrp bf-fld-wrp bf-field-wrapper \">\n  <div class=\"bi11 bBj11 bBl11  b11-7-lbl-wrp b11-lbl-wrp bf-lbl-wrp bf-label-wrapper \"><label id=\"b11-7-1-lbl\" class=\"bA11 bH11 bi11 bu11 bAt11 bBj11 bBk11 bDC11  b11-7-lbl b11-lbl bf-lbl bf-label \" for=\"b11-7-1\">\n          \n          \n          Time:\n          \n          <span class=\"bBE11 bBF11  b11-7-req-smbl b11-req-smbl bf-req-smbl bf-asterisk-symbol \" aria-hidden=\"true\">*<\/span>\n        <\/label><\/div>\n  <div class=\"b11-7-inp-wrp b11-inp-wrp bf-inp-wrp bf-input-wrapper \">\n    <div class=\"bl11 bm11  b11-7-inp-fld-wrp b11-inp-fld-wrp bf-inp-fld-wrp bf-input-field-wrapper \">\n        <input id=\"b11-7-1\" class=\"bC11 bI11 bJ11 bq11 bs11 bt11 bBJ11 bBK11 bBL11 bBN11 bBO11 bBQ11 bBR11 bBS11 bBU11 bBV11 bBW11 bBX11 bBY11 bBZ11 bBa11 bBb11 bBc11 bBd11 bBe11 bBf11 bBg11 bBh11 bBi11 bBm11 bBn11 bCv11 bDE11 bDF11 bDG11 bDH11 bDI11 bDJ11 bDK11 bDL11 bDM11 bDN11  b11-7-fld b11-fld bf-fld bf-field \" type=\"time\" required aria-required=\"true\" aria-describedby=\"b11-7-err-txt\" name=\"time-9-7\" data-bf-show-picker=\"1\" \/>\n        \n        \n      <\/div>\n      \n    \n    <div class=\"bAB11 bAC11 bAD11  b11-7-err-wrp b11-err-wrp bf-err-wrp bf-error-wrapper\" role=\"alert\" aria-live=\"assertive\" style=\"opacity: 0 !important;height: 0px !important\">\n        <div class=\"bw11  b11-7-err-inner b11-err-inner bf-err-inner bf-error-inner\">\n          \n          \n          <div id=\"b11-7-err-txt\" class=\"bA11 bH11 bo11 bAH11 bAw11 bAx11 bAy11 bAz11 bBA11 bBB11 bBC11 bBD11  b11-7-err-msg b11-err-msg bf-err-msg bf-error-messages-container  bAA11  b11-7-err-txt b11-err-txt bf-err-txt bf-error-text  \" style=\"display: none !important\">\n            \n          <\/div>\n          \n          \n        <\/div>\n      <\/div>\n  <\/div>\n<\/div><\/div><div class=\"btcd-fld-itm b11-30 \"><div class=\"bh11 bm11 bAA11 bAE11  b11-30-fld-wrp b11-fld-wrp bf-fld-wrp bf-field-wrapper \">\n  <div class=\"bi11 bBj11 bBl11  b11-30-lbl-wrp b11-lbl-wrp bf-lbl-wrp bf-label-wrapper \"><label id=\"b11-30-1-lbl\" class=\"bA11 bH11 bi11 bu11 bAt11 bBj11 bBk11 bDC11  b11-30-lbl b11-lbl bf-lbl bf-label \" for=\"b11-30-1\">\n          \n          \n          AMA#\n          \n          <span class=\"bBE11 bBF11  b11-30-req-smbl b11-req-smbl bf-req-smbl bf-asterisk-symbol \" aria-hidden=\"true\">*<\/span>\n        <\/label><\/div>\n  <div class=\"b11-30-inp-wrp b11-inp-wrp bf-inp-wrp bf-input-wrapper \">\n    <div class=\"bl11 bm11  b11-30-inp-fld-wrp b11-inp-fld-wrp bf-inp-fld-wrp bf-input-field-wrapper \">\n        <input id=\"b11-30-1\" class=\"bC11 bI11 bJ11 bq11 bs11 bt11 bBJ11 bBK11 bBL11 bBN11 bBO11 bBQ11 bBR11 bBS11 bBU11 bBV11 bBW11 bBX11 bBY11 bBZ11 bBa11 bBb11 bBc11 bBd11 bBe11 bBf11 bBg11 bBh11 bBi11 bBm11 bBn11 bCv11 bDE11 bDF11 bDG11 bDH11 bDI11 bDJ11 bDK11 bDL11 bDM11 bDN11  b11-30-fld b11-fld bf-fld bf-field \" type=\"text\" required aria-required=\"true\" aria-describedby=\"b11-30-err-txt\" name=\"text-11-30\" \/>\n        \n        \n      <\/div>\n      \n    \n    <div class=\"bAB11 bAC11 bAD11  b11-30-err-wrp b11-err-wrp bf-err-wrp bf-error-wrapper\" role=\"alert\" aria-live=\"assertive\" style=\"opacity: 0 !important;height: 0px !important\">\n        <div class=\"bw11  b11-30-err-inner b11-err-inner bf-err-inner bf-error-inner\">\n          \n          \n          <div id=\"b11-30-err-txt\" class=\"bA11 bH11 bo11 bAH11 bAw11 bAx11 bAy11 bAz11 bBA11 bBB11 bBC11 bBD11  b11-30-err-msg b11-err-msg bf-err-msg bf-error-messages-container  bAA11  b11-30-err-txt b11-err-txt bf-err-txt bf-error-text  \" style=\"display: none !important\">\n            \n          <\/div>\n          \n          \n        <\/div>\n      <\/div>\n  <\/div>\n<\/div><\/div><div class=\"btcd-fld-itm b11-10 \"><div class=\"bh11 bm11 bAA11 bAF11  b11-10-fld-wrp b11-fld-wrp bf-fld-wrp bf-field-wrapper \">\n        <p>Type of Incident<\/p>\n      <\/div><\/div><div class=\"btcd-fld-itm b11-11 \"><div class=\"bh11 bm11 bAA11 bAE11  b11-11-fld-wrp b11-fld-wrp bf-fld-wrp bf-field-wrapper \">\n  <div class=\"b11-11-lbl-wrp b11-lbl-wrp bf-lbl-wrp bf-label-wrapper \"><label id=\"b11-11-1-lbl\" class=\"b11-11-lbl b11-lbl bf-lbl bf-label \" for=\"b11-11-1\">\n          \n          \n          Check all incident types that apply\n          \n          <span class=\"bBE11 bBF11  b11-11-req-smbl b11-req-smbl bf-req-smbl bf-asterisk-symbol \" aria-hidden=\"true\">*<\/span>\n        <\/label><\/div>\n  <div class=\"b11-11-inp-wrp b11-inp-wrp bf-inp-wrp bf-input-wrapper \">\n    <div class=\"bi11 bAB11 bAP11 bAQ11 bAR11  b11-11-cc b11-cc bf-cc bf-cc \" role=\"group\" aria-labelledby=\"b11-11-1-lbl\" aria-describedby=\"b11-11-err-txt\" aria-required=\"true\">\n        <svg class=\"bAT11 bAp11 bAq11 bAr11 bAs11  b11-11-cks b11-cks bf-cks bf-cks\" aria-hidden=\"true\">\n          <symbol id=\"b11-11-ck-svg\" viewbox=\"0 0 12 10\">\n            <polyline class=\"bAj11 bAk11 bAl11 bAm11 bAn11 bAo11  b11-11-ck-svgline b11-ck-svgline bf-ck-svgline bf-ck-svgline\" points=\"1.5 6 4.5 9 10.5 1\"><\/polyline>\n          <\/symbol>\n        <\/svg>\n        \n        <div class=\"b11-11-cw b11-cw bf-cw bf-cw \">\n          <input id=\"b11-11-1-chk-0\" type=\"checkbox\" class=\"bAS11 bAT11 bAU11 bAV11 bAW11 bAX11 bAY11 bAZ11 bAa11 bAb11 bAc11 bAd11 bAe11 bAf11 bAg11 bAh11 bCx11 bCy11 bCz11 bDA11 bDB11  b11-11-ci b11-ci bf-ci bf-ci \" value=\"Crash outside FRIAA boundary (Mandatory Report)\" name=\"check-9-11[]\" \/>\n          <label data-cl for=\"b11-11-1-chk-0\" class=\"bA11 bG11 bH11 bv11 bAt11 bDC11  b11-11-cl b11-cl bf-cl bf-cl \">\n            <span data-bx class=\"bA11 bL11 bm11 bz11 bAG11 bAH11 bAI11 bAJ11 bAK11 bAL11 bAM11 bAN11 bAO11 bCw11  b11-11-bx b11-bx bf-bx bf-box \">\n              <svg width=\"12\" height=\"10\" viewbox=\"0 0 12 10\" class=\"bBG11 bBH11 bBI11 bDD11  b11-11-svgwrp b11-svgwrp bf-svgwrp bf-svgwrp \" aria-hidden=\"true\">\n                <use data-ck-icn href=\"#b11-11-ck-svg\" class=\"bAi11  b11-11-ck-icn b11-ck-icn bf-ck-icn bf-ck-icon \" \/>\n              <\/svg>\n            <\/span>\n            <span class=\"bu11 bAu11 bAv11  b11-11-ct b11-ct bf-ct bf-ct \">\n              Crash outside FRIAA boundary (Mandatory Report)\n            <\/span>\n          <\/label>\n        <\/div>\n        <div class=\"b11-11-cw b11-cw bf-cw bf-cw \">\n          <input id=\"b11-11-1-chk-1\" type=\"checkbox\" class=\"bAS11 bAT11 bAU11 bAV11 bAW11 bAX11 bAY11 bAZ11 bAa11 bAb11 bAc11 bAd11 bAe11 bAf11 bAg11 bAh11 bCx11 bCy11 bCz11 bDA11 bDB11  b11-11-ci b11-ci bf-ci bf-ci \" value=\"Personal Injury (Mandatory Report)\" name=\"check-9-11[]\" \/>\n          <label data-cl for=\"b11-11-1-chk-1\" class=\"bA11 bG11 bH11 bv11 bAt11 bDC11  b11-11-cl b11-cl bf-cl bf-cl \">\n            <span data-bx class=\"bA11 bL11 bm11 bz11 bAG11 bAH11 bAI11 bAJ11 bAK11 bAL11 bAM11 bAN11 bAO11 bCw11  b11-11-bx b11-bx bf-bx bf-box \">\n              <svg width=\"12\" height=\"10\" viewbox=\"0 0 12 10\" class=\"bBG11 bBH11 bBI11 bDD11  b11-11-svgwrp b11-svgwrp bf-svgwrp bf-svgwrp \" aria-hidden=\"true\">\n                <use data-ck-icn href=\"#b11-11-ck-svg\" class=\"bAi11  b11-11-ck-icn b11-ck-icn bf-ck-icn bf-ck-icon \" \/>\n              <\/svg>\n            <\/span>\n            <span class=\"bu11 bAu11 bAv11  b11-11-ct b11-ct bf-ct bf-ct \">\n              Personal Injury (Mandatory Report)\n            <\/span>\n          <\/label>\n        <\/div>\n        <div class=\"b11-11-cw b11-cw bf-cw bf-cw \">\n          <input id=\"b11-11-1-chk-2\" type=\"checkbox\" class=\"bAS11 bAT11 bAU11 bAV11 bAW11 bAX11 bAY11 bAZ11 bAa11 bAb11 bAc11 bAd11 bAe11 bAf11 bAg11 bAh11 bCx11 bCy11 bCz11 bDA11 bDB11  b11-11-ci b11-ci bf-ci bf-ci \" value=\"Property Damage (Mandatory Report - photo documentation required\" name=\"check-9-11[]\" \/>\n          <label data-cl for=\"b11-11-1-chk-2\" class=\"bA11 bG11 bH11 bv11 bAt11 bDC11  b11-11-cl b11-cl bf-cl bf-cl \">\n            <span data-bx class=\"bA11 bL11 bm11 bz11 bAG11 bAH11 bAI11 bAJ11 bAK11 bAL11 bAM11 bAN11 bAO11 bCw11  b11-11-bx b11-bx bf-bx bf-box \">\n              <svg width=\"12\" height=\"10\" viewbox=\"0 0 12 10\" class=\"bBG11 bBH11 bBI11 bDD11  b11-11-svgwrp b11-svgwrp bf-svgwrp bf-svgwrp \" aria-hidden=\"true\">\n                <use data-ck-icn href=\"#b11-11-ck-svg\" class=\"bAi11  b11-11-ck-icn b11-ck-icn bf-ck-icn bf-ck-icon \" \/>\n              <\/svg>\n            <\/span>\n            <span class=\"bu11 bAu11 bAv11  b11-11-ct b11-ct bf-ct bf-ct \">\n              Property Damage (Mandatory Report - photo documentation required\n            <\/span>\n          <\/label>\n        <\/div>\n        <div class=\"b11-11-cw b11-cw bf-cw bf-cw \">\n          <input id=\"b11-11-1-chk-3\" type=\"checkbox\" class=\"bAS11 bAT11 bAU11 bAV11 bAW11 bAX11 bAY11 bAZ11 bAa11 bAb11 bAc11 bAd11 bAe11 bAf11 bAg11 bAh11 bCx11 bCy11 bCz11 bDA11 bDB11  b11-11-ci b11-ci bf-ci bf-ci \" value=\"Crash behind Flight Line (Larger aircraft over 35cc &amp; electric of equivalent size)\" name=\"check-9-11[]\" \/>\n          <label data-cl for=\"b11-11-1-chk-3\" class=\"bA11 bG11 bH11 bv11 bAt11 bDC11  b11-11-cl b11-cl bf-cl bf-cl \">\n            <span data-bx class=\"bA11 bL11 bm11 bz11 bAG11 bAH11 bAI11 bAJ11 bAK11 bAL11 bAM11 bAN11 bAO11 bCw11  b11-11-bx b11-bx bf-bx bf-box \">\n              <svg width=\"12\" height=\"10\" viewbox=\"0 0 12 10\" class=\"bBG11 bBH11 bBI11 bDD11  b11-11-svgwrp b11-svgwrp bf-svgwrp bf-svgwrp \" aria-hidden=\"true\">\n                <use data-ck-icn href=\"#b11-11-ck-svg\" class=\"bAi11  b11-11-ck-icn b11-ck-icn bf-ck-icn bf-ck-icon \" \/>\n              <\/svg>\n            <\/span>\n            <span class=\"bu11 bAu11 bAv11  b11-11-ct b11-ct bf-ct bf-ct \">\n              Crash behind Flight Line (Larger aircraft over 35cc &amp; electric of equivalent size)\n            <\/span>\n          <\/label>\n        <\/div>\n        <div class=\"b11-11-cw b11-cw bf-cw bf-cw \">\n          <input id=\"b11-11-1-chk-4\" type=\"checkbox\" class=\"bAS11 bAT11 bAU11 bAV11 bAW11 bAX11 bAY11 bAZ11 bAa11 bAb11 bAc11 bAd11 bAe11 bAf11 bAg11 bAh11 bCx11 bCy11 bCz11 bDA11 bDB11  b11-11-ci b11-ci bf-ci bf-ci \" value=\"Other (please specify):\" name=\"check-9-11[]\" \/>\n          <label data-cl for=\"b11-11-1-chk-4\" class=\"bA11 bG11 bH11 bv11 bAt11 bDC11  b11-11-cl b11-cl bf-cl bf-cl \">\n            <span data-bx class=\"bA11 bL11 bm11 bz11 bAG11 bAH11 bAI11 bAJ11 bAK11 bAL11 bAM11 bAN11 bAO11 bCw11  b11-11-bx b11-bx bf-bx bf-box \">\n              <svg width=\"12\" height=\"10\" viewbox=\"0 0 12 10\" class=\"bBG11 bBH11 bBI11 bDD11  b11-11-svgwrp b11-svgwrp bf-svgwrp bf-svgwrp \" aria-hidden=\"true\">\n                <use data-ck-icn href=\"#b11-11-ck-svg\" class=\"bAi11  b11-11-ck-icn b11-ck-icn bf-ck-icn bf-ck-icon \" \/>\n              <\/svg>\n            <\/span>\n            <span class=\"bu11 bAu11 bAv11  b11-11-ct b11-ct bf-ct bf-ct \">\n              Other (please specify):\n            <\/span>\n          <\/label>\n        <\/div>\n      <\/div>\n    \n    <div class=\"bAB11 bAC11 bAD11  b11-11-err-wrp b11-err-wrp bf-err-wrp bf-error-wrapper\" role=\"alert\" aria-live=\"assertive\" style=\"opacity: 0 !important;height: 0px !important\">\n        <div class=\"bw11  b11-11-err-inner b11-err-inner bf-err-inner bf-error-inner\">\n          \n          \n          <div id=\"b11-11-err-txt\" class=\"bA11 bH11 bo11 bAH11 bAw11 bAx11 bAy11 bAz11 bBA11 bBB11 bBC11 bBD11  b11-11-err-msg b11-err-msg bf-err-msg bf-error-messages-container  bAA11  