{"id":19883,"date":"2023-10-02T10:46:31","date_gmt":"2023-10-02T09:46:31","guid":{"rendered":"https:\/\/www.worcestercity.org.uk\/forms\/?page_id=19883"},"modified":"2023-10-02T10:46:31","modified_gmt":"2023-10-02T09:46:31","slug":"allotment-incident-reporting-form","status":"publish","type":"page","link":"https:\/\/www.worcestercity.org.uk\/forms\/allotment-incident-reporting-form\/","title":{"rendered":"Allotment Incident Reporting Form"},"content":{"rendered":"<style type=\"text\/css\" id=\"159\" data-form-unique-id=\"68961\" >.arf_heading_div h2.arf_sec_heading_field {\r\n\tfont-size: 20px !important;\r\n}\r\n.alert {\r\n\tcolor: red;\r\n\tborder: 3px solid #000;\r\n\tpadding: 10px;\r\n\tfont-size: 1.3em;\r\n}\r\n.alert2 {\r\n\tcolor: #000;\r\n\tborder: 2px solid #000;\r\n\tpadding: 10px;\r\n\tfont-size: 1.3em;\r\n}\r\n.arf_main_label {\r\n\tmargin-bottom: 10px !important;\r\n\tfont-weight: bolder !important;\r\n\tfont-size: 17px !important;\r\n}\r\ndiv.arf_field_description\t{\r\n\ttext-align: left !important;\r\n}\r\nlabel span.arfcheckrequiredfield {\r\n\tcolor: red !important;\r\n}\r\n.dot {\r\n  height: 10px;\r\n  width: 10px;\r\n  background-color: #000;\r\n  border-radius: 50%;\r\n  display: inline-block;\r\n}\r\n.arf_field_description {\r\n\tfont-size: 14px !important;\r\n}\r\n.arf_repeater_field {\r\n\tborder: 1px solid #CCC;\r\n\tpadding: 15px;\r\n}\r\n\/*\r\n.arf_heading_div {\r\n\tborder: 1px solid #000;\r\n\tmargin-bottom: 30px !important;\r\n\tpadding-right: 10px !important;\r\n}\r\n*\/<\/style><div class=\"arf_form ar_main_div_159 arf_form_outer_wrapper \" id=\"arffrm_159_container\"><div id=\"arf_message_error\" class=\"frm_error_style\" style=\"display:none;\"><div class=\"msg-detail\"><div class=\"msg-description-success\">Form Submission is restricted<\/div><\/div><\/div><div id=\"arf_message_success_popup\" style=\"display:none;\"><div class=\"msg-detail\"><div class=\"msg-description-success\">Form was successfully submitted. Thank you!<\/div><\/div><\/div><form enctype=\"multipart\/form-data\" method=\"post\" class=\"arfshowmainform  \" style=\"\" data-form-id=\"form_wuxlf9\"  novalidate=\"\" onsubmit=\"return arf_validate_form_submit()\" arf_form_submit = 0 data-id=\"68961\"  data-random-id=\"159_DjV4ZEK3Fd\"  data-submission-key=\"BP8cogy4\"  data-key-validate=\"false\"  data-popup-id=\"\"><label for='arf_filter_input_159_DjV4ZEK3Fd' class='arf_hidden_element' style='color:transparent !important;'>Filter<\/label><input id='arf_filter_input_159_DjV4ZEK3Fd' type='text' name='arf_filter_input' data-jqvalidate='false' data-random-key='159_DjV4ZEK3Fd' value='' style='opacity:0 !important;display:none !important;visibility:hidden !important;' \/><input type='hidden' id='arf_ajax_url' value='https:\/\/www.worcestercity.org.uk\/forms\/wp-admin\/admin-ajax.php' \/><input type=\"hidden\" data-jqvalidate=\"false\" class=\"kpress\" value=\"\" \/><input type=\"hidden\" data-jqvalidate=\"false\" class=\"stime\" value=\"1775659457\" \/><input type=\"hidden\" data-jqvalidate=\"false\" data-id=\"nonce_start_time\" class=\"nonce_start_time\" value=\"form_filter_st\" \/><input type=\"hidden\" data-jqvalidate=\"false\" data-id=\"nonce_keyboard_press\" class=\"nonce_keyboard_press\" value=\"form_filter_kp\" \/><input type=\"hidden\" data-jqvalidate=\"false\" data-id=\"arm_nonce_check\" name=\"arm_nonce_check\" value=\"a7bc402637\" \/><input type=\"hidden\" name=\"repeater_removed_fields\" id=\"repeater_remove_fields\" \/><input type=\"hidden\" id=\"repeater_field_ids\" name=\"repeater_field_ids\" value='[\"3128\"]' \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arf_redirect_url_to\" id=\"arf_redirect_url_to\" value=\"same_tab\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arf_browser_name\" data-id=\"arf_browser_name\" data-version=\"unknown\" value=\"Unknown\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arforms_nonce\" id=\"arforms_nonce\" value=\"22dd8a0100\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arf_file_token_159\" id=\"arf_file_token_159\" value=\"VTK8TT1Acm\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"upload_field_id_159_68961\" id=\"upload_field_id_159_68961\" value=\"\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arfdecimal_separator\" data-id=\"arfdecimal_separator\" value=\".\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arfform_date_formate_159\" data-id=\"arfform_date_formate_159\" value=\"DD\/MM\/YYYY\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"form_key_159\" data-id=\"form_key_159\" value=\"wuxlf9\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arf_success_message_show_time_159\" data-id=\"arf_success_message_show_time_159\" value=\"30\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arf_form_hide_after_submit_159\" data-id=\"arf_form_hide_after_submit_159\" value=\"1\" \/><input type=\"hidden\" 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class=\"arf_front_tooltip_settings\" data-form-id=\"159\" data-color=\"#FFFFFF\" data-position=\"top\" data-width=\"\" data-bg-color=\"#000000\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arfsuccessmsgposition_159\" data-id=\"arfsuccessmsgposition_159\"  value=\"top\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arfpagebreakstyle_159\" data-id=\"arfpagebreakstyle_159\"  value=\"number\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arfpagebreakaddtimer_159\" data-id=\"arfpagebreakaddtimer_159\" value=\"0\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"form_tooltip_error_159\" data-id=\"form_tooltip_error_159\" data-color=\"\" data-position=\"bottom\" value=\"advance\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arfaction\" value=\"create\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"form_id\" data-id=\"form_id\" value=\"159\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"form_data_id\" data-id=\"form_data_id\" value=\"68961\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"form_key\" data-id=\"form_key\" value=\"wuxlf9\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arf_ajax_url\" value=\"https:\/\/www.worcestercity.org.uk\/forms\/wp-admin\/admin-ajax.php\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"form_display_type\" data-id=\"form_display_type\" value=\"0|https:\/\/www.worcestercity.org.uk\/forms\/allotment-incident-reporting-form\/\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"form_submit_type\" data-id=\"form_submit_type\" value=\"1\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arf_http_referrer_url\" data-id=\"arf_http_referrer_url\" value=\"\" \/><input type=\"hidden\" data-jqvalidate=\"false\" id=\"arf_image_directory_url_159_68961\" name=\"arf_image_directory_url\" value=\"https:\/\/www.worcestercity.org.uk\/forms\/wp-content\/plugins\/arforms\/images\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arffiledragurl\" data-id=\"arffiledragurl\" value=\"https:\/\/www.worcestercity.org.uk\/forms\/wp-content\/plugins\/arforms\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"entry_key\" value=\"\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arf_skip_captcha\" data-id=\"arf_skip_captcha\" value=\"\" \/><input type='hidden' id='arf_pb_field_animation_style_front_159' name='arf_pb_field_animation_style_front_159' value='slideInLeft' \/><input type='hidden' id='arf_pb_field_animation_duration_front_159' name='arf_pb_field_animation_duration_front_159' value='' \/><input type='hidden' id='arf_pb_field_animation_delay_front_159' name='arf_pb_field_animation_delay_front_159' value='' \/><input type='hidden' id='arf_pb_field_animation_inherit_159' name='arf_pb_field_animation_inherit_159' value='0' \/><input type='hidden' id='arf_field_animation_style_front_159' name='arf_field_animation_style_front_159' value='' \/><input type='hidden' id='arf_field_animation_duration_front_159' name='arf_field_animation_duration_front_159' value='' \/><input type='hidden' id='arf_field_animation_delay_front_159' name='arf_field_animation_delay_front_159' value='' \/><input type=\"hidden\" id=\"arf_form_site_wide_159\" value=\"\" \/><div class=\"allfields\" style=\"visibility:hidden;height:0;\"><div class=\"arf_fieldset arf_standard_form\" id=\"arf_fieldset_68961\"><div id=\"page_0\" class=\"page_break\"><div id=\"arf_field_3017_68961_container\" class=\"      arfformfield control-group arfmainformfield  arf_vertical_radio  arffieldrequired arf_field_type_radio   top_container  top_container arfformfield  arf_field_3017\"  style='width: 100%'  data-field-type=\"radio\" data-parent_field=\"0\"><label data-type=\"radio\" for=\"field_on82md_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Type of incident<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"setting_radio controls arf_standard_radio \" style=\"padding-top:5px;\"><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3017]\" data-type=\"radio\" id=\"field_3017-0-68961\" data-unique-id=\"68961\" value=\"Personal Injury \"   class=\" arf_required \" data-validation-minchecked-minchecked=\"1\" data-validation-minchecked-message=\"This field cannot be blank.