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<cfinclude template="/header.cfm">
<style>
.block-form-8 .form-control {
--cnvs-input-btn-input-bg: var(--cnvs-contrast-200);
--cnvs-input-btn-input-color: var(--cnvs-contrast-1000);
--cnvs-input-focus-color: var(--cnvs-input-btn-input-color);
}
.block-form-8 .form-select {
background-color: var(--cnvs-contrast-200);
}
</style>
</head>
<body class="stretched block-form-8">
<!-- Document Wrapper
============================================= -->
<div id="wrapper">
<!-- Content
============================================= -->
<section id="content">
<div class="content-wrap" style="background: linear-gradient(to bottom, #f9f5f2 640px, var(--cnvs-contrast-0) 640px);">
<img src="images/blocks/preview/pattern.svg" alt=".." class="position-absolute top-0 start-0 op-01 w-100">
<div class="w-100 h-100 position-absolute top-0 left-0" style="background: linear-gradient(to bottom, transparent 640px, var(--cnvs-contrast-0) 640px);"></div>
<div class="container mw-lg">
<div class="row justify-content-between col-mb-30">
<div class="col-lg-5">
<cfquery name="Getc" datasource="cg22">
select copy from columntable where id = 157286
</cfquery>
<cfoutput>#getc.copy#</cfoutput>
</div>
<div class="col-lg-6">
<div class="card bg-contrast-0 rounded-6 border-0 shadow">
<div class="card-body p-5">
<div class="form-wi1dget">
<cfif structKeyExists(form, "submit")>
<Cfquery name="checkuser" datasource="#ds#">
select id from familyfun_users
where email = '#form.email#'
</Cfquery>
<cfif #checkuser.recordcount# gt 0>
Error, user already exists. Need help? <a href="/contact.cfm">Contact Us</a>...
</div>
</section><!-- #content end -->
</div><!-- #wrapper end -->
<cfinclude template="/footer.cfm">
<cfabort>
</cfif>
<cfparam name="form.full_name" default="">
<Cfparam name="form.contactname" default="">
<cfparam name="form.address" default="">
<cfparam name="form.city" default="">
<cfparam name="form.state" default="">
<cfparam name="form.zip" default="">
<cfparam name="form.email" default="">
<cfparam name="form.submitting_personnel_title" default="">
<cfparam name="form.phone" default="">
<cfparam name="form.website" default="">
<cfparam name="form.experience_nature" default="">
<cfparam name="form.experience_nature_other" default="">
<cfparam name="form.indoors_outdoors" default="">
<cfparam name="form.appropriate_ppl" default="">
<cfparam name="form.age_range_attendees" default="">
<cfparam name="form.times_days_offered" default="">
<cfparam name="form.educational_component" default="">
<cfparam name="form.adult_staffing" default="">
<cfparam name="form.sensory_friendly" default="">
<cfparam name="form.sensory_friendly_explanation" default="">
<cfparam name="form.potential_risks" default="">
<cfparam name="form.wheelchair_accessible" default="">
<cfparam name="form.languages_spoken" default="">
<cfparam name="form.languages_spoken_other" default="">
<cfparam name="form.experience_duration" default="">
<cfparam name="form.social_handles_instagram" default="">
<cfparam name="form.social_handles_facebook" default="">
<cfparam name="form.social_handles_twitter" default="">
<cfparam name="form.social_handles_tiktok" default="">
<cfparam name="form.description" default="">
<cfparam name="form.manageremail" default="">
<cfparam name="form.managertitle" default="">
<cfparam name="form.managername" default="">
<cfparam name="form.justdays" default="">
<cfparam name="form.adultchild" default="">
<cfparam name="form.submitting_personnel_phone" default="">
<cfparam name="form.managerphone" default="">
<cfparam name="form.age_range_other" default="">
<CFMAIL TO="[email protected]"
SUBJECT="New Xperience Added - #form.full_name#"
FROM="City Guide Events <[email protected]>"
SERVER="us-smtp-outbound-1.mimecast.com">
#form.full_name# has been submitted.