b11-11-err-txt b11-err-txt bf-err-txt bf-error-text  \" style=\"display: none !important\">\n            \n          <\/div>\n          \n          \n        <\/div>\n      <\/div>\n  <\/div>\n<\/div><\/div><div class=\"btcd-fld-itm b11-3 \"><div class=\"bh11 bm11 bAA11 bAE11  b11-3-fld-wrp b11-fld-wrp bf-fld-wrp bf-field-wrapper \">\n  <div class=\"bi11 bBj11 bBl11  b11-3-lbl-wrp b11-lbl-wrp bf-lbl-wrp bf-label-wrapper \"><label id=\"b11-3-1-lbl\" class=\"bA11 bH11 bi11 bu11 bAt11 bBj11 bBk11 bDC11  b11-3-lbl b11-lbl bf-lbl bf-label \" for=\"b11-3-1\">\n          \n          \n          Other:\n          \n          \n        <\/label><\/div>\n  <div class=\"b11-3-inp-wrp b11-inp-wrp bf-inp-wrp bf-input-wrapper \">\n    <div class=\"bl11 bm11  b11-3-inp-fld-wrp b11-inp-fld-wrp bf-inp-fld-wrp bf-input-field-wrapper \">\n      <textarea id=\"b11-3-1\" class=\"bC11 bI11 bJ11 bq11 bs11 bt11 bBJ11 bBK11 bBL11 bBM11 bBN11 bBO11 bBP11 bBQ11 bBR11 bBS11 bBT11 bBU11 bBV11 bBW11 bBX11 bBY11 bBZ11 bBa11 bBb11 bBc11 bBd11 bBe11 bBf11 bBg11 bBh11 bBi11 bCv11 bDE11 bDF11 bDG11 bDH11 bDI11 bDJ11 bDK11 bDL11 bDM11 bDN11  b11-3-fld b11-fld bf-fld bf-field \" aria-describedby=\"b11-3-err-txt\" placeholder=\"Type of incident..\" name=\"textarea-b11-3\"><\/textarea>\n      \n      \n    <\/div>\n    \n    <div class=\"bAB11 bAC11 bAD11  b11-3-err-wrp b11-err-wrp bf-err-wrp bf-error-wrapper\" role=\"alert\" aria-live=\"assertive\" style=\"opacity: 0 !important;height: 0px !important\">\n        <div class=\"bw11  b11-3-err-inner b11-err-inner bf-err-inner bf-error-inner\">\n          \n          \n          <div id=\"b11-3-err-txt\" class=\"bA11 bH11 bo11 bAH11 bAw11 bAx11 bAy11 bAz11 bBA11 bBB11 bBC11 bBD11  b11-3-err-msg b11-err-msg bf-err-msg bf-error-messages-container  bAA11  b11-3-err-txt b11-err-txt bf-err-txt bf-error-text  \" style=\"display: none !important\">\n            \n          <\/div>\n          \n          \n        <\/div>\n      <\/div>\n  <\/div>\n<\/div><\/div><div class=\"btcd-fld-itm b11-12 \"><div class=\"bh11 bm11 bAA11 bAF11  b11-12-fld-wrp b11-fld-wrp bf-fld-wrp bf-field-wrapper \">\n        <p>Brief Description of Accident\/Incident<\/p>\n<p>Please describe what happened, including location and circumstances:<\/p>\n      <\/div><\/div><div class=\"btcd-fld-itm b11-13 \"><div class=\"bh11 bm11 bAA11 bAE11  b11-13-fld-wrp b11-fld-wrp bf-fld-wrp bf-field-wrapper \">\n  <div class=\"bi11 bBj11 bBl11  b11-13-lbl-wrp b11-lbl-wrp bf-lbl-wrp bf-label-wrapper \"><label id=\"b11-13-1-lbl\" class=\"bA11 bH11 bi11 bu11 bAt11 bBj11 bBk11 bDC11  b11-13-lbl b11-lbl bf-lbl bf-label \" for=\"b11-13-1\">\n          \n          \n          Brief Description\n          \n          <span class=\"bBE11 bBF11  b11-13-req-smbl b11-req-smbl bf-req-smbl bf-asterisk-symbol \" aria-hidden=\"true\">*<\/span>\n        <\/label><\/div>\n  <div class=\"b11-13-inp-wrp b11-inp-wrp bf-inp-wrp bf-input-wrapper \">\n    <div class=\"bl11 bm11  b11-13-inp-fld-wrp b11-inp-fld-wrp bf-inp-fld-wrp bf-input-field-wrapper \">\n      <textarea id=\"b11-13-1\" class=\"bC11 bI11 bJ11 bq11 bs11 bt11 bBJ11 bBK11 bBL11 bBM11 bBN11 bBO11 bBP11 bBQ11 bBR11 bBS11 bBT11 bBU11 bBV11 bBW11 bBX11 bBY11 bBZ11 bBa11 bBb11 bBc11 bBd11 bBe11 bBf11 bBg11 bBh11 bBi11 bCv11 bDE11 bDF11 bDG11 bDH11 bDI11 bDJ11 bDK11 bDL11 bDM11 bDN11  b11-13-fld b11-fld bf-fld bf-field \" required aria-required=\"true\" aria-describedby=\"b11-13-err-txt\" placeholder=\"Please describe what happened\" name=\"textarea-9-13\"><\/textarea>\n      \n      \n    <\/div>\n    \n    <div class=\"bAB11 bAC11 bAD11  b11-13-err-wrp b11-err-wrp bf-err-wrp bf-error-wrapper\" role=\"alert\" aria-live=\"assertive\" style=\"opacity: 0 !important;height: 0px !important\">\n        <div class=\"bw11  b11-13-err-inner b11-err-inner bf-err-inner bf-error-inner\">\n          \n          \n          <div id=\"b11-13-err-txt\" class=\"bA11 bH11 bo11 bAH11 bAw11 bAx11 bAy11 bAz11 bBA11 bBB11 bBC11 bBD11  b11-13-err-msg b11-err-msg bf-err-msg bf-error-messages-container  bAA11  b11-13-err-txt b11-err-txt bf-err-txt bf-error-text  \" style=\"display: none !important\">\n            \n          <\/div>\n          \n          \n        <\/div>\n      <\/div>\n  <\/div>\n<\/div><\/div><div class=\"btcd-fld-itm b11-14 \"><div class=\"bh11 bm11 bAA11 bAF11  b11-14-fld-wrp b11-fld-wrp bf-fld-wrp bf-field-wrapper \">\n        <p>Contributing Factors<\/p>\n      <\/div><\/div><div class=\"btcd-fld-itm b11-15 \"><div class=\"bh11 bm11 bAA11 bAE11  b11-15-fld-wrp b11-fld-wrp bf-fld-wrp bf-field-wrapper \">\n  <div class=\"bi11 bBj11 bBl11  b11-15-lbl-wrp b11-lbl-wrp bf-lbl-wrp bf-label-wrapper \"><label id=\"b11-15-1-lbl\" class=\"bA11 bH11 bi11 bu11 bAt11 bBj11 bBk11 bDC11  b11-15-lbl b11-lbl bf-lbl bf-label \" for=\"b11-15-1\">\n          \n          \n          Check all contributing factors that apply*\n          \n          <span class=\"bBE11 bBF11  b11-15-req-smbl b11-req-smbl bf-req-smbl bf-asterisk-symbol \" aria-hidden=\"true\">*<\/span>\n        <\/label><\/div>\n  <div class=\"b11-15-inp-wrp b11-inp-wrp bf-inp-wrp bf-input-wrapper \">\n    <div class=\"bi11 bAB11 bAP11 bAQ11 bAR11  b11-15-cc b11-cc bf-cc bf-cc \" role=\"group\" aria-labelledby=\"b11-15-1-lbl\" aria-describedby=\"b11-15-err-txt\" aria-required=\"true\">\n        <svg class=\"bAT11 bAp11 bAq11 bAr11 bAs11  b11-15-cks b11-cks bf-cks bf-cks\" aria-hidden=\"true\">\n          <symbol id=\"b11-15-ck-svg\" viewbox=\"0 0 12 10\">\n            <polyline class=\"bAj11 bAk11 bAl11 bAm11 bAn11 bAo11  b11-15-ck-svgline b11-ck-svgline bf-ck-svgline bf-ck-svgline\" points=\"1.5 6 4.5 9 10.5 1\"><\/polyline>\n          <\/symbol>\n        <\/svg>\n        \n        <div class=\"b11-15-cw b11-cw bf-cw bf-cw \">\n          <input