\" onChange='arf_cl_apply_v3(68961,{\"0\":\"3026\",\"1\":\"3028\",\"2\":\"3030\",\"3\":\"3031\",\"4\":\"3033\",\"5\":\"3032\",\"6\":\"3036\",\"7\":\"3027\",\"8\":\"3046\",\"9\":\"3044\",\"10\":\"3047\",\"11\":\"3045\",\"24\":\"3116\",\"25\":\"3117\",\"26\":\"3121\",\"27\":\"3123\",\"28\":\"3125\",\"29\":\"3119\",\"42\":\"3127\",\"43\":\"3126\"});' style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3017-0-68961\" class=\"\">Personal Injury <\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3017]\" data-type=\"radio\" id=\"field_3017-1-68961\" data-unique-id=\"68961\" value=\"Property or Equipment Damage\"   class=\" arf_required \" onChange='arf_cl_apply_v3(68961,{\"0\":\"3026\",\"1\":\"3028\",\"2\":\"3030\",\"3\":\"3031\",\"4\":\"3033\",\"5\":\"3032\",\"6\":\"3036\",\"7\":\"3027\",\"8\":\"3046\",\"9\":\"3044\",\"10\":\"3047\",\"11\":\"3045\",\"24\":\"3116\",\"25\":\"3117\",\"26\":\"3121\",\"27\":\"3123\",\"28\":\"3125\",\"29\":\"3119\",\"42\":\"3127\",\"43\":\"3126\"});' style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3017-1-68961\" class=\"\">Property or Equipment Damage<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3017]\" data-type=\"radio\" id=\"field_3017-2-68961\" data-unique-id=\"68961\" value=\"Vehicle Incident\"   class=\" arf_required \" onChange='arf_cl_apply_v3(68961,{\"0\":\"3026\",\"1\":\"3028\",\"2\":\"3030\",\"3\":\"3031\",\"4\":\"3033\",\"5\":\"3032\",\"6\":\"3036\",\"7\":\"3027\",\"8\":\"3046\",\"9\":\"3044\",\"10\":\"3047\",\"11\":\"3045\",\"24\":\"3116\",\"25\":\"3117\",\"26\":\"3121\",\"27\":\"3123\",\"28\":\"3125\",\"29\":\"3119\",\"42\":\"3127\",\"43\":\"3126\"});' style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3017-2-68961\" class=\"\">Vehicle Incident<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3017]\" data-type=\"radio\" id=\"field_3017-3-68961\" data-unique-id=\"68961\" value=\"Exposure to Hazardous Substance\"   class=\" arf_required \" onChange='arf_cl_apply_v3(68961,{\"0\":\"3026\",\"1\":\"3028\",\"2\":\"3030\",\"3\":\"3031\",\"4\":\"3033\",\"5\":\"3032\",\"6\":\"3036\",\"7\":\"3027\",\"8\":\"3046\",\"9\":\"3044\",\"10\":\"3047\",\"11\":\"3045\",\"24\":\"3116\",\"25\":\"3117\",\"26\":\"3121\",\"27\":\"3123\",\"28\":\"3125\",\"29\":\"3119\",\"42\":\"3127\",\"43\":\"3126\"});' style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3017-3-68961\" class=\"\">Exposure to Hazardous Substance<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3017]\" data-type=\"radio\" id=\"field_3017-4-68961\" data-unique-id=\"68961\" value=\"Physical\/Verbal abuse\"   class=\" arf_required \" onChange='arf_cl_apply_v3(68961,{\"0\":\"3026\",\"1\":\"3028\",\"2\":\"3030\",\"3\":\"3031\",\"4\":\"3033\",\"5\":\"3032\",\"6\":\"3036\",\"7\":\"3027\",\"8\":\"3046\",\"9\":\"3044\",\"10\":\"3047\",\"11\":\"3045\",\"24\":\"3116\",\"25\":\"3117\",\"26\":\"3121\",\"27\":\"3123\",\"28\":\"3125\",\"29\":\"3119\",\"42\":\"3127\",\"43\":\"3126\"});' style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3017-4-68961\" class=\"\">Physical\/Verbal abuse<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3017]\" data-type=\"radio\" id=\"field_3017-5-68961\" data-unique-id=\"68961\" value=\"Near Hit\/Cause for Concern\"   class=\" arf_required \" onChange='arf_cl_apply_v3(68961,{\"0\":\"3026\",\"1\":\"3028\",\"2\":\"3030\",\"3\":\"3031\",\"4\":\"3033\",\"5\":\"3032\",\"6\":\"3036\",\"7\":\"3027\",\"8\":\"3046\",\"9\":\"3044\",\"10\":\"3047\",\"11\":\"3045\",\"24\":\"3116\",\"25\":\"3117\",\"26\":\"3121\",\"27\":\"3123\",\"28\":\"3125\",\"29\":\"3119\",\"42\":\"3127\",\"43\":\"3126\"});' style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3017-5-68961\" class=\"\">Near Hit\/Cause for Concern<\/label><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3018_68961_container\" class=\"    arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_date  top_container  top_container arfformfield  arf_field_3018\"  style='width: 100%'  data-field-type=\"date\" data-parent_field=\"0\"><label data-type=\"date\" for=\"field_7lmqnc_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Date and time of incident<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls arf_date_main_controls \"   ><div class=\"arf_prefix_suffix_wrapper  arf_prefix_only  \"><span id=\"arf_prefix_7lmqnc\" class=\"arf_prefix\" onclick=\"arfFocusInputField(this,'7lmqnc');\"><i class=\"fas fa-clock\"><\/i><\/span><input type=\"text\" data-date-format=\"DD\/MM\/YYYY H:mm\" data-start-date=\"01\/01\/1876 00:00 AM\" data-cl-format=\"YYYY-MM-DD H:mm\" data-date-new-format=\"DD-MM-YYYY\" data-end-date=\"31\/12\/2076 11:59 PM\" data-default-date=\"26\/10\/2023 12:45\" id=\"field_7lmqnc_68961\"    class=\" arf_required frm_date arforms_datepicker_control\" data-name='item_meta[3018]' data-format='DD\/MM\/YYYY H:mm' data-field-options=\"{&quot;required&quot;:&quot;1&quot;,&quot;required_indicator&quot;:&quot;*&quot;,&quot;blank&quot;:&quot;This field cannot be blank.&quot;,&quot;field_width&quot;:&quot;&quot;,&quot;locale&quot;:&quot;en&quot;,&quot;currentdefaultdate&quot;:&quot;0&quot;,&quot;name&quot;:&quot;Date and time of incident&quot;,&quot;default_value&quot;:&quot;&quot;,&quot;description&quot;:&quot;Select date and time from picker&quot;,&quot;placeholdertext&quot;:&quot;&quot;,&quot;show_time_calendar&quot;:&quot;1&quot;,&quot;frm_show_time_calendar_field_indicator&quot;:&quot;&quot;,&quot;clock&quot;:&quot;24&quot;,&quot;step&quot;:&quot;5&quot;,&quot;off_days&quot;:&quot;&quot;,&quot;start_date&quot;:&quot;&quot;,&quot;end_date&quot;:&quot;&quot;,&quot;arf_show_min_current_date&quot;:&quot;0&quot;,&quot;arf_show_max_current_date&quot;:&quot;0&quot;,&quot;arf_tooltip&quot;:&quot;&quot;,&quot;frm_arf_tooltip_field_indicator&quot;:&quot;&quot;,&quot;tooltip_text&quot;:&quot;&quot;,&quot;enable_arf_prefix&quot;:&quot;1&quot;,&quot;arf_prefix_icon&quot;:&quot;fas fa-clock&quot;,&quot;enable_arf_suffix&quot;:&quot;&quot;,&quot;arf_suffix_icon&quot;:&quot;&quot;,&quot;classes&quot;:&quot;arf_1&quot;,&quot;inner_class&quot;:&quot;arf_1col&quot;,&quot;key&quot;:&quot;7lmqnc&quot;,&quot;selectdefaultdate&quot;:&quot;26\\\/10\\\/2023 12:45&quot;,&quot;arfnewdateformat&quot;:&quot;&quot;,&quot;css_outer_wrapper&quot;:&quot;&quot;,&quot;css_label&quot;:&quot;&quot;,&quot;css_input_element&quot;:&quot;&quot;,&quot;css_description&quot;:&quot;&quot;,&quot;css_add_icon&quot;:&quot;&quot;,&quot;type&quot;:&quot;date&quot;,&quot;arf_enable_readonly&quot;:&quot;0&quot;,&quot;arf_aria_label&quot;:&quot;&quot;,&quot;class_selector&quot;:&quot;&quot;,&quot;image_position_from&quot;:&quot;top_left&quot;,&quot;clear_on_focus&quot;:&quot;0&quot;,&quot;default_blank&quot;:&quot;0&quot;,&quot;arf_regular_expression&quot;:&quot;&quot;}\" data-default-value=\"26\/10\/2023 12:45\" value=\"26\/10\/2023 12:45\" data-validation-required-message=\"This field cannot be blank.\" \/><input type=\"hidden\" name=\"item_meta[3018]\" id=\"field_7lmqnc_68961_formatted\" value=\"26\/10\/2023 12:45\" \/><\/div><div class=\"arf_field_description \">Select date and time from picker<\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3019_68961_container\" class=\"    arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_textarea  top_container top_container arfformfield   arf_inline_field_value  arf_field_3019\"  style='width: 100%'  data-field-type=\"textarea\" data-parent_field=\"0\"><label data-type=\"textarea\" for=\"field_3dqcef_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Incident description (what happened)<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\"   ><textarea name=\"item_meta[3019]\" id=\"field_3dqcef_68961\"  rows=\"6\"  class=\" arf_required \" data-validation-required-message=\"This field cannot be blank.\"  ><\/textarea><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3020_68961_container\" class=\"      arfformfield control-group arfmainformfield  arf_horizontal_radio  arffieldrequired arf_field_type_radio   top_container  top_container arfformfield  arf_field_3020\"  style='width: 100%'  data-field-type=\"radio\" data-parent_field=\"0\"><label data-type=\"radio\" for=\"field_suoh0m_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Name of allotment site<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"setting_radio controls arf_standard_radio \" style=\"padding-top:5px;\"><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3020]\" data-type=\"radio\" id=\"field_3020-0-68961\" data-unique-id=\"68961\" value=\"Battenhall Avenue\"   class=\" arf_required \" data-validation-minchecked-minchecked=\"1\" data-validation-minchecked-message=\"This field cannot be blank.\" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3020-0-68961\" class=\"\">Battenhall Avenue<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3020]\" data-type=\"radio\" id=\"field_3020-1-68961\" data-unique-id=\"68961\" value=\"Bromwich Road\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3020-1-68961\" class=\"\">Bromwich Road<\/label><\/div><\/div><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3020]\" data-type=\"radio\" id=\"field_3020-2-68961\" data-unique-id=\"68961\" value=\"Cherry Street\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3020-2-68961\" class=\"\">Cherry Street<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3020]\" data-type=\"radio\" id=\"field_3020-3-68961\" data-unique-id=\"68961\" value=\"Comer Road\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3020-3-68961\" class=\"\">Comer Road<\/label><\/div><\/div><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3020]\" data-type=\"radio\" id=\"field_3020-4-68961\" data-unique-id=\"68961\" value=\"Foxwell Street\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3020-4-68961\" class=\"\">Foxwell Street<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3020]\" data-type=\"radio\" id=\"field_3020-5-68961\" data-unique-id=\"68961\" value=\"Green Lane\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3020-5-68961\" class=\"\">Green Lane<\/label><\/div><\/div><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3020]\" data-type=\"radio\" id=\"field_3020-6-68961\" data-unique-id=\"68961\" value=\"Henwick Road\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3020-6-68961\" class=\"\">Henwick