<p>
<a href='https://www.cityguideny.com/newadmin/familyfun-providers.cfm'>admin</a>
</p>
</cfmail>
<cfquery datasource="cg22" result="results">
INSERT INTO familyfun_experiences (
full_name,
address,
address2,
city,
state,
zip,
email,
submitting_personnel_title,
phone,
website,
experience_nature,
experience_nature_other,
indoors_outdoors,
appropriate_ppl,
age_range_attendees,
times_days_offered,
educational_component,
adult_staffing,
sensory_friendly,
sensory_friendly_explanation,
potential_risks,
wheelchair_accessible,
languages_spoken,
languages_spoken_other,
experience_duration,
social_handles_instagram,
social_handles_facebook,
social_handles_twitter,
social_handles_tiktok,
description,
signature,managername,manageremail,managertitle,justdays,adultchild,submitting_personnel_phone,
managerphone,age_range_other,contactname
)
VALUES (
<cfqueryparam value="#form.full_name#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.address#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.address2#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.city#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.state#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.zip#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.email#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.submitting_personnel_title#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.phone#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.website#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.experience_nature#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.experience_nature_other#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.indoors_outdoors#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.appropriate_ppl#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.age_range_attendees#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.times_days_offered#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.educational_component#" cfsqltype="cf_sql_longvarchar">,
<cfqueryparam value="#form.adult_staffing#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.sensory_friendly#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.sensory_friendly_explanation#" cfsqltype="cf_sql_longvarchar">,
<cfqueryparam value="#form.potential_risks#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.wheelchair_accessible#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.languages_spoken#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.languages_spoken_other#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.experience_duration#" cfsqltype="cf_sql_longvarchar">,
<cfqueryparam value="#form.social_handles_instagram#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.social_handles_facebook#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.social_handles_twitter#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.social_handles_tiktok#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.description#" cfsqltype="cf_sql_longvarchar">,
<cfqueryparam value="#form.signature#" cfsqltype="cf_sql_longvarchar">,
<cfqueryparam value="#form.managername#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.manageremail#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.managertitle#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.justdays#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.adultchild#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.submitting_personnel_phone#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.managerphone#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.age_range_other#" cfsqltype="cf_sql_varchar">,
<cfqueryparam value="#form.contactname#" cfsqltype="cf_sql_varchar">
)
</cfquery>
<cfquery name="insertRecord" datasource="cg22" >
INSERT INTO familyfun_users
(email,password,isa,associated)
VALUES
(
<cfqueryparam value="#form.email#" cfsqltype="cf_sql_varchar" maxlength="255">,
<cfqueryparam value="#form.password#" cfsqltype="cf_sql_varchar" maxlength="255">,
'Provider',#results.generatedkey#
)
</cfquery>
<!--- Display success message or redirect to a success page --->
<div class="form-result">
<cfquery name="getc" datasource="cg22">
select copy from columntable where id = 157288
</cfquery>
<Cfoutput>#getc.copy#</Cfoutput>
<cfquery name="getc" datasource="cg22">
select copy from columntable where id = 157287
</cfquery>
<CFMAIL
TO="#form.manageremail#"
SUBJECT="NYC Youth Xplorations Submission"
FROM="[email protected]"
SERVER="us-smtp-outbound-1.mimecast.com"
type="html"
>#getc.copy#
</cfmail>
</div>
<cfelse>
<form class="mb-0" action="/xperiences.cfm?form" method="post">
<div class="row">
<h3>Xperience Information</h3>
<div class="col-12 form-group">
<label for="template-contactform-name">Name </label>
<input type="text" id="template-contactform-name" name="full_name" value="" class="form-control required">
</div>
<!-- Address and Contact Information -->
<div class="col-12 form-group">
<label for="template-contactform-address">Address </label>
<input type="text" id="template-contactform-address" name="address" value="" class="form-control required" placeholder="Address">
</div>
<div class="col-12 form-group">
<label for="template-contactform-address">Cross Street </label>