id=\"b11-15-1-chk-0\" type=\"checkbox\" class=\"bAS11 bAT11 bAU11 bAV11 bAW11 bAX11 bAY11 bAZ11 bAa11 bAb11 bAc11 bAd11 bAe11 bAf11 bAg11 bAh11 bCx11 bCy11 bCz11 bDA11 bDB11  b11-15-ci b11-ci bf-ci bf-ci \" value=\"Radio failure\" name=\"check-9-15[]\" \/>\n          <label data-cl for=\"b11-15-1-chk-0\" class=\"bA11 bG11 bH11 bv11 bAt11 bDC11  b11-15-cl b11-cl bf-cl bf-cl \">\n            <span data-bx class=\"bA11 bL11 bm11 bz11 bAG11 bAH11 bAI11 bAJ11 bAK11 bAL11 bAM11 bAN11 bAO11 bCw11  b11-15-bx b11-bx bf-bx bf-box \">\n              <svg width=\"12\" height=\"10\" viewbox=\"0 0 12 10\" class=\"bBG11 bBH11 bBI11 bDD11  b11-15-svgwrp b11-svgwrp bf-svgwrp bf-svgwrp \" aria-hidden=\"true\">\n                <use data-ck-icn href=\"#b11-15-ck-svg\" class=\"bAi11  b11-15-ck-icn b11-ck-icn bf-ck-icn bf-ck-icon \" \/>\n              <\/svg>\n            <\/span>\n            <span class=\"bu11 bAu11 bAv11  b11-15-ct b11-ct bf-ct bf-ct \">\n              Radio failure\n            <\/span>\n          <\/label>\n        <\/div>\n        <div class=\"b11-15-cw b11-cw bf-cw bf-cw \">\n          <input id=\"b11-15-1-chk-1\" type=\"checkbox\" class=\"bAS11 bAT11 bAU11 bAV11 bAW11 bAX11 bAY11 bAZ11 bAa11 bAb11 bAc11 bAd11 bAe11 bAf11 bAg11 bAh11 bCx11 bCy11 bCz11 bDA11 bDB11  b11-15-ci b11-ci bf-ci bf-ci \" value=\"Engine failure\" name=\"check-9-15[]\" \/>\n          <label data-cl for=\"b11-15-1-chk-1\" class=\"bA11 bG11 bH11 bv11 bAt11 bDC11  b11-15-cl b11-cl bf-cl bf-cl \">\n            <span data-bx class=\"bA11 bL11 bm11 bz11 bAG11 bAH11 bAI11 bAJ11 bAK11 bAL11 bAM11 bAN11 bAO11 bCw11  b11-15-bx b11-bx bf-bx bf-box \">\n              <svg width=\"12\" height=\"10\" viewbox=\"0 0 12 10\" class=\"bBG11 bBH11 bBI11 bDD11  b11-15-svgwrp b11-svgwrp bf-svgwrp bf-svgwrp \" aria-hidden=\"true\">\n                <use data-ck-icn href=\"#b11-15-ck-svg\" class=\"bAi11  b11-15-ck-icn b11-ck-icn bf-ck-icn bf-ck-icon \" \/>\n              <\/svg>\n            <\/span>\n            <span class=\"bu11 bAu11 bAv11  b11-15-ct b11-ct bf-ct bf-ct \">\n              Engine failure\n            <\/span>\n          <\/label>\n        <\/div>\n        <div class=\"b11-15-cw b11-cw bf-cw bf-cw \">\n          <input id=\"b11-15-1-chk-2\" type=\"checkbox\" class=\"bAS11 bAT11 bAU11 bAV11 bAW11 bAX11 bAY11 bAZ11 bAa11 bAb11 bAc11 bAd11 bAe11 bAf11 bAg11 bAh11 bCx11 bCy11 bCz11 bDA11 bDB11  b11-15-ci b11-ci bf-ci bf-ci \" value=\"Pilot error\/Loss of orientation\" name=\"check-9-15[]\" \/>\n          <label data-cl for=\"b11-15-1-chk-2\" class=\"bA11 bG11 bH11 bv11 bAt11 bDC11  b11-15-cl b11-cl bf-cl bf-cl \">\n            <span data-bx class=\"bA11 bL11 bm11 bz11 bAG11 bAH11 bAI11 bAJ11 bAK11 bAL11 bAM11 bAN11 bAO11 bCw11  b11-15-bx b11-bx bf-bx bf-box \">\n              <svg width=\"12\" height=\"10\" viewbox=\"0 0 12 10\" class=\"bBG11 bBH11 bBI11 bDD11  b11-15-svgwrp b11-svgwrp bf-svgwrp bf-svgwrp \" aria-hidden=\"true\">\n                <use data-ck-icn href=\"#b11-15-ck-svg\" class=\"bAi11  b11-15-ck-icn b11-ck-icn bf-ck-icn bf-ck-icon \" \/>\n              <\/svg>\n            <\/span>\n            <span class=\"bu11 bAu11 bAv11  b11-15-ct b11-ct bf-ct bf-ct \">\n              Pilot error\/Loss of orientation\n            <\/span>\n          <\/label>\n        <\/div>\n        <div class=\"b11-15-cw b11-cw bf-cw bf-cw \">\n          <input id=\"b11-15-1-chk-3\" type=\"checkbox\" class=\"bAS11 bAT11 bAU11 bAV11 bAW11 bAX11 bAY11 bAZ11 bAa11 bAb11 bAc11 bAd11 bAe11 bAf11 bAg11 bAh11 bCx11 bCy11 bCz11 bDA11 bDB11  b11-15-ci b11-ci bf-ci bf-ci \" value=\"Mechanical\" name=\"check-9-15[]\" \/>\n          <label data-cl for=\"b11-15-1-chk-3\" class=\"bA11 bG11 bH11 bv11 bAt11 bDC11  b11-15-cl b11-cl bf-cl bf-cl \">\n            <span data-bx class=\"bA11 bL11 bm11 bz11 bAG11 bAH11 bAI11 bAJ11 bAK11 bAL11 bAM11 bAN11 bAO11 bCw11  b11-15-bx b11-bx bf-bx bf-box \">\n              <svg width=\"12\" height=\"10\" viewbox=\"0 0 12 10\" class=\"bBG11 bBH11 bBI11 bDD11  b11-15-svgwrp b11-svgwrp bf-svgwrp bf-svgwrp \" aria-hidden=\"true\">\n                <use data-ck-icn href=\"#b11-15-ck-svg\" class=\"bAi11  b11-15-ck-icn b11-ck-icn bf-ck-icn bf-ck-icon \" \/>\n              <\/svg>\n            <\/span>\n            <span class=\"bu11 bAu11 bAv11  b11-15-ct b11-ct bf-ct bf-ct \">\n              Mechanical\n            <\/span>\n          <\/label>\n        <\/div>\n        <div class=\"b11-15-cw b11-cw bf-cw bf-cw \">\n          <input id=\"b11-15-1-chk-4\" type=\"checkbox\" class=\"bAS11 bAT11 bAU11 bAV11 bAW11 bAX11 bAY11 bAZ11 bAa11 bAb11 bAc11 bAd11 bAe11 bAf11 bAg11 bAh11 bCx11 bCy11 bCz11 bDA11 bDB11  b11-15-ci b11-ci bf-ci bf-ci \" value=\"Other (please specify):\" name=\"check-9-15[]\" \/>\n          <label data-cl for=\"b11-15-1-chk-4\" class=\"bA11 bG11 bH11 bv11 bAt11 bDC11  b11-15-cl b11-cl bf-cl bf-cl \">\n            <span data-bx class=\"bA11 bL11 bm11 bz11 bAG11 bAH11 bAI11 bAJ11 bAK11 bAL11 bAM11 bAN11 bAO11 bCw11  b11-15-bx b11-bx bf-bx bf-box \">\n              <svg width=\"12\" height=\"10\" viewbox=\"0 0 12 10\" class=\"bBG11 bBH11 bBI11 bDD11  b11-15-svgwrp b11-svgwrp bf-svgwrp bf-svgwrp \" aria-hidden=\"true\">\n                <use data-ck-icn href=\"#b11-15-ck-svg\" class=\"bAi11  b11-15-ck-icn b11-ck-icn bf-ck-icn bf-ck-icon \" \/>\n              <\/svg>\n            <\/span>\n            <span class=\"bu11 bAu11 bAv11  b11-15-ct b11-ct bf-ct bf-ct \">\n              Other (please specify):\n            <\/span>\n          <\/label>\n        <\/div>\n      <\/div>\n    \n    <div class=\"bAB11 bAC11 bAD11  b11-15-err-wrp b11-err-wrp bf-err-wrp bf-error-wrapper\" role=\"alert\" aria-live=\"assertive\" style=\"opacity: 0 !important;height: 0px !important\">\n        <div class=\"bw11  b11-15-err-inner b11-err-inner