Road<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3020]\" data-type=\"radio\" id=\"field_3020-7-68961\" data-unique-id=\"68961\" value=\"Hillborough\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3020-7-68961\" class=\"\">Hillborough<\/label><\/div><\/div><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3020]\" data-type=\"radio\" id=\"field_3020-8-68961\" data-unique-id=\"68961\" value=\"Langdale Drive\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3020-8-68961\" class=\"\">Langdale Drive<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3020]\" data-type=\"radio\" id=\"field_3020-9-68961\" data-unique-id=\"68961\" value=\"Lansdowne Crescent\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3020-9-68961\" class=\"\">Lansdowne Crescent<\/label><\/div><\/div><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3020]\" data-type=\"radio\" id=\"field_3020-10-68961\" data-unique-id=\"68961\" value=\"Lansdowne Road South\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3020-10-68961\" class=\"\">Lansdowne Road South<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3020]\" data-type=\"radio\" id=\"field_3020-11-68961\" data-unique-id=\"68961\" value=\"Northwick Road\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3020-11-68961\" class=\"\">Northwick Road<\/label><\/div><\/div><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3020]\" data-type=\"radio\" id=\"field_3020-12-68961\" data-unique-id=\"68961\" value=\"Old Northwick Lane\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3020-12-68961\" class=\"\">Old Northwick Lane<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3020]\" data-type=\"radio\" id=\"field_3020-13-68961\" data-unique-id=\"68961\" value=\"Perdiswell: Droitwich Road\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3020-13-68961\" class=\"\">Perdiswell: Droitwich Road<\/label><\/div><\/div><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3020]\" data-type=\"radio\" id=\"field_3020-14-68961\" data-unique-id=\"68961\" value=\"Pitchcroft Lane\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3020-14-68961\" class=\"\">Pitchcroft Lane<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3020]\" data-type=\"radio\" id=\"field_3020-15-68961\" data-unique-id=\"68961\" value=\"Pitmaston\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3020-15-68961\" class=\"\">Pitmaston<\/label><\/div><\/div><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3020]\" data-type=\"radio\" id=\"field_3020-16-68961\" data-unique-id=\"68961\" value=\"Rogers Hill\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3020-16-68961\" class=\"\">Rogers Hill<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3020]\" data-type=\"radio\" id=\"field_3020-17-68961\" data-unique-id=\"68961\" value=\"The Grove\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3020-17-68961\" class=\"\">The Grove<\/label><\/div><\/div><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3020]\" data-type=\"radio\" id=\"field_3020-18-68961\" data-unique-id=\"68961\" value=\"Timberdine Avenue\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3020-18-68961\" class=\"\">Timberdine Avenue<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3020]\" data-type=\"radio\" id=\"field_3020-19-68961\" data-unique-id=\"68961\" value=\"Waterworks Road\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3020-19-68961\" class=\"\">Waterworks Road<\/label><\/div><\/div><div class=\"arf_chk_radio_col_two\"><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3020]\" data-type=\"radio\" id=\"field_3020-20-68961\" data-unique-id=\"68961\" value=\"Winchester Avenue\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3020-20-68961\" class=\"\">Winchester Avenue<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3020]\" data-type=\"radio\" id=\"field_3020-21-68961\" data-unique-id=\"68961\" value=\"Windsor Avenue\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3020-21-68961\" class=\"\">Windsor Avenue<\/label><\/div><\/div><div class=\"arf_chk_radio_col_two\"><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3021_68961_container\" class=\"    arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_textarea  top_container top_container arfformfield   arf_inline_field_value  arf_field_3021\"  style='width: 100%'  data-field-type=\"textarea\" data-parent_field=\"0\"><label data-type=\"textarea\" for=\"field_loardd_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Incident address and\/or location<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\"   ><textarea name=\"item_meta[3021]\" id=\"field_loardd_68961\"  rows=\"5\"  class=\" arf_required \" data-validation-required-message=\"This field cannot be blank.\"  ><\/textarea><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3022_68961_container\" class=\"    arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_text  top_container top_container arfformfield   arf_inline_field_value  arf_field_3022\"  style='width: 100%' data-field-type=\"text\" data-parent_field=\"0\" ><label data-type=\"text\" for=\"field_9v2ahf_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Allotment Plot Number<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\"   ><input   type=\"text\" id=\"field_9v2ahf_68961\"  name=\"item_meta[3022]\"  class=\" arf_required \" data-validation-required-message=\"This field cannot be blank.\"   \/><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3024_68961_container\" class=\"    arfformfield control-group arfmainformfield  arf_field_type_text  top_container top_container arfformfield   arf_inline_field_value  arf_field_3024\"  style='width: 100%' data-field-type=\"text\" data-parent_field=\"0\" ><label data-type=\"text\" for=\"field_gzvhev_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Contact number<\/label><div class=\"controls\"   ><div class=\"arf_prefix_suffix_wrapper  arf_prefix_only  \"><span id=\"arf_prefix_gzvhev\" class=\"arf_prefix\" onclick=\"arfFocusInputField(this,'gzvhev');\"><i class=\"fas fa-phone-alt\"><\/i><\/span><input   type=\"text\" id=\"field_gzvhev_68961\"  name=\"item_meta[3024]\"   \/><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3145_68961_container\" class=\"    arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_email  top_container  arf_inline_field_value   top_container arfformfield  arf_field_3145\"  style='width: 100%'  data-field-type=\"email\" data-parent_field=\"0\"><label data-type=\"email\" for=\"field_69wqu6_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Contact Email<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\"   ><div class=\"arf_prefix_suffix_wrapper  arf_prefix_only  \"><span id=\"arf_prefix_69wqu6\" class=\"arf_prefix\" onclick=\"arfFocusInputField(this,'69wqu6');\"><i class=\"fas fa-envelope\"><\/i><\/span><input type=\"text\" id=\"field_69wqu6_68961\" name=\"item_meta[3145]\"  class=\" arf_required \" data-validation-required-message=\"This field cannot be blank.\"  data-validation-regex-regex=\"[\\p{L}0-9._-]+@[\\p{L}0-9.-]+\\.[\\p{L}]+\" data-validation-regex-message=\"Email is invalid\"  \/><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3023_68961_container\" class=\"    arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_text  top_container top_container arfformfield   arf_inline_field_value  arf_field_3023\"  style='width: 100%' data-field-type=\"text\" data-parent_field=\"0\" ><label data-type=\"text\" for=\"field_umb7lc_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Reported by<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\"   ><input   type=\"text\" id=\"field_umb7lc_68961\"  name=\"item_meta[3023]\"  class=\" arf_required \" data-validation-required-message=\"This field cannot be blank.\"   \/><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3025_68961_container\" class=\"    arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_date  top_container  top_container arfformfield  arf_field_3025\"  style='width: 100%'  data-field-type=\"date\" data-parent_field=\"0\"><label data-type=\"date\" for=\"field_cdtwwh_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Date reported<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls arf_date_main_controls \"   ><input type=\"text\" data-date-format=\"DD\/MM\/YYYY\" data-start-date=\"01\/01\/1876 00:00 AM\" data-cl-format=\"YYYY-MM-DD\" data-date-new-format=\"DD-MM-YYYY\" data-end-date=\"31\/12\/2076 11:59 PM\" data-default-date=\"\" id=\"field_cdtwwh_68961\"    class=\" arf_required frm_date arforms_datepicker_control\" data-name='item_meta[3025]' data-format='DD\/MM\/YYYY' data-field-options=\"{&quot;required&quot;:&quot;1&quot;,&quot;required_indicator&quot;:&quot;*&quot;,&quot;blank&quot;:&quot;This field cannot be blank.&quot;,&quot;field_width&quot;:&quot;&quot;,&quot;locale&quot;:&quot;en&quot;,&quot;currentdefaultdate&quot;:&quot;0&quot;,&quot;name&quot;:&quot;Date reported&quot;,&quot;default_value&quot;:&quot;&quot;,&quot;description&quot;:&quot;&quot;,&quot;placeholdertext&quot;:&quot;&quot;,&quot;show_time_calendar&quot;:&quot;0&quot;,&quot;frm_show_time_calendar_field_indicator&quot;:&quot;&quot;,&quot;clock&quot;:&quot;12&quot;,&quot;step&quot;:&quot;30&quot;,&quot;off_days&quot;:&quot;&quot;,&quot;start_date&quot;:&quot;&quot;,&quot;end_date&quot;:&quot;&quot;,&quot;arf_show_min_current_date&quot;:&quot;0&quot;,&quot;arf_show_max_current_date&quot;:&quot;0&quot;,&quot;arf_tooltip&quot;:&quot;&quot;,&quot;frm_arf_tooltip_field_indicator&quot;:&quot;&quot;,&quot;tooltip_text&quot;:&quot;&quot;,&quot;enable_arf_prefix&quot;:&quot;&quot;,&quot;arf_prefix_icon&quot;:&quot;&quot;,&quot;enable_arf_suffix&quot;:&quot;&quot;,&quot;arf_suffix_icon&quot;:&quot;&quot;,&quot;classes&quot;:&quot;arf_1&quot;,&quot;inner_class&quot;:&quot;arf_1col&quot;,&quot;key&quot;:&quot;cdtwwh&quot;,&quot;selectdefaultdate&quot;:&quot;&quot;,&quot;arfnewdateformat&quot;:&quot;&quot;,&quot;css_outer_wrapper&quot;:&quot;&quot;,&quot;css_label&quot;:&quot;&quot;,&quot;css_input_element&quot;:&quot;&quot;,&quot;css_description&quot;:&quot;&quot;,&quot;css_add_icon&quot;:&quot;&quot;,&quot;type&quot;:&quot;date&quot;,&quot;arf_enable_readonly&quot;:&quot;0&quot;,&quot;arf_aria_label&quot;:&quot;&quot;,&quot;class_selector&quot;:&quot;&quot;,&quot;image_position_from&quot;:&quot;top_left&quot;,&quot;clear_on_focus&quot;:&quot;0&quot;,&quot;default_blank&quot;:&quot;0&quot;,&quot;arf_regular_expression&quot;:&quot;&quot;}\" data-validation-required-message=\"This field cannot be blank.