<input type="text" id="template-contactform-address2" name="address2" value="" class="form-control" placeholder="Address 2">
</div>
<div class="col-6 form-group">
<input type="text" id="template-contactform-city" name="city" value="" class="form-control required" placeholder="City">
</div>
<div class="col-6 form-group">
<input type="text" id="template-contactform-state" name="state" class="form-control required" placeholder="State" value="NY">
</div>
<div class="col-12 form-group">
<input type="text" id="template-contactform-zip" name="zip" value="" class="form-control required" placeholder="Zip">
</div>
<!-- Website -->
<div class="col-12 form-group">
<label for="template-contactform-website">What is the website of the Xperience?</label>
<input type="text" id="template-contactform-website" name="website" value="" class="form-control">
</div>
<!-- Phone Number -->
<div class="col-12 form-group">
<label for="template-contactform-phone">What is the phone number of the Xperience? </label>
<input type="text" id="template-contactform-phone" name="phone" value="" class="form-control required">
</div>
<div class="col-12 form-group">
<label for="template-contactform-description">Provide a description of the Xperience that the youth group will have to help the adult determine if it is appropriate for their children. (100 word maximum)</label>
<textarea class="form-control" id="template-contactform-description" name="experience_description" rows="3"></textarea>
</div>
<h3>Xperience Manager</h3>
<div class="col-12 form-group">
<input type="text" id="template-contactform-email" name="managername" value="" class="required email form-control" placeholder="Name">
</div>
<!-- Submitting Personnel Title -->
<div class="col-12 form-group">
<label for="template-contactform-personnel-title">Title</label>
<input type="text" id="template-contactform-personnel-title" name="managertitle" value="" class="form-control">
</div>
<div class="col-12 form-group">
<label for="template-contactform-personnel-title">Email</label>
<input type="text" id="template-contactform-personnel-title" name="manageremail" value="" class="form-control" >
</div>
<div class="col-12 form-group">
<label for="template-contactform-personnel-title">Phone #</label>
<input type="text" id="template-contactform-personnel-title" name="managerphone" value="" class="form-control">
</div>
<h3>Xperience Contact<br><font size=-1>(person working directly with Xplorer group)</font></h3>
<div class="col-12 form-group">
<input type="text" id="template-contactform-email" name="contactname" value="" class="required email form-control" placeholder="Contact Name">
</div>
<div class="col-12 form-group">
<input type="email" id="template-contactform-email" name="email" value="" class="required email form-control" placeholder="Email">
</div>
<!-- Submitting Personnel Title -->
<div class="col-12 form-group">
<label for="template-contactform-personnel-title">Title of submitting personnel</label>
<input type="text" id="template-contactform-personnel-title" name="submitting_personnel_title" value="" class="form-control">
</div>
<div class="col-12 form-group">
<label for="template-contactform-personnel-title">Phone # of submitting personnel</label>
<input type="text" id="template-contactform-personnel-title" name="submitting_personnel_phone" value="" class="form-control">
</div>
<div class="col-12 form-group">
<label for="template-contactform-personnel-title">Password</label> (Pick a password to help you login and make changes)
<input type="text" id="template-contactform-personnel-title" name="password" value="" class="form-control" placeholder="Pick a password to allow you to login.">
</div>
<!-- Nature of Experience -->
<div class="col-12 form-group">
<label for="template-contactform-experience-nature">Xperience Category</label>
<select id="template-contactform-experience-nature" name="experience_nature" class="form-control">
<option value="">-- Select --</option>
<option value="Music">Music</option>
<option value="Attractions">Attractions</option>
<option value="Theatre">Theatre</option>
<option value="Museum">Museum</option>
<option value="Cultural">Cultural</option>
<option value="Other">Other</option>
</select>
</div>
<!-- Nature of Experience (Other) -->
<div class="col-12 form-group">
<label for="template-contactform-experience-nature-other">If Other, please specify</label>
<input type="text" id="template-contactform-experience-nature-other" name="experience_nature_other" value="" class="form-control">
</div>
<!-- Indoors/Outdoors -->
<div class="col-12 form-group">
<label for="template-contactform-indoors-outdoors">Is the Xperience indoors or outdoors?</label><br>
<div class="form-check form-check-inline">
<input class="form-check-input" type="radio" name="indoors_outdoors" id="template-contactform-indoors" value="Indoors">
<label class="form-check-label" for="template-contactform-indoors">Indoors</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="radio" name="indoors_outdoors" id="template-contactform-outdoors" value="Outdoors">
<label class="form-check-label" for="template-contactform-outdoors">Outdoors</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="radio" name="indoors_outdoors" id="template-contactform-both" value="Both">