bf-err-inner bf-error-inner\">\n          \n          \n          <div id=\"b11-15-err-txt\" class=\"bA11 bH11 bo11 bAH11 bAw11 bAx11 bAy11 bAz11 bBA11 bBB11 bBC11 bBD11  b11-15-err-msg b11-err-msg bf-err-msg bf-error-messages-container  bAA11  b11-15-err-txt b11-err-txt bf-err-txt bf-error-text  \" style=\"display: none !important\">\n            \n          <\/div>\n          \n          \n        <\/div>\n      <\/div>\n  <\/div>\n<\/div><\/div><div class=\"btcd-fld-itm b11-16 \"><div class=\"bh11 bm11 bAA11 bAE11  b11-16-fld-wrp b11-fld-wrp bf-fld-wrp bf-field-wrapper \">\n  <div class=\"bi11 bBj11 bBl11  b11-16-lbl-wrp b11-lbl-wrp bf-lbl-wrp bf-label-wrapper \"><label id=\"b11-16-1-lbl\" class=\"bA11 bH11 bi11 bu11 bAt11 bBj11 bBk11 bDC11  b11-16-lbl b11-lbl bf-lbl bf-label \" for=\"b11-16-1\">\n          \n          \n          Other:\n          \n          \n        <\/label><\/div>\n  <div class=\"b11-16-inp-wrp b11-inp-wrp bf-inp-wrp bf-input-wrapper \">\n    <div class=\"bl11 bm11  b11-16-inp-fld-wrp b11-inp-fld-wrp bf-inp-fld-wrp bf-input-field-wrapper \">\n        <input id=\"b11-16-1\" class=\"bC11 bI11 bJ11 bq11 bs11 bt11 bBJ11 bBK11 bBL11 bBN11 bBO11 bBQ11 bBR11 bBS11 bBU11 bBV11 bBW11 bBX11 bBY11 bBZ11 bBa11 bBb11 bBc11 bBd11 bBe11 bBf11 bBg11 bBh11 bBi11 bBm11 bBn11 bCv11 bDE11 bDF11 bDG11 bDH11 bDI11 bDJ11 bDK11 bDL11 bDM11 bDN11  b11-16-fld b11-fld bf-fld bf-field \" type=\"text\" aria-describedby=\"b11-16-err-txt\" placeholder=\"Please describe...\" name=\"text-9-16\" \/>\n        \n        \n      <\/div>\n      \n    \n    <div class=\"bAB11 bAC11 bAD11  b11-16-err-wrp b11-err-wrp bf-err-wrp bf-error-wrapper\" role=\"alert\" aria-live=\"assertive\" style=\"opacity: 0 !important;height: 0px !important\">\n        <div class=\"bw11  b11-16-err-inner b11-err-inner bf-err-inner bf-error-inner\">\n          \n          \n          <div id=\"b11-16-err-txt\" class=\"bA11 bH11 bo11 bAH11 bAw11 bAx11 bAy11 bAz11 bBA11 bBB11 bBC11 bBD11  b11-16-err-msg b11-err-msg bf-err-msg bf-error-messages-container  bAA11  b11-16-err-txt b11-err-txt bf-err-txt bf-error-text  \" style=\"display: none !important\">\n            \n          <\/div>\n          \n          \n        <\/div>\n      <\/div>\n  <\/div>\n<\/div><\/div>\n            <\/div>\n            <div class=\"bh11 _frm-b11-stp-btn-wrpr\">\n              <div class=\"bA11 bH11 bg11 bBw11 _frm-b11-stp-btn-cntnt\">\n                <button class=\"bA11 bB11 bC11 bD11 bE11 bF11 bG11 bH11 bI11 bJ11 bK11 bL11 bM11 bN11 bO11 bP11 bQ11 bV11 bW11 bX11 bY11 bZ11 ba11 bb11 bc11 bd11 bCr11 bCs11 bCt11 _frm-b11-prev-step-btn prev-step-btn\" name=\"prev-step-btn\" type=\"button\">\n          \n          Previous\n          \n          <span class=\"bf-spinner d-none\"><\/span>\n        <\/button>\n                <button class=\"bA11 bB11 bC11 bD11 bE11 bF11 bG11 bH11 bI11 bJ11 bK11 bL11 bM11 bN11 bO11 bP11 bQ11 bV11 bW11 bX11 bY11 bZ11 ba11 bb11 bc11 bd11 bCr11 bCs11 bCt11 _frm-b11-next-step-btn next-step-btn\" name=\"next-step-btn\" type=\"button\">\n          \n          Next\n          \n          <span class=\"bf-spinner d-none\"><\/span>\n        <\/button>\n              <\/div>\n      <\/div>\n          <\/div>\n\n          <div class=\"bH11 be11 bi11 bBy11 bBz11 bCA11 _frm-b11-stp-cntnt _frm-b-stp-cntnt deactive\" data-step=\"2\" role=\"tabpanel\" id=\"step-11-2-panel\" aria-labelledby=\"step-11-2-tab\" aria-hidden=\"true\">\n            <div class=\"_frm-b11 _frm-b\">\n              <div class=\"btcd-fld-itm b11-17 \"><div class=\"bh11 bm11 bAA11 bAF11  b11-17-fld-wrp b11-fld-wrp bf-fld-wrp bf-field-wrapper \">\n        <p>Additional Comments, Suggestions, Photo Documentation: Use additional pages as needed<\/p>\n      <\/div><\/div><div class=\"btcd-fld-itm b11-18 \"><div class=\"bh11 bm11 bAA11 bAE11  b11-18-fld-wrp b11-fld-wrp bf-fld-wrp bf-field-wrapper \">\n  <div class=\"bi11 bBj11 bBl11  b11-18-lbl-wrp b11-lbl-wrp bf-lbl-wrp bf-label-wrapper \"><label id=\"b11-18-1-lbl\" class=\"bA11 bH11 bi11 bu11 bAt11 bBj11 bBk11 bDC11  b11-18-lbl b11-lbl bf-lbl bf-label \" for=\"b11-18-1\">\n          \n          \n          Comments or Suggestions\n          \n          \n        <\/label><\/div>\n  <div class=\"b11-18-inp-wrp b11-inp-wrp bf-inp-wrp bf-input-wrapper \">\n    <div class=\"bl11 bm11  b11-18-inp-fld-wrp b11-inp-fld-wrp bf-inp-fld-wrp bf-input-field-wrapper \">\n      <textarea id=\"b11-18-1\" class=\"bC11 bI11 bJ11 bq11 bs11 bt11 bBJ11 bBK11 bBL11 bBM11 bBN11 bBO11 bBP11 bBQ11 bBR11 bBS11 bBT11 bBU11 bBV11 bBW11 bBX11 bBY11 bBZ11 bBa11 bBb11 bBc11 bBd11 bBe11 bBf11 bBg11 bBh11 bBi11 bCv11 bDE11 bDF11 bDG11 bDH11 bDI11 bDJ11 bDK11 bDL11 bDM11 bDN11  b11-18-fld b11-fld bf-fld bf-field \" aria-describedby=\"b11-18-err-txt\" name=\"textarea-9-18\"><\/textarea>\n      \n      \n    <\/div>\n    \n    <div class=\"bAB11 bAC11 bAD11  b11-18-err-wrp b11-err-wrp bf-err-wrp bf-error-wrapper\" role=\"alert\" aria-live=\"assertive\" style=\"opacity: 0 !important;height: 0px !important\">\n        <div class=\"bw11  b11-18-err-inner b11-err-inner bf-err-inner bf-error-inner\">\n          \n          \n          <div id=\"b11-18-err-txt\" class=\"bA11 bH11 bo11 bAH11 bAw11 bAx11 bAy11 bAz11 bBA11 bBB11 bBC11 bBD11  b11-18-err-msg b11-err-msg bf-err-msg bf-error-messages-container  bAA11  b11-18-err-txt b11-err-txt bf-err-txt bf-error-text  \" style=\"display: none !important\">\n            \n          <\/div>\n          \n          \n        <\/div>\n      <\/div>\n  <\/div>\n<\/div><\/div><div class=\"btcd-fld-itm b11-29 \"><div class=\"bh11 bm11 bAA11 bAE11 bCd11 bCe11  b11-29-fld-wrp b11-fld-wrp bf-fld-wrp bf-field-wrapper \">\n  <div class=\"bi11 bBj11 bBl11  b11-29-lbl-wrp b11-lbl-wrp bf-lbl-wrp bf-label-wrapper \"><label