\" \/><input type=\"hidden\" name=\"item_meta[3025]\" id=\"field_cdtwwh_68961_formatted\" \/><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3027_68961_container\" class=\"    arfformfield arf_display_to_confirmation_summary control-group arfmainformfield  arf_field_type_html  top_container  top_container arfformfield  arf_field_3027\" data-field-type=\"html\" data-parent_field=\"0\" style='width: 100%'><div class=\"arf_htmlfield_control\"><h2>Personal Injury<\/h2><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3026_68961_container\" class=\"    arfformfield control-group arfmainformfield  arf_field_type_text  top_container top_container arfformfield   arf_inline_field_value  arf_field_3026\"  style='width: 100%' data-field-type=\"text\" data-parent_field=\"0\" ><label data-type=\"text\" for=\"field_b4g3tb_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Injured\/affected person<\/label><div class=\"controls\"   ><input   type=\"text\" id=\"field_b4g3tb_68961\"  name=\"item_meta[3026]\"   \/><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3028_68961_container\" class=\"    arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_text  top_container top_container arfformfield   arf_inline_field_value  arf_field_3028\"  style='width: 100%' data-field-type=\"text\" data-parent_field=\"0\" ><label data-type=\"text\" for=\"field_24z78e_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Name<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\"   ><input   type=\"text\" id=\"field_24z78e_68961\"  name=\"item_meta[3028]\"  class=\" arf_required \" data-validation-required-message=\"This field cannot be blank.\"   \/><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3030_68961_container\" class=\"    arfformfield control-group arfmainformfield  arf_field_type_date  top_container  top_container arfformfield  arf_field_3030\"  style='width: 100%'  data-field-type=\"date\" data-parent_field=\"0\"><label data-type=\"date\" for=\"field_p1nvi1_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Date of Birth<\/label><div class=\"controls arf_date_main_controls \"   ><input type=\"text\" data-date-format=\"DD\/MM\/YYYY\" data-start-date=\"01\/01\/1876 00:00 AM\" data-cl-format=\"YYYY-MM-DD\" data-date-new-format=\"DD-MM-YYYY\" data-end-date=\"31\/12\/2076 11:59 PM\" data-default-date=\"\" id=\"field_p1nvi1_68961\"    class=\"frm_date arforms_datepicker_control\" data-name='item_meta[3030]' data-format='DD\/MM\/YYYY' data-field-options=\"{&quot;required&quot;:&quot;0&quot;,&quot;required_indicator&quot;:&quot;*&quot;,&quot;blank&quot;:&quot;This field cannot be blank.&quot;,&quot;field_width&quot;:&quot;&quot;,&quot;locale&quot;:&quot;en&quot;,&quot;currentdefaultdate&quot;:&quot;0&quot;,&quot;name&quot;:&quot;Date of Birth&quot;,&quot;default_value&quot;:&quot;&quot;,&quot;description&quot;:&quot;Use picker or type the date: Format must be dd\\\/mm\\\/yyyy&quot;,&quot;placeholdertext&quot;:&quot;&quot;,&quot;show_time_calendar&quot;:&quot;0&quot;,&quot;frm_show_time_calendar_field_indicator&quot;:&quot;&quot;,&quot;clock&quot;:&quot;12&quot;,&quot;step&quot;:&quot;30&quot;,&quot;off_days&quot;:&quot;&quot;,&quot;start_date&quot;:&quot;&quot;,&quot;end_date&quot;:&quot;&quot;,&quot;arf_show_min_current_date&quot;:&quot;0&quot;,&quot;arf_show_max_current_date&quot;:&quot;0&quot;,&quot;arf_tooltip&quot;:&quot;&quot;,&quot;frm_arf_tooltip_field_indicator&quot;:&quot;&quot;,&quot;tooltip_text&quot;:&quot;&quot;,&quot;enable_arf_prefix&quot;:&quot;&quot;,&quot;arf_prefix_icon&quot;:&quot;&quot;,&quot;enable_arf_suffix&quot;:&quot;&quot;,&quot;arf_suffix_icon&quot;:&quot;&quot;,&quot;classes&quot;:&quot;arf_1&quot;,&quot;inner_class&quot;:&quot;arf_1col&quot;,&quot;key&quot;:&quot;p1nvi1&quot;,&quot;selectdefaultdate&quot;:&quot;&quot;,&quot;arfnewdateformat&quot;:&quot;&quot;,&quot;css_outer_wrapper&quot;:&quot;&quot;,&quot;css_label&quot;:&quot;&quot;,&quot;css_input_element&quot;:&quot;&quot;,&quot;css_description&quot;:&quot;&quot;,&quot;css_add_icon&quot;:&quot;&quot;,&quot;type&quot;:&quot;date&quot;,&quot;arf_enable_readonly&quot;:&quot;0&quot;,&quot;arf_aria_label&quot;:&quot;&quot;,&quot;class_selector&quot;:&quot;&quot;,&quot;image_position_from&quot;:&quot;top_left&quot;,&quot;clear_on_focus&quot;:&quot;0&quot;,&quot;default_blank&quot;:&quot;0&quot;,&quot;arf_regular_expression&quot;:&quot;&quot;}\" \/><input type=\"hidden\" name=\"item_meta[3030]\" id=\"field_p1nvi1_68961_formatted\" \/><div class=\"arf_field_description \">Use picker or type the date: Format must be dd\/mm\/yyyy<\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3031_68961_container\" class=\"    arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_text  top_container top_container arfformfield   arf_inline_field_value  arf_field_3031\"  style='width: 100%' data-field-type=\"text\" data-parent_field=\"0\" ><label data-type=\"text\" for=\"field_mghrsf_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Site Coordinator<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\"   ><input   type=\"text\" id=\"field_mghrsf_68961\"  name=\"item_meta[3031]\"  class=\" arf_required \" data-validation-required-message=\"This field cannot be blank.\"   \/><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3033_68961_container\" class=\"    arfformfield control-group arfmainformfield  arf_horizontal_radio  arffieldrequired arf_field_type_checkbox   top_container  top_container arfformfield  arf_field_3033\"  style='width: 100%'  data-field-type=\"checkbox\" data-parent_field=\"0\"><label data-type=\"checkbox\" for=\"field_6f83wa_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Person injured<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"setting_checkbox controls arf_standard_checkbox\" style=\"padding-top:5px;\" ><div class=\"arf_checkbox_style \" id=\"frm_checkbox_3033-0\"><div class='arf_checkbox_input_wrapper '><input type=\"checkbox\" name=\"item_meta[3033][]\" data-type=\"checkbox\" id=\"field_3033-0-68961\" value=\"Volunteer\" data-label=\"Volunteer\"    class=\" arf_required \"data-validation-minchecked-minchecked=\"1\" data-validation-minchecked-message=\"This field cannot be blank.\" style=''  \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_3033-0-68961\" aria-label=\"Volunteer\">Volunteer<\/label><\/div><div class=\"arf_checkbox_style \" id=\"frm_checkbox_3033-1\"><div class='arf_checkbox_input_wrapper '><input type=\"checkbox\" name=\"item_meta[3033][]\" data-type=\"checkbox\" id=\"field_3033-1-68961\" value=\"Tenant\" data-label=\"Tenant\"    class=\" arf_required \" style=''  \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_3033-1-68961\" aria-label=\"Tenant\">Tenant<\/label><\/div><div class=\"arf_checkbox_style \" id=\"frm_checkbox_3033-2\"><div class='arf_checkbox_input_wrapper '><input type=\"checkbox\" name=\"item_meta[3033][]\" data-type=\"checkbox\" id=\"field_3033-2-68961\" value=\"Co-Worker\" data-label=\"Co-Worker\"    class=\" arf_required \" style=''  \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_3033-2-68961\" aria-label=\"Co-Worker\">Co-Worker<\/label><\/div><div class=\"arf_checkbox_style \" id=\"frm_checkbox_3033-3\"><div class='arf_checkbox_input_wrapper '><input type=\"checkbox\" name=\"item_meta[3033][]\" data-type=\"checkbox\" id=\"field_3033-3-68961\" value=\"Visitor\" data-label=\"Visitor\"    class=\" arf_required \" style=''  \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_3033-3-68961\" aria-label=\"Visitor\">Visitor<\/label><\/div><div class=\"arf_checkbox_style \" id=\"frm_checkbox_3033-4\"><div class='arf_checkbox_input_wrapper '><input type=\"checkbox\" name=\"item_meta[3033][]\" data-type=\"checkbox\" id=\"field_3033-4-68961\" value=\"Contractor\" data-label=\"Contractor\"    class=\" arf_required \" style=''  \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_3033-4-68961\" aria-label=\"Contractor\">Contractor<\/label><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3032_68961_container\" class=\"    arfformfield control-group arfmainformfield  arf_field_type_text  top_container top_container arfformfield   arf_inline_field_value  arf_field_3032\"  style='width: 100%' data-field-type=\"text\" data-parent_field=\"0\" ><label data-type=\"text\" for=\"field_po081_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Any other Person(s) Involved<\/label><div class=\"controls\"   ><input   type=\"text\" id=\"field_po081_68961\"  name=\"item_meta[3032]\"   \/><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3036_68961_container\" class=\"      arfformfield control-group arfmainformfield  arf_horizontal_radio  arffieldrequired arf_field_type_radio   top_container  top_container arfformfield  arf_field_3036\"  style='width: 100%'  data-field-type=\"radio\" data-parent_field=\"0\"><label data-type=\"radio\" for=\"field_hjawpi_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Was treatment required?