{"id":217,"date":"2020-07-20T06:58:57","date_gmt":"2020-07-20T10:58:57","guid":{"rendered":"https:\/\/research.ohioguidestone.org\/study\/?page_id=217"},"modified":"2022-09-30T12:51:15","modified_gmt":"2022-09-30T16:51:15","slug":"joyful-together-follow-up-consent-interview-addendum","status":"publish","type":"page","link":"https:\/\/research.ohioguidestone.org\/study\/joyful-together-follow-up-consent-interview-addendum\/","title":{"rendered":"Joyful Together&reg; Follow-up Consent Form &#8211; 2017-2022"},"content":{"rendered":"<div class=\"wpforms-container wpforms-container-full wpforms-container-save-resume\" id=\"wpforms-1012\"><form id=\"wpforms-form-1012\" class=\"wpforms-validate wpforms-form\" data-formid=\"1012\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/study\/wp-json\/wp\/v2\/pages\/217\" data-token=\"64eab49ce7e8ad311d159dd7814d33c3\" data-token-time=\"1776658308\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-1012-field_12-container\" class=\"wpforms-field wpforms-field-html\" data-field-id=\"12\"><div id=\"wpforms-1012-field_12\"><style>\r\nh6 {font-size: 1.2em;}\r\n<\/style>\r\n<h6>Introduction<\/h6>\r\n<p>You are being asked to participate in a research study at OhioGuidestone\u2019s Institute of Family &amp; Community Impact called \u201cJoyful Together Follow-up Study\u201d. The word \u201cyou\u201d in this document refers to a parent\/guardian.<\/p> \r\n\r\n<p>You are being asked to participate in this study because you and your child participated in the Joyful Play Babies and Children Study trying out OhioGuidestone\u2019s Joyful Together\u00ae activities. You and your child participated as a parent-child pair and completed all of your study visits and activities.<\/p>  \r\n\r\n<p>Your participation in this study is voluntary and is not required to receive services from OhioGuidestone.  Your current services will not be affected if you do or do not choose to participate.  Please read the information below and ask questions to better understand this research study. <\/p>  \r\n\r\n<h6>Purpose of the Study<\/h6> \r\n<p>OhioGuidestone wants to follow-up to learn more about parent-child pairs who had lower stress and improved relationships with their child when they were in the Joyful Play Babies and Children\u2019s Study during 2017-2022.  OhioGuidestone wants to look at participants records who are also OhioGuidestone clients to learn if Joyful Together\u00ae helped their treatment.<\/p>   \r\n\r\n<p>Learning how Joyful Together\u00ae affects parents and, or children\u2019s treatment with their community mental health worker or therapist will help us understand how to use Joyful Together\u00ae with other families in the future.<\/p> \r\n\r\n<p>We are still working to create and study a short evidence-based intervention (Joyful Together\u00ae) that will help children and parent\/guardians to play more together.  The intervention wants to help children experience joy at an early age in hopes of building strengths in children to help them face life\u2019s stressors.  Evidence-based interventions are a type of activity that uses research results to support and improve services. <\/p>  \r\n\r\n<h6>Procedures<\/h6> \r\n<p>During the study we will collect information from you as well as your OhioGuidestone record about your health.  If you, and\/or your child is an OhioGuidestone client we will get information from your health record and your questionnaires. For which ever person in your parent-child pair is not an OhioGuidestone client, we will only get information from your questionnaires. If neither you or your child is an OhioGuidestone client, we will only get information from your questionnaires.<\/p>  \r\n\r\n<h6 style=\"font-style:italic;\">HOW LONG AM I IN THE STUDY?<\/h6> \r\n<p>Your participation in this follow-up study will be a one or two-time event at 6 months and 12 months after you finished your last study visit. If you are asked to participate in this follow-up study and it is beyond or more than 6 months from your last study visit you can still participate at the 12 month or beyond point.<\/p> \r\n\r\n<p>You can do study activities on-line, on the phone or in-person or through a videoconference with study staff, or on-paper and return in the mail. It will take about 15-20 minutes to complete the study.  (If you have more than one child who participated with you in the same study, you will complete separate paperwork and questionnaires for each child.)