id=\"b11-29-1-lbl\" class=\"bA11 bH11 bi11 bu11 bAt11 bBj11 bBk11 bDC11  b11-29-lbl b11-lbl bf-lbl bf-label \" for=\"b11-29-1\">\n          \n          \n          File Upload\n          \n          \n        <\/label><\/div>\n  <div class=\"b11-29-inp-wrp b11-inp-wrp bf-inp-wrp bf-input-wrapper \">\n    <div class=\"b11-29-file-up-container b11-file-up-container bf-file-up-container bf-file-up-container \">\n        <div class=\"b11-29-file-up-wrpr b11-file-up-wrpr bf-file-up-wrpr bf-file-up-wrpr   \">\n          <div class=\"bCS11 bCT11 bCU11 bCV11 bCW11 bCX11 bCY11 bCZ11 bCa11 bDV11 bDW11 bDX11 bDY11 bDZ11 bDa11  b11-29-file-input-wrpr b11-file-input-wrpr bf-file-input-wrpr bf-file-input-wrpr \">\n            <div class=\"bA11 bH11 bm11 bBo11  b11-29-btn-wrpr b11-btn-wrpr bf-btn-wrpr bf-button-wrpr \">\n              <button type=\"button\" class=\"bA11 bC11 bF11 bG11 bJ11 bM11 bP11 bW11 ba11 bb11 bc11 bAJ11 bBo11 bBp11 bCf11 bCs11 bDb11  b11-29-inp-btn b11-inp-btn bf-inp-btn bf-input-button \">\n                <img decoding=\"async\" class=\"bx11 by11 bBs11  b11-29-pre-i b11-pre-i bf-pre-i bf-field-prefix-icon \" src=\"https:\/\/grassfieldrc.org\/wp-content\/plugins\/bit-form\/assets\/..\/static\/file-upload\/paperclip.svg\" alt=\"\" aria-hidden=\"true\" \/>\n                <span class=\"b11-29-btn-txt b11-btn-txt bf-btn-txt bf-button-text \">\n                  Attach File\n                <\/span>\n                \n              <\/button>\n              <div class=\"bu11 bAt11 bDC11  b11-29-file-select-status b11-file-select-status bf-file-select-status bf-file-select-status \">\n          No Choosen File\n        <\/div>\n              <small class=\"bCg11 bDc11  b11-29-max-size-lbl b11-max-size-lbl bf-max-size-lbl bf-max-size-label \">\n              (Max 10 MB)\n            <\/small>\n              <input type=\"file\" class=\"bG11 bi11 bAA11 bAT11 bBp11 bBq11 bBr11 bCc11  b11-29-file-upload-input b11-file-upload-input bf-file-upload-input bf-file-upload-input \" id=\"b11-29-1\" name=\"file-up-11-29[]\" multiple aria-disabled=\"true\" tabindex=\"-1\" \/>\n            <\/div>\n            <div class=\"err-wrp \"><\/div>\n          <\/div>\n        <\/div>\n      <\/div>\n    \n    <div class=\"bAB11 bAC11 bAD11  b11-29-err-wrp b11-err-wrp bf-err-wrp bf-error-wrapper\" role=\"alert\" aria-live=\"assertive\" style=\"opacity: 0 !important;height: 0px !important\">\n        <div class=\"bw11  b11-29-err-inner b11-err-inner bf-err-inner bf-error-inner\">\n          \n          \n          <div id=\"b11-29-err-txt\" class=\"bA11 bH11 bo11 bAH11 bAw11 bAx11 bAy11 bAz11 bBA11 bBB11 bBC11 bBD11  b11-29-err-msg b11-err-msg bf-err-msg bf-error-messages-container  bAA11  b11-29-err-txt b11-err-txt bf-err-txt bf-error-text  \" style=\"display: none !important\">\n            \n          <\/div>\n          \n          \n        <\/div>\n      <\/div>\n  <\/div>\n<\/div><\/div><div class=\"btcd-fld-itm b11-20 \"><div class=\"bh11 bm11 bAA11 bAF11  b11-20-fld-wrp b11-fld-wrp bf-fld-wrp bf-field-wrapper \">\n        <p>Witness Section: Mandatory for Property Damage or Personal Injury<\/p>\n      <\/div><\/div><div class=\"btcd-fld-itm b11-21 \"><div class=\"bh11 bm11 bAA11 bAE11  b11-21-fld-wrp b11-fld-wrp bf-fld-wrp bf-field-wrapper \">\n  <div class=\"bi11 bBj11 bBl11  b11-21-lbl-wrp b11-lbl-wrp bf-lbl-wrp bf-label-wrapper \"><label id=\"b11-21-1-lbl\" class=\"bA11 bH11 bi11 bu11 bAt11 bBj11 bBk11 bDC11  b11-21-lbl b11-lbl bf-lbl bf-label \" for=\"b11-21-1\">\n          \n          \n          Witness Name\n          \n          \n        <\/label><\/div>\n  <div class=\"b11-21-inp-wrp b11-inp-wrp bf-inp-wrp bf-input-wrapper \">\n    <div class=\"bl11 bm11  b11-21-inp-fld-wrp b11-inp-fld-wrp bf-inp-fld-wrp bf-input-field-wrapper \">\n        <input id=\"b11-21-1\" class=\"bC11 bI11 bJ11 bq11 bs11 bt11 bBJ11 bBK11 bBL11 bBN11 bBO11 bBQ11 bBR11 bBS11 bBU11 bBV11 bBW11 bBX11 bBY11 bBZ11 bBa11 bBb11 bBc11 bBd11 bBe11 bBf11 bBg11 bBh11 bBi11 bBm11 bBn11 bCv11 bDE11 bDF11 bDG11 bDH11 bDI11 bDJ11 bDK11 bDL11 bDM11 bDN11  b11-21-fld b11-fld bf-fld bf-field \" type=\"text\" aria-describedby=\"b11-21-err-txt\" placeholder=\"Name\" name=\"text-9-21\" \/>\n        \n        \n      <\/div>\n      \n    \n    <div class=\"bAB11 bAC11 bAD11  b11-21-err-wrp b11-err-wrp bf-err-wrp bf-error-wrapper\" role=\"alert\" aria-live=\"assertive\" style=\"opacity: 0 !important;height: 0px !important\">\n        <div class=\"bw11  b11-21-err-inner b11-err-inner bf-err-inner bf-error-inner\">\n          \n          \n          <div id=\"b11-21-err-txt\" class=\"bA11 bH11 bo11 bAH11 bAw11 bAx11 bAy11 bAz11 bBA11 bBB11 bBC11 bBD11  b11-21-err-msg b11-err-msg bf-err-msg bf-error-messages-container  bAA11  b11-21-err-txt b11-err-txt bf-err-txt bf-error-text  \" style=\"display: none !important\">\n            \n          <\/div>\n          \n          \n        <\/div>\n      <\/div>\n  <\/div>\n<\/div><\/div><div class=\"btcd-fld-itm b11-23 \"><div class=\"bh11 bm11 bAA11 bAE11  b11-23-fld-wrp b11-fld-wrp bf-fld-wrp bf-field-wrapper \">\n  <div class=\"bi11 bBj11 bBl11  b11-23-lbl-wrp b11-lbl-wrp bf-lbl-wrp bf-label-wrapper \"><label id=\"b11-23-1-lbl\" class=\"bA11 bH11 bi11 bu11 bAt11 bBj11 bBk11 bDC11  b11-23-lbl b11-lbl bf-lbl bf-label \" for=\"b11-23-1\">\n          \n          \n          Brief Witness Description:\n          \n          \n        <\/label><\/div>\n  <div class=\"b11-23-inp-wrp b11-inp-wrp bf-inp-wrp bf-input-wrapper \">\n    <div class=\"bl11 bm11  b11-23-inp-fld-wrp b11-inp-fld-wrp bf-inp-fld-wrp bf-input-field-wrapper \">\n      <textarea id=\"b11-23-1\" class=\"bC11 bI11 bJ11 bq11 bs11 bt11 bBJ11 bBK11 bBL11 bBM11 bBN11 bBO11 bBP11 bBQ11 bBR11 bBS11 bBT11 bBU11 bBV11 bBW11 bBX11 bBY11 bBZ11 bBa11 bBb11 bBc11 bBd11 