<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"setting_radio controls arf_standard_radio \" style=\"padding-top:5px;\"><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3036]\" data-type=\"radio\" id=\"field_3036-0-68961\" data-unique-id=\"68961\" value=\"Yes\"   class=\" arf_required \" data-validation-minchecked-minchecked=\"1\" data-validation-minchecked-message=\"This field cannot be blank.\" onChange='arf_cl_apply_v3(68961,{\"0\":\"3035\",\"1\":\"3034\",\"2\":\"3037\",\"4\":\"3041\",\"5\":\"3040\",\"6\":\"3038\",\"7\":\"3039\",\"8\":\"3043\",\"10\":\"3042\"});' style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3036-0-68961\" class=\"\">Yes<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3036]\" data-type=\"radio\" id=\"field_3036-1-68961\" data-unique-id=\"68961\" value=\"No\"   class=\" arf_required \" onChange='arf_cl_apply_v3(68961,{\"0\":\"3035\",\"1\":\"3034\",\"2\":\"3037\",\"4\":\"3041\",\"5\":\"3040\",\"6\":\"3038\",\"7\":\"3039\",\"8\":\"3043\",\"10\":\"3042\"});' style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3036-1-68961\" class=\"\">No<\/label><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3035_68961_container\" class=\"      arfformfield control-group arfmainformfield  arf_horizontal_radio  arffieldrequired arf_field_type_radio   top_container  top_container arfformfield  arf_field_3035\"  style='width: 100%'  data-field-type=\"radio\" data-parent_field=\"0\"><label data-type=\"radio\" for=\"field_kn2q9p_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Was the injured person unconscious?<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"setting_radio controls arf_standard_radio \" style=\"padding-top:5px;\"><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3035]\" data-type=\"radio\" id=\"field_3035-0-68961\" data-unique-id=\"68961\" value=\"Yes\"   class=\" arf_required \" data-validation-minchecked-minchecked=\"1\" data-validation-minchecked-message=\"This field cannot be blank.\" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3035-0-68961\" class=\"\">Yes<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3035]\" data-type=\"radio\" id=\"field_3035-1-68961\" data-unique-id=\"68961\" value=\"No\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3035-1-68961\" class=\"\">No<\/label><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3034_68961_container\" class=\"      arfformfield control-group arfmainformfield  arf_horizontal_radio  arffieldrequired arf_field_type_radio   top_container  top_container arfformfield  arf_field_3034\"  style='width: 100%'  data-field-type=\"radio\" data-parent_field=\"0\"><label data-type=\"radio\" for=\"field_ga6gve_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Did the injured person require resuscitation?<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"setting_radio controls arf_standard_radio \" style=\"padding-top:5px;\"><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3034]\" data-type=\"radio\" id=\"field_3034-0-68961\" data-unique-id=\"68961\" value=\"Yes\"   class=\" arf_required \" data-validation-minchecked-minchecked=\"1\" data-validation-minchecked-message=\"This field cannot be blank.\" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3034-0-68961\" class=\"\">Yes<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3034]\" data-type=\"radio\" id=\"field_3034-1-68961\" data-unique-id=\"68961\" value=\"No\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3034-1-68961\" class=\"\">No<\/label><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3037_68961_container\" class=\"      arfformfield control-group arfmainformfield  arf_horizontal_radio  arffieldrequired arf_field_type_radio   top_container  top_container arfformfield  arf_field_3037\"  style='width: 100%'  data-field-type=\"radio\" data-parent_field=\"0\"><label data-type=\"radio\" for=\"field_egugo1_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Did the injured person require treatment?<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"setting_radio controls arf_standard_radio \" style=\"padding-top:5px;\"><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3037]\" data-type=\"radio\" id=\"field_3037-0-68961\" data-unique-id=\"68961\" value=\"Yes\"   class=\" arf_required \" data-validation-minchecked-minchecked=\"1\" data-validation-minchecked-message=\"This field cannot be blank.\" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3037-0-68961\" class=\"\">Yes<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3037]\" data-type=\"radio\" id=\"field_3037-1-68961\" data-unique-id=\"68961\" value=\"No\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3037-1-68961\" class=\"\">No<\/label><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3041_68961_container\" class=\"      arfformfield control-group arfmainformfield  arf_horizontal_radio  arffieldrequired arf_field_type_radio   top_container  top_container arfformfield  arf_field_3041\"  style='width: 100%'  data-field-type=\"radio\" data-parent_field=\"0\"><label data-type=\"radio\" for=\"field_o5zcdt_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Did the injured person receive first aid?<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"setting_radio controls arf_standard_radio \" style=\"padding-top:5px;\"><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3041]\" data-type=\"radio\" id=\"field_3041-0-68961\" data-unique-id=\"68961\" value=\"Yes\"   class=\" arf_required \" data-validation-minchecked-minchecked=\"1\" data-validation-minchecked-message=\"This field cannot be blank.\" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3041-0-68961\" class=\"\">Yes<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3041]\" data-type=\"radio\" id=\"field_3041-1-68961\" data-unique-id=\"68961\" value=\"No\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3041-1-68961\" class=\"\">No<\/label><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3040_68961_container\" class=\"    arfformfield control-group arfmainformfield  arf_field_type_text  top_container top_container arfformfield   arf_inline_field_value  arf_field_3040\"  style='width: 100%' data-field-type=\"text\" data-parent_field=\"0\" ><label data-type=\"text\" for=\"field_zczsmz_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Name of first aider<\/label><div class=\"controls\"   ><input   type=\"text\" id=\"field_zczsmz_68961\"  name=\"item_meta[3040]\"   \/><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3038_68961_container\" class=\"    arfformfield control-group arfmainformfield  arf_field_type_textarea  top_container top_container arfformfield   arf_inline_field_value  arf_field_3038\"  style='width: 100%'  data-field-type=\"textarea\" data-parent_field=\"0\"><label data-type=\"textarea\" for=\"field_whel3o_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Treatment provided<\/label><div class=\"controls\"   ><textarea name=\"item_meta[3038]\" id=\"field_whel3o_68961\"  rows=\"5\"  ><\/textarea><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3039_68961_container\" class=\"      arfformfield control-group arfmainformfield  arf_horizontal_radio  arffieldrequired arf_field_type_radio   top_container  top_container arfformfield  arf_field_3039\"  style='width: 100%'  data-field-type=\"radio\" data-parent_field=\"0\"><label data-type=\"radio\" for=\"field_4thoyy_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Did the injured person go to hospital?<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"setting_radio controls arf_standard_radio \" style=\"padding-top:5px;\"><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3039]\" data-type=\"radio\" id=\"field_3039-0-68961\" data-unique-id=\"68961\" value=\"Yes\"   class=\" arf_required \" data-validation-minchecked-minchecked=\"1\" data-validation-minchecked-message=\"This field cannot be blank.\" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3039-0-68961\" class=\"\">Yes<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3039]\" data-type=\"radio\" id=\"field_3039-1-68961\" data-unique-id=\"68961\" value=\"No\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3039-1-68961\" class=\"\">No<\/label><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3043_68961_container\" class=\"      arfformfield control-group arfmainformfield  arf_horizontal_radio  arf_field_type_radio   top_container  top_container arfformfield  arf_field_3043\"  style='width: 100%'  data-field-type=\"radio\" data-parent_field=\"0\"><label data-type=\"radio\" for=\"field_3okmft_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Was the person in hospital for more than 24hours?<\/label><div class=\"setting_radio controls arf_standard_radio \" style=\"padding-top:5px;\"><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3043]\" data-type=\"radio\" id=\"field_3043-0-68961\" data-unique-id=\"68961\" value=\"Yes\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3043-0-68961\" class=\"\">Yes<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3043]\" data-type=\"radio\" id=\"field_3043-1-68961\" data-unique-id=\"68961\" value=\"No\"   style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3043-1-68961\" class=\"\">No<\/label><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3042_68961_container\" class=\"      arfformfield control-group arfmainformfield  arf_horizontal_radio  arffieldrequired arf_field_type_radio   top_container  top_container arfformfield  arf_field_3042\"  style='width: 100%'  data-field-type=\"radio\" data-parent_field=\"0\"><label data-type=\"radio\" for=\"field_mcpir0_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Did the injured person refuse hospital treatment?