<\/p> \r\n\r\n<h6 style=\"font-style:italic;\">WHAT AM I DOING IN THE STUDY?<\/h6>\r\n<p>You will fill out questionnaires (surveys) about your children and yourself as a parent\/caregiver.  There are five total questionnaires.  Four questionnaires are the same that you filled out for the study last year; and two are new.<\/p>\r\n\r\n<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/research.ohioguidestone.org\/study\/wp-content\/uploads\/2020\/07\/jtLongTimeline.jpg\" alt=\"Joyful Together Longitudinal Timeline\" width=\"1247\" height=\"60\" class=\"alignnone size-full wp-image-211\" srcset=\"https:\/\/research.ohioguidestone.org\/study\/wp-content\/uploads\/2020\/07\/jtLongTimeline.jpg 1247w, https:\/\/research.ohioguidestone.org\/study\/wp-content\/uploads\/2020\/07\/jtLongTimeline-300x14.jpg 300w, https:\/\/research.ohioguidestone.org\/study\/wp-content\/uploads\/2020\/07\/jtLongTimeline-1024x49.jpg 1024w, https:\/\/research.ohioguidestone.org\/study\/wp-content\/uploads\/2020\/07\/jtLongTimeline-768x37.jpg 768w\" sizes=\"auto, (max-width: 1247px) 100vw, 1247px\" \/>\r\n\r\n<h6>Questionnaires:<\/h6>\r\n<ul style=\"padding-left: 30px !important;\">\r\n<li>Child Survey- survey about your child\u2019s strengths and behavior<\/li>\r\n<li>Parent Stress Survey- questions about general life stress, and stress connected to being a parent<\/li> \r\n<li>(New) Family Survey- questions about strengths and needs and differences for your family<\/li> \r\n<li>Information Sheet- basic questions about you and your family, and your medical history<\/li>\r\n<li>(New) Joyful Together\u00ae Feedback- questions which Joyful Together\u00ae games your family uses<\/li>\r\n<\/ul>\r\n\r\n<h6 style=\"font-style:italic;\">WHEN DO I COMPLETE THE QUESTIONNAIRES?<\/h6>\r\n<p>You will complete questionnaires at 6 months and at 12 months (or longer) after you finished your last study visit.<\/p>  \r\n<p>You can complete the questionnaires online, over the phone or through a videoconference, or on paper.<\/p>  \r\n<ul style=\"padding-left: 30px !important;\">\r\n<li><strong>Online -<\/strong> If you want to complete the questionnaires Online, you will use a special number called an \u201cAccess Code\u201d to log into a special page on our website.<\/li> \r\n<li><strong>By Phone -<\/strong> study staff will do the questionnaires over the phone with you.<\/li>  \r\n<li><strong>In-Person Appointment -<\/strong> study staff will come and do the questionnaires in person with you.<\/li> \r\n<li><strong>By Mail -<\/strong> you can do the questionnaires on paper and mail the forms in.<\/li> \r\n<\/ul>\r\n \r\n<h6 style=\"font-style:italic;\">WHAT IS VIDEOCONFERENCING?<\/h6>\r\n<p>Videoconferencing is a face-to-face meeting over the internet using a device that has both video (see) and audio (hear). We will use a safe, and secure video conferencing platform like Zoom, or Lifesize. To participate in video conferencing sessions you will need a device that has a camera, audio (speakers), and can connect to the internet. Research staff will help connecting to video conferencing platforms.<\/p>\r\n\r\n<h6>Potential Risks<\/h6>  \r\n<p>There are no known potential risks associated with participation.<\/p> \r\n\r\n<h6>Anticipated Benefits<\/h6>  \r\n<p>You may or may not benefit from this study. Information learned from this research study may also benefit future children and families.<\/p> \r\n\r\n<p>You will receive a $25.00 gift card for you and your family as a as a thank you gift for participating once all of your paperwork has been returned.  If you have more than one child who participated with you in the same study, you will complete separate paperwork and questionnaires for each child- and receive a gift card for each parent-child pair.<\/p>   \r\n\r\n<h6>Confidentiality<\/h6> \r\n<p>Your information will be kept confidential and only used for this research study. Only people working on this research study will have access to your study information. We will collect your demographic information, but a unique number instead of your name or other identifying information will be used on study documents. Your name or anything else that could identify you will not be included in reports, presentations or publications from this study. Your information will be kept in a locked file cabinet in a locked room, and computer files will only be opened on password protected computers. All documentation with identifying information will be destroyed once the study has ended.