bBe11 bBf11 bBg11 bBh11 bBi11 bCv11 bDE11 bDF11 bDG11 bDH11 bDI11 bDJ11 bDK11 bDL11 bDM11 bDN11  b11-23-fld b11-fld bf-fld bf-field \" aria-describedby=\"b11-23-err-txt\" name=\"textarea-9-23\"><\/textarea>\n      \n      \n    <\/div>\n    \n    <div class=\"bAB11 bAC11 bAD11  b11-23-err-wrp b11-err-wrp bf-err-wrp bf-error-wrapper\" role=\"alert\" aria-live=\"assertive\" style=\"opacity: 0 !important;height: 0px !important\">\n        <div class=\"bw11  b11-23-err-inner b11-err-inner bf-err-inner bf-error-inner\">\n          \n          \n          <div id=\"b11-23-err-txt\" class=\"bA11 bH11 bo11 bAH11 bAw11 bAx11 bAy11 bAz11 bBA11 bBB11 bBC11 bBD11  b11-23-err-msg b11-err-msg bf-err-msg bf-error-messages-container  bAA11  b11-23-err-txt b11-err-txt bf-err-txt bf-error-text  \" style=\"display: none !important\">\n            \n          <\/div>\n          \n          \n        <\/div>\n      <\/div>\n  <\/div>\n<\/div><\/div><div class=\"btcd-fld-itm b11-31 \"><div class=\"bh11 bm11 bAA11 bAE11  b11-31-fld-wrp b11-fld-wrp bf-fld-wrp bf-field-wrapper \">\n  <div class=\"bi11 bBj11 bBl11  b11-31-lbl-wrp b11-lbl-wrp bf-lbl-wrp bf-label-wrapper \"><label id=\"b11-31-1-lbl\" class=\"bA11 bH11 bi11 bu11 bAt11 bBj11 bBk11 bDC11  b11-31-lbl b11-lbl bf-lbl bf-label \" for=\"b11-31-1\">\n          \n          \n          AMA#\n          \n          \n        <\/label><\/div>\n  <div class=\"b11-31-inp-wrp b11-inp-wrp bf-inp-wrp bf-input-wrapper \">\n    <div class=\"bl11 bm11  b11-31-inp-fld-wrp b11-inp-fld-wrp bf-inp-fld-wrp bf-input-field-wrapper \">\n        <input id=\"b11-31-1\" class=\"bC11 bI11 bJ11 bq11 bs11 bt11 bBJ11 bBK11 bBL11 bBN11 bBO11 bBQ11 bBR11 bBS11 bBU11 bBV11 bBW11 bBX11 bBY11 bBZ11 bBa11 bBb11 bBc11 bBd11 bBe11 bBf11 bBg11 bBh11 bBi11 bBm11 bBn11 bCv11 bDE11 bDF11 bDG11 bDH11 bDI11 bDJ11 bDK11 bDL11 bDM11 bDN11  b11-31-fld b11-fld bf-fld bf-field \" type=\"text\" aria-describedby=\"b11-31-err-txt\" name=\"text-11-31\" \/>\n        \n        \n      <\/div>\n      \n    \n    <div class=\"bAB11 bAC11 bAD11  b11-31-err-wrp b11-err-wrp bf-err-wrp bf-error-wrapper\" role=\"alert\" aria-live=\"assertive\" style=\"opacity: 0 !important;height: 0px !important\">\n        <div class=\"bw11  b11-31-err-inner b11-err-inner bf-err-inner bf-error-inner\">\n          \n          \n          <div id=\"b11-31-err-txt\" class=\"bA11 bH11 bo11 bAH11 bAw11 bAx11 bAy11 bAz11 bBA11 bBB11 bBC11 bBD11  b11-31-err-msg b11-err-msg bf-err-msg bf-error-messages-container  bAA11  b11-31-err-txt b11-err-txt bf-err-txt bf-error-text  \" style=\"display: none !important\">\n            \n          <\/div>\n          \n          \n        <\/div>\n      <\/div>\n  <\/div>\n<\/div><\/div><div class=\"btcd-fld-itm b11-24 \"><div class=\"bh11 bm11 bAA11 bAF11  b11-24-fld-wrp b11-fld-wrp bf-fld-wrp bf-field-wrapper \">\n        <p>For Club Use Only<\/p>\n      <\/div><\/div><div class=\"btcd-fld-itm b11-25 \"><div class=\"bh11 bm11 bAA11 bAE11  b11-25-fld-wrp b11-fld-wrp bf-fld-wrp bf-field-wrapper \">\n  <div class=\"bi11 bBj11 bBl11  b11-25-lbl-wrp b11-lbl-wrp bf-lbl-wrp bf-label-wrapper \"><label id=\"b11-25-1-lbl\" class=\"bA11 bH11 bi11 bu11 bAt11 bBj11 bBk11 bDC11  b11-25-lbl b11-lbl bf-lbl bf-label \" for=\"b11-25-1\">\n          \n          \n          Received By:\n          \n          \n        <\/label><\/div>\n  <div class=\"b11-25-inp-wrp b11-inp-wrp bf-inp-wrp bf-input-wrapper \">\n    <div class=\"bl11 bm11  b11-25-inp-fld-wrp b11-inp-fld-wrp bf-inp-fld-wrp bf-input-field-wrapper \">\n        <input id=\"b11-25-1\" class=\"bC11 bI11 bJ11 bq11 bs11 bt11 bBJ11 bBK11 bBL11 bBN11 bBO11 bBQ11 bBR11 bBS11 bBU11 bBV11 bBW11 bBX11 bBY11 bBZ11 bBa11 bBb11 bBc11 bBd11 bBe11 bBf11 bBg11 bBh11 bBi11 bBm11 bBn11 bCv11 bDE11 bDF11 bDG11 bDH11 bDI11 bDJ11 bDK11 bDL11 bDM11 bDN11  b11-25-fld b11-fld bf-fld bf-field \" type=\"text\" aria-describedby=\"b11-25-err-txt\" readonly placeholder=\"First Name\" name=\"text-9-25\" \/>\n        \n        \n      <\/div>\n      \n    \n    <div class=\"bAB11 bAC11 bAD11  b11-25-err-wrp b11-err-wrp bf-err-wrp bf-error-wrapper\" role=\"alert\" aria-live=\"assertive\" style=\"opacity: 0 !important;height: 0px !important\">\n        <div class=\"bw11  b11-25-err-inner b11-err-inner bf-err-inner bf-error-inner\">\n          \n          \n          <div id=\"b11-25-err-txt\" class=\"bA11 bH11 bo11 bAH11 bAw11 bAx11 bAy11 bAz11 bBA11 bBB11 bBC11 bBD11  b11-25-err-msg b11-err-msg bf-err-msg bf-error-messages-container  bAA11  b11-25-err-txt b11-err-txt bf-err-txt bf-error-text  \" style=\"display: none !important\">\n            \n          <\/div>\n          \n          \n        <\/div>\n      <\/div>\n  <\/div>\n<\/div><\/div><div class=\"btcd-fld-itm b11-26 \"><div class=\"bh11 bm11 bAA11 bAE11  b11-26-fld-wrp b11-fld-wrp bf-fld-wrp bf-field-wrapper \">\n  <div class=\"bi11 bBj11 bBl11  b11-26-lbl-wrp b11-lbl-wrp bf-lbl-wrp bf-label-wrapper \"><label id=\"b11-26-1-lbl\" class=\"bA11 bH11 bi11 bu11 bAt11 bBj11 bBk11 bDC11  b11-26-lbl b11-lbl bf-lbl bf-label \" for=\"b11-26-1\">\n          \n          \n          Date Received:\n          \n          \n        <\/label><\/div>\n  <div class=\"b11-26-inp-wrp b11-inp-wrp bf-inp-wrp bf-input-wrapper \">\n    <div class=\"bl11 bm11  b11-26-inp-fld-wrp b11-inp-fld-wrp bf-inp-fld-wrp bf-input-field-wrapper \">\n        <input id=\"b11-26-1\" class=\"bC11 bI11 bJ11 bq11 bs11 bt11 bBJ11 bBK11 bBL11 bBN11 bBO11 bBQ11 bBR11 bBS11 bBU11 bBV11 bBW11 bBX11 bBY11 bBZ11 bBa11 bBb11 bBc11 bBd11 bBe11 bBf11 bBg11 bBh11 bBi11 bBm11 bBn11 bCv11 bDE11 bDF11 bDG11 bDH11 bDI11 bDJ11 bDK11 bDL11 bDM11 bDN11  b11-26-fld b11-fld bf-fld bf-field \" type=\"date\" aria-describedby=\"b11-26-err-txt\" readonly name=\"date-9-26\" data-bf-show-picker=\"1\" \/>\n        \n        \n      <\/div>\n      \n    \n    <div class=\"bAB11 bAC11 bAD11  b11-26-err-wrp b11-err-wrp bf-err-wrp bf-error-wrapper\" role=\"alert\" aria-live=\"assertive\" style=\"opacity: 0 !important;height: 0px !important\">\n        <div class=\"bw11  b11-26-err-inner b11-err-inner bf-err-inner bf-error-inner\">\n          \n          \n          <div id=\"b11-26-err-txt\" class=\"bA11 bH11 bo11 bAH11 bAw11 bAx11 bAy11 bAz11 bBA11 bBB11 bBC11 bBD11  b11-26-err-msg b11-err-msg bf-err-msg bf-error-messages-container  bAA11  b11-26-err-txt b11-err-txt bf-err-txt bf-error-text  \" style=\"display: none !important\">\n            \n          <\/div>\n          \n          \n        <\/div>\n      <\/div>\n  <\/div>\n<\/div><\/div><div class=\"btcd-fld-itm b11-27 \"><div class=\"bh11 bm11 bAA11 bAE11  b11-27-fld-wrp b11-fld-wrp bf-fld-wrp bf-field-wrapper \">\n  <div class=\"bi11 bBj11 bBl11  b11-27-lbl-wrp b11-lbl-wrp bf-lbl-wrp bf-label-wrapper \"><label id=\"b11-27-1-lbl\" class=\"bA11 bH11 bi11 bu11 bAt11 bBj11 bBk11 bDC11  b11-27-lbl b11-lbl bf-lbl bf-label \" for=\"b11-27-1\">\n          \n          \n          Follow-Up Actions\n          \n          \n        <\/label><\/div>\n  <div class=\"b11-27-inp-wrp b11-inp-wrp bf-inp-wrp bf-input-wrapper \">\n    <div class=\"bl11 bm11  b11-27-inp-fld-wrp b11-inp-fld-wrp bf-inp-fld-wrp bf-input-field-wrapper \">\n      <textarea id=\"b11-27-1\" class=\"bC11 bI11 bJ11 bq11 bs11 bt11 bBJ11 bBK11 bBL11 bBM11 bBN11 bBO11 bBP11 bBQ11 bBR11 bBS11 bBT11 bBU11 bBV11 bBW11 bBX11 bBY11 bBZ11 bBa11 bBb11 bBc11 bBd11 bBe11 bBf11 bBg11 bBh11 bBi11 bCv11 bDE11 bDF11 bDG11 bDH11 bDI11 bDJ11 bDK11 bDL11 bDM11 bDN11  b11-27-fld b11-fld bf-fld bf-field \" aria-describedby=\"b11-27-err-txt\" readonly name=\"textarea-9-27\"><\/textarea>\n      \n      \n    <\/div>\n    \n    <div class=\"bAB11 bAC11 bAD11  b11-27-err-wrp b11-err-wrp bf-err-wrp bf-error-wrapper\" role=\"alert\" aria-live=\"assertive\" style=\"opacity: 0 !important;height: 0px !important\">\n        <div class=\"bw11  b11-27-err-inner b11-err-inner bf-err-inner bf-error-inner\">\n          \n          \n          <div id=\"b11-27-err-txt\" class=\"bA11 bH11 bo11 bAH11 bAw11 bAx11 bAy11 bAz11 bBA11 bBB11 bBC11 bBD11  b11-27-err-msg b11-err-msg bf-err-msg bf-error-messages-container  bAA11  b11-27-err-txt b11-err-txt bf-err-txt bf-error-text  \" style=\"display: none !important\">\n            \n          <\/div>\n          \n          \n        <\/div>\n      <\/div>\n  <\/div>\n<\/div><\/div><div class=\"btcd-fld-itm b11-1 \"><div class=\"bh11 bm11 bAA11 bAE11  b11-1-fld-wrp b11-fld-wrp bf-fld-wrp bf-field-wrapper \">\n  \n  <div class=\"b11-1-inp-wrp b11-inp-wrp bf-inp-wrp bf-input-wrapper \">\n    <div class=\"bH11  b11-1-inp-fld-wrp b11-inp-fld-wrp bf-inp-fld-wrp bf-input-field-wrapper \">\n        <button class=\"bA11 bB11 bC11 bD11 bE11 bF11 bG11 bH11 bI11 bJ11 bK11 bL11 bM11 bN11 bO11 bP11 bW11 bX11 bY11 bZ11 ba11 bb11 bc11 bd11 bi11 bCr11 bCs11 bCt11  b11-1-btn b11-btn bf-btn bf-button  \" type=\"submit\" name=\"button-b11-1\" aria-describedby=\"b11-1-err-txt\">\n          \n          Submit\n          \n          <span class=\"bf-spinner d-none\" aria-hidden=\"true\"><\/span>\n        <\/button>\n      <\/div>\n    \n    \n  <\/div>\n<\/div><\/div>\n            <\/div>\n            <div class=\"bh11 _frm-b11-stp-btn-wrpr\">\n              <div class=\"bA11 bH11 bg11 bBw11 _frm-b11-stp-btn-cntnt\">\n                <button class=\"bA11 bB11 bC11 bD11 bE11 bF11 bG11 bH11 bI11 bJ11 bK11 bL11 bM11 bN11 bO11 bP11 bQ11 bV11 bW11 bX11 bY11 bZ11 ba11 bb11 bc11 bd11 bCr11 bCs11 bCt11 _frm-b11-prev-step-btn prev-step-btn\" name=\"prev-step-btn\" type=\"button\">\n          \n          Previous\n          \n          <span class=\"bf-spinner d-none\"><\/span>\n        <\/button>\n                <button class=\"bA11 bB11 bC11 bD11 bE11 bF11 bG11 bH11 bI11 bJ11 bK11 bL11 bM11 bN11 bO11 bP11 bQ11 bV11 bW11 bX11 bY11 bZ11 ba11 bb11 bc11 bd11 bCr11 bCs11 bCt11 _frm-b11-next-step-btn next-step-btn\" name=\"next-step-btn\" type=\"button\">\n          \n          Next\n          \n          <span class=\"bf-spinner d-none\"><\/span>\n        <\/button>\n              <\/div>\n      <\/div>\n          <\/div>\n\n          <\/div>\n        <\/div>\n      <\/div>\n\n          <\/form>\n          \n          <div id=\"bf-form-msg-wrp-bitforms_11_11483_1\"><\/div>\n          <!-- \n            Live Region for Screen Reader Announcements (Accessibility)\n          -->\n          <div class=\"bf-live-region\" role=\"status\" aria-live=\"polite\" style=\"position: absolute;width: 1px;height: 1px;padding: 0;margin: -1px;overflow: hidden;white-space: nowrap;border: 0\"><\/div>\n          \n      <\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":13,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-11483","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/grassfieldrc.org\/index.php?rest_route=\/wp\/v2\/pages\/11483","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/grassfieldrc.org\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/grassfieldrc.org\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/grassfieldrc.org\/index.php?rest_route=\/wp\/v2\/users\/13"}],"replies":[{"embeddable":true,"href":"https:\/\/grassfieldrc.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=11483"}],"version-history":[{"count":1,"href":"https:\/\/grassfieldrc.org\/index.php?rest_route=\/wp\/v2\/pages\/11483\/revisions"}],"predecessor-version":[{"id":11484,"href":"https:\/\/grassfieldrc.org\/index.php?rest_route=\/wp\/v2\/pages\/11483\/revisions\/11484"}],"wp:attachment":[{"href":"https:\/\/grassfieldrc.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=11483"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}