<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"setting_radio controls arf_standard_radio \" style=\"padding-top:5px;\"><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3042]\" data-type=\"radio\" id=\"field_3042-0-68961\" data-unique-id=\"68961\" value=\"Yes\"   class=\" arf_required \" data-validation-minchecked-minchecked=\"1\" data-validation-minchecked-message=\"This field cannot be blank.\" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3042-0-68961\" class=\"\">Yes<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3042]\" data-type=\"radio\" id=\"field_3042-1-68961\" data-unique-id=\"68961\" value=\"No\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3042-1-68961\" class=\"\">No<\/label><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3046_68961_container\" class=\"    arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_text  top_container top_container arfformfield   arf_inline_field_value  arf_field_3046\"  style='width: 100%' data-field-type=\"text\" data-parent_field=\"0\" ><label data-type=\"text\" for=\"field_dsn6dv_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Injury Type<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\"   ><input   type=\"text\" id=\"field_dsn6dv_68961\"  name=\"item_meta[3046]\"  class=\" arf_required \" data-validation-required-message=\"This field cannot be blank.\"   \/><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3044_68961_container\" class=\"    arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_text  top_container top_container arfformfield   arf_inline_field_value  arf_field_3044\"  style='width: 100%' data-field-type=\"text\" data-parent_field=\"0\" ><label data-type=\"text\" for=\"field_1uhq8x_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Part of the body injured<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\"   ><input   type=\"text\" id=\"field_1uhq8x_68961\"  name=\"item_meta[3044]\"  class=\" arf_required \" data-validation-required-message=\"This field cannot be blank.\"   \/><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3047_68961_container\" class=\"    arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_text  top_container top_container arfformfield   arf_inline_field_value  arf_field_3047\"  style='width: 100%' data-field-type=\"text\" data-parent_field=\"0\" ><label data-type=\"text\" for=\"field_u1jd01_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Nature of incident<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\"   ><input   type=\"text\" id=\"field_u1jd01_68961\"  name=\"item_meta[3047]\"  class=\" arf_required \" data-validation-required-message=\"This field cannot be blank.\"   \/><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3045_68961_container\" class=\"    arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_textarea  top_container top_container arfformfield   arf_inline_field_value  arf_field_3045\"  style='width: 100%'  data-field-type=\"textarea\" data-parent_field=\"0\"><label data-type=\"textarea\" for=\"field_ha2lp4_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Injury description<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\"   ><textarea name=\"item_meta[3045]\" id=\"field_ha2lp4_68961\"  rows=\"5\"  class=\" arf_required \" data-validation-required-message=\"This field cannot be blank.\"  ><\/textarea><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3116_68961_container\" class=\"    arfformfield arf_display_to_confirmation_summary control-group arfmainformfield  arf_field_type_html  top_container  top_container arfformfield  arf_field_3116\" data-field-type=\"html\" data-parent_field=\"0\" style='width: 100%'><div class=\"arf_htmlfield_control\"><h2>Incident relating to property or equipment damage \/ vehicle damage \/ near hit \/ cause for concern<\/h2><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3117_68961_container\" class=\"    arfformfield control-group arfmainformfield  arf_vertical_radio  arffieldrequired arf_field_type_checkbox   top_container  top_container arfformfield  arf_field_3117\"  style='width: 100%'  data-field-type=\"checkbox\" data-parent_field=\"0\"><label data-type=\"checkbox\" for=\"field_d91my8_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Please choose the type<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"setting_checkbox controls arf_standard_checkbox\" style=\"padding-top:5px;\" ><div class=\"arf_checkbox_style \" id=\"frm_checkbox_3117-0\"><div class='arf_checkbox_input_wrapper '><input type=\"checkbox\" name=\"item_meta[3117][]\" data-type=\"checkbox\" id=\"field_3117-0-68961\" value=\"Damage or cause for concern \" data-label=\"Damage or cause for concern \"    class=\" arf_required \"data-validation-minchecked-minchecked=\"1\" data-validation-minchecked-message=\"This field cannot be blank.\" style=''  onChange='arf_cl_apply_v3(68961,[\"3118\"]);' \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_3117-0-68961\" aria-label=\"Damage or cause for concern \">Damage or cause for concern <\/label><\/div><div class=\"arf_checkbox_style \" id=\"frm_checkbox_3117-1\"><div class='arf_checkbox_input_wrapper '><input type=\"checkbox\" name=\"item_meta[3117][]\" data-type=\"checkbox\" id=\"field_3117-1-68961\" value=\"Property damage\" data-label=\"Property damage\"    class=\" arf_required \" style=''  onChange='arf_cl_apply_v3(68961,[\"3118\"]);' \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_3117-1-68961\" aria-label=\"Property damage\">Property damage<\/label><\/div><div class=\"arf_checkbox_style \" id=\"frm_checkbox_3117-2\"><div class='arf_checkbox_input_wrapper '><input type=\"checkbox\" name=\"item_meta[3117][]\" data-type=\"checkbox\" id=\"field_3117-2-68961\" value=\"Other\" data-label=\"Other\"    class=\" arf_required \" style=''  onChange='arf_cl_apply_v3(68961,[\"3118\"]);' \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_3117-2-68961\" aria-label=\"Other\">Other<\/label><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3118_68961_container\" class=\"    arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_textarea  top_container top_container arfformfield   arf_inline_field_value  arf_field_3118\"  style='width: 100%'  data-field-type=\"textarea\" data-parent_field=\"0\"><label data-type=\"textarea\" for=\"field_jtia2e_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Please give a description<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\"   ><textarea name=\"item_meta[3118]\" id=\"field_jtia2e_68961\"  rows=\"5\"  class=\" arf_required \" data-validation-required-message=\"This field cannot be blank.\"  ><\/textarea><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3119_68961_container\" class=\"      arfformfield control-group arfmainformfield  arf_horizontal_radio  arffieldrequired arf_field_type_radio   top_container  top_container arfformfield  arf_field_3119\"  style='width: 100%'  data-field-type=\"radio\" data-parent_field=\"0\"><label data-type=\"radio\" for=\"field_u8h06n_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Has a vehicle has been involved?<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"setting_radio controls arf_standard_radio \" style=\"padding-top:5px;\"><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3119]\" data-type=\"radio\" id=\"field_3119-0-68961\" data-unique-id=\"68961\" value=\"Yes\"   class=\" arf_required \" data-validation-minchecked-minchecked=\"1\" data-validation-minchecked-message=\"This field cannot be blank.\" onChange='arf_cl_apply_v3(68961,[\"3120\"]);' style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3119-0-68961\" class=\"\">Yes<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3119]\" data-type=\"radio\" id=\"field_3119-1-68961\" data-unique-id=\"68961\" value=\"No\"   class=\" arf_required \" onChange='arf_cl_apply_v3(68961,[\"3120\"]);' style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3119-1-68961\" class=\"\">No<\/label><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3120_68961_container\" class=\"    arfformfield control-group arfmainformfield  arf_field_type_text  top_container top_container arfformfield   arf_inline_field_value  arf_field_3120\"  style='width: 100%' data-field-type=\"text\" data-parent_field=\"0\" ><label data-type=\"text\" for=\"field_vxhraa_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Please give the vehicle registration number<\/label><div class=\"controls\"   ><input   type=\"text\" id=\"field_vxhraa_68961\"  name=\"item_meta[3120]\"   \/><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3121_68961_container\" class=\"      arfformfield control-group arfmainformfield  arf_horizontal_radio  arffieldrequired arf_field_type_radio   top_container  top_container arfformfield  arf_field_3121\"  style='width: 100%'  data-field-type=\"radio\" data-parent_field=\"0\"><label data-type=\"radio\" for=\"field_o2vfbm_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Has anything been stolen or vandalised?<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"setting_radio controls arf_standard_radio \" style=\"padding-top:5px;\"><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3121]\" data-type=\"radio\" id=\"field_3121-0-68961\" data-unique-id=\"68961\" value=\"Yes\"   class=\" arf_required \" data-validation-minchecked-minchecked=\"1\" data-validation-minchecked-message=\"This field cannot be blank.