<\/p>  \r\n\r\n<h6>Voluntary Participation and Withdrawal<\/h6> \r\n<p>Your participation in this study is completely voluntary. If you choose not to participate, it will not affect your relationship with OhioGuidestone.  You will still have the right to services that you are eligible for at OhioGuidestone. You will not be treated differently if you decide not to participate.<\/p>  \r\n\r\n<p>If you decide to participate, you are free to withdraw your consent and stop at any time.  You will not be treated any differently if you decide to withdraw from the study. If you withdraw from the study, you will still continue to receive mental health services at OhioGuidestone.<\/p>\r\n\r\n<p>If you do participate in this study, your access to current and future services and client rights will not be changed or different. There is no cost to participate in this research study.<\/p>  \r\n\r\n<h6>Contacts and Questions<\/h6> \r\n<p>If you have any questions about this study, you can contact the study team at: <a href=\"mailto:research@ohioguidestone.org\">research@ohioguidestone.org<\/a> or <a href=\"tel:4402608865\">440.260.8865<\/a>.<\/p>\r\n<p>If you have any questions about OhioGuidestone\u2019s services, including client rights, you can contact the agency\u2019s Client Advocate at <a href=\"tel:4402608308\">440.260.8308<\/a>. \r\nYou may also ask your program staff any questions that you have now, or any part of the research study.<\/p>  \r\n\r\n<h6>Signature of Research Subject<\/h6> \r\n<p>Informed consent to participate in research is very important.  By signing or clicking below you agree:<\/p>\r\n<ul style=\"padding-left: 30px !important;\">\r\n<li>That you have read the information about this research study; <\/li>\r\n<li>You have been given the chance to answer questions and they have been answered; <\/li>\r\n<li>You volunteer to participate in the study and understand that you can withdraw from the study at any time. <\/li>\r\n<\/ul>\r\n<p>A copy of this consent form will be provided to you.<\/p><\/div><\/div><div id=\"wpforms-1012-field_17-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"17\"><label class=\"wpforms-field-label\">Electronic Agreement <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-1012-field_17\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-1012-field_17_1\" name=\"wpforms[fields][17][]\" value=\"By checking this box, I agree to use electronic records and electronic signatures.\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1012-field_17_1\">By checking this box, I agree to use electronic records and electronic signatures.<\/label><\/li><\/ul><\/div><div id=\"wpforms-1012-field_0-container\" class=\"wpforms-field wpforms-field-name wpforms-one-third wpforms-first\" data-field-id=\"0\"><label class=\"wpforms-field-label\">Name of Child Participant <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-1012-field_0\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][0][first]\" required><label for=\"wpforms-1012-field_0\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-1012-field_0-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][0][last]\" required><label for=\"wpforms-1012-field_0-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-1012-field_11-container\" class=\"wpforms-field wpforms-field-name wpforms-one-third\" data-field-id=\"11\"><label class=\"wpforms-field-label\">Name of Parent\/Guardian <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-1012-field_11\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][11][first]\" required><label for=\"wpforms-1012-field_11\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-1012-field_11-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][11][last]\" required><label for=\"wpforms-1012-field_11-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-1012-field_4-container\" class=\"wpforms-field wpforms-field-date-time wpforms-one-third\" data-field-id=\"4\"><label class=\"wpforms-field-label\" for=\"wpforms-1012-field_4\">Date <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-datepicker-wrap\"><input type=\"text\" id=\"wpforms-1012-field_4\" class=\"wpforms-field-date-time-date wpforms-datepicker wpforms-field-required wpforms-field-large\" data-date-format=\"m\/d\/Y\" data-disable-past-dates=\"0\" data-input=\"true\" name=\"wpforms[fields][4][date]\" required><a title=\"Clear Date\" data-clear role=\"button\" tabindex=\"0\" class=\"wpforms-datepicker-clear\" aria-label=\"Clear Date\" style=\"display:none;\"><\/a><\/div><\/div><div