<label class="form-check-label" for="template-contactform-both">Both</label>
</div>
</div>
<div class="col-12 form-group">
<label for="template-contactform-duration">What is the duration of the Xperience? </label>
<textarea class="form-control" id="template-contactform-duration" name="experience_duration" rows="3"></textarea>
</div>
<h3>Group Requirements</h3>
<!-- Appropriate Number of People -->
<div class="col-12 form-group">
<label for="template-contactform-appropriate-ppl">What is the appropriate number of people for the Xperience?</label>
<select id="template-contactform-appropriate-ppl" name="appropriate_ppl" class="form-control">
<option value="">-- Select --</option>
<option value="10-25">10-25</option>
<option value="26-50">26-50</option>
<option value="51-75">51-75</option>
<option value="76-100">76-100</option>
<option value="100+">100+</option>
</select>
</div>
<!-- Age Range of Attendees -->
<div class="col-12 form-group">
<label for="template-contactform-age-range">What are the age ranges for Xplorers? (Check all that apply)</label><br>
<div class="form-check form-check-inline">
<input class="form-check-input" type="checkbox" name="age_range_attendees" id="template-contactform-age-range-1-4" value="1-4yo">
<label class="form-check-label" for="template-contactform-age-range-1-4">1-4yo</label>
</div> <div class="form-check form-check-inline">
<input class="form-check-input" type="checkbox" name="age_range_attendees" id="template-contactform-age-range-5-10" value="5-10yo">
<label class="form-check-label" for="template-contactform-age-range-5-10">5-10yo</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="checkbox" name="age_range_attendees" id="template-contactform-age-range-11-13" value="11-13yo">
<label class="form-check-label" for="template-contactform-age-range-11-13">11-13yo</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="checkbox" name="age_range_attendees" id="template-contactform-age-range-14-18" value="14-18yo">
<label class="form-check-label" for="template-contactform-age-range-14-18">14-18yo</label>
<input placeholder="Other" type="text" name="age_range_other" id="template-contactform-age-range-14-18" >
</div>
</div>
<div class="col-12 form-group">
<label>What days can you offer the Xperience? (check all that apply)</label><br>
<div class="form-check form-check-inline">
<input class="form-check-input" type="checkbox" name="justdays" id="template-contactform-days-morning" value="Sunday">
<label class="form-check-label" for="template-contactform-days-morning">Sunday</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="checkbox" name="justdays" id="template-contactform-days-morning" value="Monday">
<label class="form-check-label" for="template-contactform-days-morning">Monday</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="checkbox" name="justdays" id="template-contactform-days-morning" value="Tuesday">
<label class="form-check-label" for="template-contactform-days-morning">Tuesday</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="checkbox" name="justdays" id="template-contactform-days-morning" value="Wednesday">
<label class="form-check-label" for="template-contactform-days-morning">Wednesday</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="checkbox" name="justdays" id="template-contactform-days-morning" value="Thursday">
<label class="form-check-label" for="template-contactform-days-morning">Thursday</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="checkbox" name="justdays" id="template-contactform-days-morning" value="Friday">
<label class="form-check-label" for="template-contactform-days-morning">Friday</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="checkbox" name="justdays" id="template-contactform-days-morning" value="Saturday">
<label class="form-check-label" for="template-contactform-days-morning">Saturday</label>
</div>
</div>
<div class="col-12 form-group">
<label>What are the times?</label><br>
<div class="form-check form-check-inline">
<input class="form-check-input" type="checkbox" name="days_offered" id="template-contactform-days-morning" value="morning">
<label class="form-check-label" for="template-contactform-days-morning">Morning</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="checkbox" name="days_offered" id="template-contactform-days-afternoon" value="afternoon">
<label class="form-check-label" for="template-contactform-days-afternoon">Afternoon</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="checkbox" name="days_offered" id="template-contactform-days-evening" value="evening">
<label class="form-check-label" for="template-contactform-days-evening">Evening</label>
</div>
</div>
<div class="col-12 form-group">
<label for="template-contactform-educational-component">What is the maximum child/adult ratio?</label>
<textarea class="form-control" id="template-contactform-educational-component" name="adultchild" rows="3"></textarea>
</div>
<div class="col-12 form-group">
<label for="template-contactform-educational-component">Is there an educational component to the Xperience? If yes, please explain.</label>
<textarea class="form-control" id="template-contactform-educational-component" name="educational_component" rows="3"></textarea>