\" onChange='arf_cl_apply_v3(68961,[\"3122\"]);' style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3121-0-68961\" class=\"\">Yes<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3121]\" data-type=\"radio\" id=\"field_3121-1-68961\" data-unique-id=\"68961\" value=\"No\"   class=\" arf_required \" onChange='arf_cl_apply_v3(68961,[\"3122\"]);' style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3121-1-68961\" class=\"\">No<\/label><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3122_68961_container\" class=\"    arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_textarea  top_container top_container arfformfield   arf_inline_field_value  arf_field_3122\"  style='width: 100%'  data-field-type=\"textarea\" data-parent_field=\"0\"><label data-type=\"textarea\" for=\"field_z3ylbg_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >What item(s) have been damaged or stolen<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\"   ><textarea name=\"item_meta[3122]\" id=\"field_z3ylbg_68961\"  rows=\"5\"  class=\" arf_required \" data-validation-required-message=\"This field cannot be blank.\"  ><\/textarea><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3123_68961_container\" class=\"      arfformfield control-group arfmainformfield  arf_horizontal_radio  arffieldrequired arf_field_type_radio   top_container  top_container arfformfield  arf_field_3123\"  style='width: 100%'  data-field-type=\"radio\" data-parent_field=\"0\"><label data-type=\"radio\" for=\"field_z5191y_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Has this been reported to the Police?<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"setting_radio controls arf_standard_radio \" style=\"padding-top:5px;\"><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3123]\" data-type=\"radio\" id=\"field_3123-0-68961\" data-unique-id=\"68961\" value=\"Yes\"   class=\" arf_required \" data-validation-minchecked-minchecked=\"1\" data-validation-minchecked-message=\"This field cannot be blank.\" onChange='arf_cl_apply_v3(68961,[\"3124\"]);' style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3123-0-68961\" class=\"\">Yes<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[3123]\" data-type=\"radio\" id=\"field_3123-1-68961\" data-unique-id=\"68961\" value=\"No\"   class=\" arf_required \" onChange='arf_cl_apply_v3(68961,[\"3124\"]);' style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_3123-1-68961\" class=\"\">No<\/label><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3124_68961_container\" class=\"    arfformfield control-group arfmainformfield  arf_field_type_text  top_container top_container arfformfield   arf_inline_field_value  arf_field_3124\"  style='width: 100%' data-field-type=\"text\" data-parent_field=\"0\" ><label data-type=\"text\" for=\"field_3w5xb1_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Crime reference number<\/label><div class=\"controls\"   ><input   type=\"text\" id=\"field_3w5xb1_68961\"  name=\"item_meta[3124]\"   \/><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3125_68961_container\" class=\"    arfformfield control-group arfmainformfield  arf_field_type_textarea  top_container top_container arfformfield   arf_inline_field_value  arf_field_3125\"  style='width: 100%'  data-field-type=\"textarea\" data-parent_field=\"0\"><label data-type=\"textarea\" for=\"field_12g8on_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Any further details<\/label><div class=\"controls\"   ><textarea name=\"item_meta[3125]\" id=\"field_12g8on_68961\"  rows=\"5\"  ><\/textarea><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3126_68961_container\" class=\"    arfformfield arf_display_to_confirmation_summary control-group arfmainformfield  arf_field_type_html  top_container  top_container arfformfield  arf_field_3126\" data-field-type=\"html\" data-parent_field=\"0\" style='width: 100%'><div class=\"arf_htmlfield_control\"><h2>Incident relating to physical or verbal abuse<\/h2><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3127_68961_container\" class=\"    arfformfield control-group arfmainformfield  arf_field_type_textarea  top_container top_container arfformfield   arf_inline_field_value  arf_field_3127\"  style='width: 100%'  data-field-type=\"textarea\" data-parent_field=\"0\"><label data-type=\"textarea\" for=\"field_ljnmk1_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Please provide statement and any relevant details (If not completed in the Incident Description box above)<\/label><div class=\"controls\"   ><textarea name=\"item_meta[3127]\" id=\"field_ljnmk1_68961\"  rows=\"5\"  ><\/textarea><\/div><\/div><div style=\"clear:both;\"><\/div><input type=\"hidden\" id=\"arf_repeatable_field_counter_3128\" data-max_add=\"0\" value=\"1\" \/><div class=\"arf_repeater_field_wrapper    arf_heading_div arfmainformfieldrepeater\"><h2 class=\"arf_sec_heading_field pos_top\"  style='display:block;'>Witnesses<\/h2><div id=\"arf_field_3128_68961_container_0\" class=\"arf_repeater_field arfformfield control-group arfmainformfield input-field arf_field_type_arf_repeater  top_container  top_container arfformfield  arf_field_3128\" data-field-type=\"arf_repeater\"><div class=\"repeater_field_controls\"><div id=\"arf_field_3129_68961_container\" class=\"    arfformfield control-group arfmainformfield  arf_field_type_text  arf_child_field  arf_autosave_field_exclude  top_container top_container arfformfield   arf_field_3129\"  style='width: 100%' data-field-type=\"text\" data-parent_field=\"3128\" ><label data-type=\"text\" for=\"field_drz3cf_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Name<\/label><div class=\"controls\"   ><input   type=\"text\" id=\"field_drz3cf_68961\"  name=\"item_meta[3128][3129][0]\"   \/><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3132_68961_container\" class=\"    arfformfield control-group arfmainformfield  arf_field_type_textarea  arf_child_field  arf_autosave_field_exclude  top_container top_container arfformfield   arf_field_3132\"  style='width: 100%'  data-field-type=\"textarea\" data-parent_field=\"3128\"><label data-type=\"textarea\" for=\"field_zxo0nv_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Address<\/label><div class=\"controls\"   ><textarea name=\"item_meta[3128][3132][0]\" id=\"field_zxo0nv_68961\"  rows=\"5\"  ><\/textarea><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3131_68961_container\" class=\"    arfformfield control-group arfmainformfield  arf_field_type_text  arf_child_field  arf_autosave_field_exclude  top_container top_container arfformfield   arf_field_3131\"  style='width: 100%' data-field-type=\"text\" data-parent_field=\"3128\" ><label data-type=\"text\" for=\"field_icj22n_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Postcode<\/label><div class=\"controls\"   ><input   type=\"text\" id=\"field_icj22n_68961\"  name=\"item_meta[3128][3131][0]\"   \/><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3130_68961_container\" class=\"    arfformfield control-group arfmainformfield  arf_field_type_text  arf_child_field  arf_autosave_field_exclude  top_container top_container arfformfield   arf_field_3130\"  style='width: 100%' data-field-type=\"text\" data-parent_field=\"3128\" ><label data-type=\"text\" for=\"field_hjvzr1_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Contact Number<\/label><div class=\"controls\"   ><input   type=\"text\" id=\"field_hjvzr1_68961\"  name=\"item_meta[3128][3130][0]\"   \/><\/div><\/div><div style=\"clear:both;\"><\/div><\/div><div class=\"arf_repeater_button_wrapper\"><button type=\"button\" class=\"arf_repeater_remove_new_button arf_remove_btn_3128\" aria-label=\"Remove item\" data-random-id=\"68961\" data-field-id=\"3128\"><i class=\"fa fa-minus fa-lg\"><\/i><\/button><button type=\"button\" class=\"arf_repeater_add_new_button arf_add_new_btn_3128\" aria-label=\"Add Item\" data-random-id=\"68961\" data-field-id=\"3128\"><i class=\"fa fa-plus fa-lg\"><\/i><\/button><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3133_68961_container\" class=\"    arfformfield arf_display_to_confirmation_summary control-group arfmainformfield  arf_field_type_html  top_container  top_container arfformfield  arf_field_3133\" data-field-type=\"html\" data-parent_field=\"0\" style='width: 100%'><div class=\"arf_htmlfield_control\"><p style=\"text-align: right\"><strong>Click on the + button above to add more witnesses<strong><\/p><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3134_68961_container\" class=\"    arfformfield arf_display_to_confirmation_summary control-group arfmainformfield  arf_field_type_html  top_container  top_container arfformfield  arf_field_3134\" data-field-type=\"html\" data-parent_field=\"0\" style='width: 100%'><div class=\"arf_htmlfield_control\"><h2>Initial actions taken<\/h2><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3135_68961_container\" class=\"    arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_textarea  top_container top_container arfformfield   arf_inline_field_value  arf_field_3135\"  style='width: 100%'  data-field-type=\"textarea\" data-parent_field=\"0\"><label data-type=\"textarea\" for=\"field_vpe3xv_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >What initial actions have you taken to prevent future reoccurrence?<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\"   ><textarea name=\"item_meta[3135]\" id=\"field_vpe3xv_68961\"  rows=\"5\"  class=\" arf_required \" data-validation-required-message=\"This field cannot be blank.