id=\"wpforms-1012-field_7-container\" class=\"wpforms-field wpforms-field-email wpforms-one-third wpforms-first\" data-field-id=\"7\"><label class=\"wpforms-field-label\" for=\"wpforms-1012-field_7\">Email Address<\/label><input type=\"email\" id=\"wpforms-1012-field_7\" class=\"wpforms-field-large\" name=\"wpforms[fields][7]\" spellcheck=\"false\" ><div class=\"wpforms-field-description\">If entered, we will email a copy of this consent to the supplied email address<\/div><\/div><div id=\"wpforms-1012-field_6-container\" class=\"wpforms-field wpforms-field-phone wpforms-one-third\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-1012-field_6\">Phone<\/label><input type=\"tel\" id=\"wpforms-1012-field_6\" class=\"wpforms-field-large wpforms-smart-phone-field\" data-rule-smart-phone-field=\"true\" name=\"wpforms[fields][6]\" aria-label=\"Phone\" ><\/div><div id=\"wpforms-1012-field_8-container\" class=\"wpforms-field wpforms-field-radio wpforms-one-third wpforms-list-inline\" data-field-id=\"8\"><label class=\"wpforms-field-label\">How was this form completed? <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-1012-field_8\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-1012-field_8_1\" name=\"wpforms[fields][8]\" value=\"In-Person\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1012-field_8_1\">In-Person<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-1012-field_8_2\" name=\"wpforms[fields][8]\" value=\"By Phone\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1012-field_8_2\">By Phone<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-1012-field_8_3\" name=\"wpforms[fields][8]\" value=\"Online\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1012-field_8_3\">Online<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-1012-field_8_5\" name=\"wpforms[fields][8]\" value=\"Mail-In\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1012-field_8_5\">Mail-In<\/label><\/li><\/ul><\/div><div id=\"wpforms-1012-field_14-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-one-half wpforms-first wpforms-list-inline\" data-field-id=\"14\"><label class=\"wpforms-field-label\">Acknowledgement <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-1012-field_14\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-1012-field_14_1\" name=\"wpforms[fields][14][]\" value=\"I have received education about this research study and reviewed this document with a member of the Research Team.\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1012-field_14_1\">I have received education about this research study and reviewed this document with a member of the Research Team.<\/label><\/li><\/ul><\/div><div id=\"wpforms-1012-field_16-container\" class=\"wpforms-field wpforms-field-date-time wpforms-one-half\" data-field-id=\"16\"><label class=\"wpforms-field-label\" for=\"wpforms-1012-field_16\">Date of Informed Consent Education Session <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-datepicker-wrap\"><input type=\"text\" id=\"wpforms-1012-field_16\" class=\"wpforms-field-date-time-date wpforms-datepicker wpforms-field-required wpforms-field-large\" data-date-format=\"m\/d\/Y\" data-disable-past-dates=\"0\" data-input=\"true\" name=\"wpforms[fields][16][date]\" required><a title=\"Clear Date\" data-clear role=\"button\" tabindex=\"0\" class=\"wpforms-datepicker-clear\" aria-label=\"Clear Date\" style=\"display:none;\"><\/a><\/div><\/div><div id=\"wpforms-1012-field_5-container\" class=\"wpforms-field wpforms-field-signature\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-1012-field_5\">Signature of Participant or Parent\/Guardian <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-1012-field_5\" class=\"wpforms-signature-input wpforms-screen-reader-element wpforms-field-required\" data-is-wrapped-field=\"1\" name=\"wpforms[fields][5]\" autocomplete=\"off\" inputmode=\"none\" required><div class=\"wpforms-signature-wrap wpforms-field-row wpforms-field-large\"><canvas class=\"wpforms-signature-canvas\" id=\"wpforms-1012-field_5-signature\" data-color=\"#000000\"><\/canvas><div class=\"wpforms-signature-clear\" title=\"Clear Signature\" tabindex=\"0\">\n\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"1em\" height=\"1em\" preserveAspectRatio=\"xMidYMid meet\" viewBox=\"0 0 1536 1536\">\n\t\t\t\t\t<path fill=\"var( --wpforms-field-text-color, rgba(0, 0, 0, 0.25) )\" d=\"M1149 994q0-26-19-45L949 768l181-181q19-19 19-45q0-27-19-46l-90-90q-19-19-46-19q-26 0-45 19L768 587L587 406q-19-19-45-19q-27 0-46 19l-90 90q-19 19-19 46q0 26 19 45l181 181l-181 181q-19 19-19 45q0 27 19 46l90 90q19 19 46 19q26 0 45-19l181-181l181 181q19 19 45 19q27 0 46-19l90-90q19-19 19-46zm387-226q0 209-103 385.5T1153.5 1433T768 1536t-385.5-103T103 1153.5T0 768t103-385.5T382.5 103T768 0t385.5 103T1433 382.5T1536 768z\"\/>\n\t\t\t\t<\/svg>\n\t\t\t\t<div class=\"wpforms-signature-clear-caption\">Clear Signature<\/div>\n\t\t\t<\/div><\/div><div class=\"wpforms-field-description\">This electronic signature holds the same force and effect as an in-person signature.