</div>
<div class="col-12 form-group">
<label>Will there be any adult staffing provided at the venue?</label><br>
<div class="form-check form-check-inline">
<input class="form-check-input" type="radio" name="adult_staffing" id="template-contactform-adult-staffing-yes" value="yes">
<label class="form-check-label" for="template-contactform-adult-staffing-yes">Yes</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="radio" name="adult_staffing" id="template-contactform-adult-staffing-no" value="no">
<label class="form-check-label" for="template-contactform-adult-staffing-no">No</label>
</div>
</div>
<div class="col-12 form-group">
<label>Is the Xperience sensory friendly?</label><br>
<div class="form-check form-check-inline">
<input class="form-check-input" type="radio" name="sensory_friendly" id="template-contactform-sensory-friendly-yes" value="yes">
<label class="form-check-label" for="template-contactform-sensory-friendly-yes">Yes</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="radio" name="sensory_friendly" id="template-contactform-sensory-friendly-no" value="no">
<label class="form-check-label" for="template-contactform-sensory-friendly-no">No</label>
</div>
</div>
<div class="col-12 form-group">
<label for="template-contactform-sensory-friendly-explanation">If yes, please provide an explanation:</label>
<textarea class="form-control" id="template-contactform-sensory-friendly-explanation" name="sensory_friendly_explanation" rows="3"></textarea>
</div>
<div class="col-12 form-group">
<label>Is the venue wheelchair accessible?</label><br>
<div class="form-check form-check-inline">
<input class="form-check-input" type="radio" name="wheelchair_accessible" id="template-contactform-wheelchair-accessible-yes" value="yes">
<label class="form-check-label" for="template-contactform-wheelchair-accessible-yes">Yes</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="radio" name="wheelchair_accessible" id="template-contactform-wheelchair-accessible-no" value="no">
<label class="form-check-label" for="template-contactform-wheelchair-accessible-no">No</label>
</div>
</div>
<div class="col-12 form-group">
<label>Do any venue personnel speak any of the following languages?</label><br>
<div class="form-check form-check-inline">
<input class="form-check-input" type="checkbox" name="languages" id="template-contactform-language-spanish" value="Spanish">
<label class="form-check-label" for="template-contactform-language-spanish">Spanish</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="checkbox" name="languages" id="template-contactform-language-french" value="French">
<label class="form-check-label" for="template-contactform-language-french">French</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="checkbox" name="languages" id="template-contactform-language-mandarin" value="Mandarin">
<label class="form-check-label" for="template-contactform-language-mandarin">Mandarin</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="checkbox" name="languages" id="template-contactform-language-ukrainian" value="Ukrainian">
<label class="form-check-label" for="template-contactform-language-ukrainian">Ukrainian</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="checkbox" name="languages" id="template-contactform-language-russian" value="Russian">
<label class="form-check-label" for="template-contactform-language-russian">Russian</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="checkbox" name="languages" id="template-contactform-language-other" value="Other">
<label class="form-check-label" for="template-contactform-language-other">Other</label>
</div>
<input type="text" id="template-contactform-language-other-text" name="language_other_text" value="" class="form-control mt-2" placeholder="Other Language">
</div>
<h3>Social Media</h3>
<div class="col-12 form-group">
<label for="template-contactform-social-handles">What are your social handles?</label>
<input type="text" id="template-contactform-instagram" name="instagram" value="" class="form-control" placeholder="Instagram URL">
<input type="text" id="template-contactform-facebook" name="facebook" value="" class="form-control mt-2" placeholder="Facebook URL">
<input type="text" id="template-contactform-twitter" name="twitter" value="" class="form-control mt-2" placeholder="Twitter URL">
<input type="text" id="template-contactform-tiktok" name="tiktok" value="" class="form-control mt-2" placeholder="TikTok URL">
</div>
<div class="col-12 form-group">
<label for="template-contactform-signature">By signing electronically below, Xperience confirms they are willing to offer services gratis under the Family Fun Days program parameters upon confirmation of acceptance into the program.</label>
<input type="text" id="template-contactform-signature" name="signature" value="" class="form-control">
</div>
<div class="col-12 form-group">
<button class="button button-rounded btn-block btn-primary" type="submit" name="submit">Submit</button>
</div>
</div>
</form>
</cfif>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</section><!-- #content end -->
</div><!-- #wrapper end -->
<cfinclude template="/footer.cfm">