\"  ><\/textarea><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3143_68961_container\" class=\"    arfformfield arf_display_to_confirmation_summary control-group arfmainformfield  arf_field_type_html  top_container  top_container arfformfield  arf_field_3143\" data-field-type=\"html\" data-parent_field=\"0\" style='width: 100%'><div class=\"arf_htmlfield_control\"><h2>Supporting documents\/photos<\/h2><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3136_68961_container\" class=\"    arfformfield control-group arfmainformfield  arf_field_type_file  top_container  top_container arfformfield  arf_field_3136\"  style='width: 100%' data-field-type=\"file\" data-parent_field=\"0\"><label data-type=\"file\"  class=\"arf_main_label arf_main_label_16px\" aria-label = >Please submit any photos or documents relating to this incident<\/label><div class=\"controls\"   ><div class=\"file_main_control\" style=\"display:inline-block; \"><div class=\"arf_file_field\" style=\"display:block;\"><div id=\"arf_reply_drag_and_drop\" class=\"arf_reply_uploader_container\"><label data-label=\"file\" for=\"field_over0b_68961\" class=\"arfajax-file-upload-drag arf_reply_drag_file_label label_over0b_68961\"><span id=\"arf_file_drag_reply\" class=\"arf_file_drag_reply_container\" data-id=\"field_over0b_68961\">Drop files here or click to select<\/span><\/label><input class=\"arf_reply_drag_file\" type=\"file\"  data-max-file-upload-size=\"8M\"  name=\"file3136\" data-type=\"file\" id=\"field_over0b_68961\" data-form-data-id=\"68961\" data-field-id=\"3136\" data-form-id=\"159\" data-invalid-message=\"File is invalid\" data-is-insecure-file=\"false\"  data-insecure-file-message=\"The file could not be uploaded due to security reason as it contains malicious code\" data-size-invalid-message=\"Invalid File Size\" data-file-valid=\"true\" style=\"visibility: hidden;float: left;margin-top: -50px;padding: 0;width: 0 ;\"  accept=\".jpg, .jpeg, .jpe, .gif, .png, .bmp, .tiff, .tif, .webp, .avif, .ico, .heic, .heif, .heics, .heifs, .asf, .asx, .wmv, .wmx, .wm, .avi, .divx, .flv, .mov, .qt, .mpeg, .mpg, .mpe, .mp4, .m4v, .ogv, .webm, .mkv, .3gp, .3gpp, .3g2, .3gp2, .txt, .asc, .c, .cc, .h, .srt, .csv, .tsv, .ics, .rtx, .css, .vtt, .dfxp, .mp3, .m4a, .m4b, .aac, .ra, .ram, .wav, .x-wav, .ogg, .oga, .flac, .mid, .midi, .wma, .wax, .mka, .rtf, .pdf, .class, .tar, .zip, .gz, .gzip, .rar, .7z, .psd, .xcf, .psd, .xcf, .doc, .pot, .pps, .ppt, .wri, .xla, .xls, .xlt, .xlw, .mdb, .mpp, .docx, .docm, .dotx, .dotm, .xlsx, .xlsm, .xlsb, .xltx, .xltm, .xlam, .pptx, .pptm, .ppsx, .ppsm, .potx, .potm, .ppam, .sldx, .sldm, .onetoc, .onetoc2, .onetmp, .onepkg, .oxps, .xps, .odt, .odp, .ods, .odg, .odc, .odb, .odf, .wp, .wpd, .key, .numbers, .pages, .woff, .woff2, .ttf, .eot, .otf, .xml, .json, \" multiple=\"multiple\" ><input type=\"hidden\" data-type=\"file\" id=\"type_over0b_68961\" name=\"type_over0b\" value=\"0\" ><input type=\"hidden\" value=\"jpg|jpeg|jpe, gif, png, bmp, tiff|tif, webp, avif, ico, heic, heif, heics, heifs, asf|asx, wmv, wmx, wm, avi, divx, flv, mov|qt, mpeg|mpg|mpe, mp4|m4v, ogv, webm, mkv, 3gp|3gpp, 3g2|3gp2, txt|asc|c|cc|h|srt, csv, tsv, ics, rtx, css, vtt, dfxp, mp3|m4a|m4b, aac, ra|ram, wav|x-wav, ogg|oga, flac, mid|midi, wma, wax, mka, rtf, pdf, class, tar, zip, gz|gzip, rar, 7z, psd, xcf, psd, xcf, doc, pot|pps|ppt, wri, xla|xls|xlt|xlw, mdb, mpp, docx, docm, dotx, dotm, xlsx, xlsm, xlsb, xltx, xltm, xlam, pptx, pptm, ppsx, ppsm, potx, potm, ppam, sldx, sldm, onetoc|onetoc2|onetmp|onepkg, oxps, xps, odt, odp, ods, odg, odc, odb, odf, wp|wpd, key, numbers, pages, woff, woff2, ttf, eot, otf, xml, json, \" id=\"file_types_over0b_68961\" name=\"field_types_over0b\" \/><input type=\"hidden\" value=\"auto\" id=\"file_size_over0b_68961\" name=\"file_size_over0b\" ><input type=\"hidden\" name=\"item_meta[3136]\" id=\"item_meta_3136\" value=\"\"><input type=\"hidden\" data-jqvalidate=\"false\" name=\"uploaded_file_name_159_68961_3136\" id=\"uploaded_file_name_159_68961_3136\" class=\"uploaded_field_name\" value=\"\" \/><\/div><div id=\"progress_over0b_68961\" class=\"arfprogress progress-striped active\" style=\"margin-top: 120px;\"><div class=\"bar\" style=\"width:0%;\"><\/div><\/div><div id=\"info_over0b_68961\" class=\"arf_info\" style=\"display:none;\"><span class=\"percent\">% Completed<\/span><span id=\"percent\" class=\"percent\">0<\/span><\/div><\/div><div id=\"arf_multi_file_uploader_over0b_68961\" class=\"arf_multi_file_info_container arf_file_field\" style=\"display:none; margin-top: 0px;\"><\/div><div id=\"arf_multi_file_info_over0b_68961\" class=\"arf_multi_file_info_container arf_file_field\" style=\"display:none; margin-top: 0px;\"><\/div><\/div><div class=\"arf_tooltip_main\" ><img decoding=\"async\" alt=\"\" src=\"https:\/\/www.worcestercity.org.uk\/forms\/wp-content\/plugins\/arforms\/images\/tooltips-icon.png\" class=\"arfhelptip\" title=\"You can upload more than one file\" data-title=\"You can upload more than one file\" style=\"margin-left:10px; margin-top:4px;\"\/><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3141_68961_container\" class=\"    arfformfield control-group arfmainformfield  arf_field_type_textarea  top_container top_container arfformfield   arf_inline_field_value  arf_field_3141\"  style='width: 100%'  data-field-type=\"textarea\" data-parent_field=\"0\"><label data-type=\"textarea\" for=\"field_4bbnhn_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Summary description of photo(s) and\/or document(s) you are submitting (above)<\/label><div class=\"controls\"   ><textarea name=\"item_meta[3141]\" id=\"field_4bbnhn_68961\"  rows=\"5\"  ><\/textarea><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3144_68961_container\" class=\"    arfformfield arf_display_to_confirmation_summary control-group arfmainformfield  arf_field_type_html  top_container  top_container arfformfield  arf_field_3144\" data-field-type=\"html\" data-parent_field=\"0\" style='width: 100%'><div class=\"arf_htmlfield_control\"><h2>Declaration<\/h2><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3137_68961_container\" class=\"    arfformfield control-group arfmainformfield  arf_horizontal_radio  arffieldrequired arf_field_type_checkbox   top_container  top_container arfformfield  arf_field_3137\"  style='width: 100%'  data-field-type=\"checkbox\" data-parent_field=\"0\"><label data-type=\"checkbox\" for=\"field_iqo4pk_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >I agree to my Name and Contact details, including copies of all correspondence and emails relating to this Incident, being made available Worcester City Allotment Officer for purposes of dealing with this matter.<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"setting_checkbox controls arf_standard_checkbox\" style=\"padding-top:5px;\" ><div class=\"arf_checkbox_style \" id=\"frm_checkbox_3137-0\"><div class='arf_checkbox_input_wrapper '><input type=\"checkbox\" name=\"item_meta[3137][]\" data-type=\"checkbox\" id=\"field_3137-0-68961\" value=\"I agree\" data-label=\"I agree\"    class=\" arf_required \"data-validation-minchecked-minchecked=\"1\" data-validation-minchecked-message=\"This field cannot be blank.\" style=''  \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_3137-0-68961\" aria-label=\"I agree\">I agree<\/label><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3147_68961_container\" class=\"    arfformfield control-group arfmainformfield  arf_horizontal_radio  arffieldrequired arf_field_type_checkbox   top_container  top_container arfformfield  arf_field_3147\"  style='width: 100%'  data-field-type=\"checkbox\" data-parent_field=\"0\"><label data-type=\"checkbox\" for=\"field_sq18ol_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >I acknowledge that Worcester City Council will hold and process my information in accordance with Data Protection Law.<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"setting_checkbox controls arf_standard_checkbox\" style=\"padding-top:5px;\" ><div class=\"arf_checkbox_style \" id=\"frm_checkbox_3147-0\"><div class='arf_checkbox_input_wrapper '><input type=\"checkbox\" name=\"item_meta[3147][]\" data-type=\"checkbox\" id=\"field_3147-0-68961\" value=\"I acknowledge\" data-label=\"I acknowledge\"    class=\" arf_required \"data-validation-minchecked-minchecked=\"1\" data-validation-minchecked-message=\"This field cannot be blank.\" style=''  \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_3147-0-68961\" aria-label=\"I acknowledge\">I acknowledge<\/label><\/div><div class=\"arf_field_description \">Please see our <a href=\"https:\/\/www.worcester.gov.uk\/notices\/privacy-policy\/allotments-parks-and-open-spaces\/allotments\" target=\"_new\">Privacy Notice<\/a><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3138_68961_container\" class=\"    arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_text  top_container top_container arfformfield   arf_inline_field_value  arf_field_3138\"  style='width: 100%' data-field-type=\"text\" data-parent_field=\"0\" ><label data-type=\"text\" for=\"field_ltvtpv_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Signed<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\"   ><input   type=\"text\" id=\"field_ltvtpv_68961\"  name=\"item_meta[3138]\"  class=\" arf_required \" data-validation-required-message=\"This field cannot be blank.\"   \/><div class=\"arf_field_description \">Please type your full name<\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_3146_68961_container\" class=\"    arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_email  top_container  arf_inline_field_value   top_container arfformfield  arf_field_3146\"  style='width: 100%'  data-field-type=\"email\" data-parent_field=\"0\"><label data-type=\"email\" for=\"field_hpdfu_68961\" class=\"arf_main_label arf_main_label_16px\" aria-label = >Your Email<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\"   ><input type=\"text\" id=\"field_hpdfu_68961\" name=\"item_meta[3146]\"  class=\" arf_required \" data-validation-required-message=\"This field cannot be blank.\"  data-validation-regex-regex=\"[\\p{L}0-9._-]+@[\\p{L}0-9.-]+\\.[\\p{L}]+\" data-validation-regex-message=\"Email is invalid\"  \/><div class=\"arf_field_description \">Note: A summary of the completed form will automatically be sent to this email 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