<\/div><\/div><div id=\"wpforms-1012-field_19-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"19\"><h3 id=\"wpforms-1012-field_19\">Joyful Together\u00ae Follow-up Study Part 2: One-Time Interview Consent Section <\/h3><\/div><div id=\"wpforms-1012-field_18-container\" class=\"wpforms-field wpforms-field-html\" data-field-id=\"18\"><div id=\"wpforms-1012-field_18\"><h2>Purpose and Procedures<\/h2>\r\nThis interview is another part of the Joyful Together follow-up research study. You can choose to participate in the follow-up study by only completing surveys (as described above), or you can participate by completing surveys and an interview. If you do not want to participate in the interview, you will not complete this part of the consent form.  \r\n\r\nYou and a Joyful Together study team member will have a 30-60 minute interview using about twelve (12) questions to guide our conversation. This will be a one-time interview that will be done in-person or on the computer using video conferencing.  \r\n\r\n<h2>Potential Risks<\/h2>  \r\nThere are no known potential risks associated with participation. \r\n\r\n<h2>Anticipated Benefits<\/h2>  \r\nYou may or may not benefit from this study. Information learned from this research study may also benefit future children and families. \r\n\r\nYou will receive one $25.00 gift card for you and your family as a as a thank you gift for participating in one interview.   \r\n\r\n<h2>Confidentiality <\/h2>\r\nYour information will be kept confidential and only used for this research study. Only people working on this research study will have access to your study information. We will collect your demographic information, but a unique number and a made-up name or word will be used instead of your name or other identifying information during the interview and on study documents. Your name or anything else that could identify you will not be included in reports, presentations or publications from this study. Your information will be kept in a locked file cabinet in a locked room, and computer files will only be opened on password protected computers. All documentation with identifying information will be destroyed once the study has ended.  \r\n\r\n<h2>Voluntary Participation and Withdrawal <\/h2>\r\nYour participation in this study is completely voluntary. If you choose not to participate, it will not affect your relationship with OhioGuidestone.  You will still have the right to services that you are eligible for at OhioGuidestone. You will not be treated differently if you decide not to participate.   \r\n\r\nIf you decide to participate, you are free to withdraw your consent and stop at any time.  You will not be treated any differently if you decide to withdraw from the study. If you withdraw from the study, you will still continue to receive mental health services at OhioGuidestone.  \r\n\r\nIf you do participate in this study, your access to current and future services and client rights will not be changed or different. There is no cost to participate in this research study.  \r\n\r\n<h2>Contacts and Questions <\/h2>\r\nIf you have any questions about this study, you can contact the study team at: <a href=\"mailto:research@ohioguidestone.org\">research@ohioguidestone.org<\/a> or <a href=\"tel:4402608865\">440.260.8865<\/a>. \r\n\r\nIf you have any questions about OhioGuidestone\u2019s services, including client rights, you can contact the agency\u2019s Client Advocate at <a href=\"tel:4402608308\">440.260.8308<\/a>. \r\n\r\nYou may also ask your program staff any questions that you have now, or any part of the research study.  \r\n\r\n\r\n<h2>Signature of Research Subject <\/h2>\r\nInformed consent to participate in research is very important.  By signing or clicking below you agree:\r\n<ul style=\"padding-left: 30px !important;\">\r\n<li>That you have read the information about this research study;<\/li>\r\n<li>You have been given the chance to answer questions and they have been answered; <\/li>\r\n<li>You volunteer to participate in the study and understand that you can withdraw from the study at any time. <\/li>\r\n<\/ul>\r\nA copy of this consent form will be provided to you.<\/div><\/div><div id=\"wpforms-1012-field_26-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline wpforms-conditional-trigger\" data-field-id=\"26\"><label class=\"wpforms-field-label\">Do you want to particpate in the Joyful Together\u00ae Follow-up Interview? <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-1012-field_26\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-1012-field_26_1\" name=\"wpforms[fields][26]\" value=\"Yes\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1012-field_26_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-1012-field_26_2\" name=\"wpforms[fields][26]\" value=\"No\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1012-field_26_2\">No<\/label><\/li><\/ul><\/div><div id=\"wpforms-1012-field_20-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half wpforms-first wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"20\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-1012-field_20\">Name of Participant <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-1012-field_20\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][20]\" required><\/div><div id=\"wpforms-1012-field_21-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"21\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-1012-field_21\">Name of Parent\/Guardian (if participant is 12-17 years old)<\/label><input type=\"text\" id=\"wpforms-1012-field_21\" class=\"wpforms-field-large\" name=\"wpforms[fields][21]\" ><\/div><div id=\"wpforms-1012-field_22-container\" class=\"wpforms-field wpforms-field-date-time wpforms-one-half wpforms-first wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"22\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-1012-field_22\">Date <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-datepicker-wrap\"><input type=\"text\" id=\"wpforms-1012-field_22\" class=\"wpforms-field-date-time-date wpforms-datepicker wpforms-field-required wpforms-field-large\" data-date-format=\"m\/d\/Y\" data-disable-past-dates=\"0\" data-input=\"true\" name=\"wpforms[fields][22][date]\" required><a title=\"Clear Date\" data-clear role=\"button\" tabindex=\"0\" class=\"wpforms-datepicker-clear\" aria-label=\"Clear Date\" style=\"display:none;\"><\/a><\/div><\/div><div id=\"wpforms-1012-field_24-container\" class=\"wpforms-field wpforms-field-phone wpforms-one-half wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"24\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-1012-field_24\">Phone <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"tel\" id=\"wpforms-1012-field_24\" class=\"wpforms-field-large wpforms-field-required wpforms-smart-phone-field\" data-rule-smart-phone-field=\"true\" name=\"wpforms[fields][24]\" aria-label=\"Phone\" required><\/div><div id=\"wpforms-1012-field_23-container\" class=\"wpforms-field wpforms-field-signature wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"23\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-1012-field_23\">Signature <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-1012-field_23\" class=\"wpforms-signature-input wpforms-screen-reader-element wpforms-field-required\" data-is-wrapped-field=\"1\" name=\"wpforms[fields][23]\" autocomplete=\"off\" inputmode=\"none\" required><div class=\"wpforms-signature-wrap wpforms-field-row wpforms-field-large\"><canvas class=\"wpforms-signature-canvas\" id=\"wpforms-1012-field_23-signature\" data-color=\"#000000\"><\/canvas><div class=\"wpforms-signature-clear\" title=\"Clear Signature\" tabindex=\"0\">\n\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"1em\" height=\"1em\" preserveAspectRatio=\"xMidYMid meet\" viewBox=\"0 0 1536 1536\">\n\t\t\t\t\t<path fill=\"var( --wpforms-field-text-color, rgba(0, 0, 0, 0.25) )\" d=\"M1149 994q0-26-19-45L949 768l181-181q19-19 19-45q0-27-19-46l-90-90q-19-19-46-19q-26 0-45 19L768 587L587 406q-19-19-45-19q-27 0-46 19l-90 90q-19 19-19 46q0 26 19 45l181 181l-181 181q-19 19-19 45q0 27 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name=\"wpforms[submit]\" id=\"wpforms-submit-1012\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\" aria-live=\"assertive\" value=\"wpforms-submit\">Submit<\/button><\/div><\/form><\/div>  <!-- .wpforms-container 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