[gravityform id="69" title="false" description="false"]
<script type="text/javascript">if(!gform){document.addEventListener("gform_main_scripts_loaded",function(){gform.scriptsLoaded=!0}),window.addEventListener("DOMContentLoaded",function(){gform.domLoaded=!0});var gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener("DOMContentLoaded",o):document.addEventListener("gform_main_scripts_loaded",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook("action",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook("filter",o,n,r,t)},doAction:function(o){gform.doHook("action",o,arguments)},applyFilters:function(o){return gform.doHook("filter",o,arguments)},removeAction:function(o,n){gform.removeHook("action",o,n)},removeFilter:function(o,n,r){gform.removeHook("filter",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+"_"+e.length),null==t&&(t=10),gform.hooks[o][n].push({tag:i,callable:r,priority:t})},doHook:function(o,n,r){if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[o][n]){var t,i=gform.hooks[o][n];i.sort(function(o,n){return o.priority-n.priority});for(var e=0;e<i.length;e++)"function"!=typeof(t=i[e].callable)&&(t=window[t]),"action"==o?t.apply(null,r):r[0]=t.apply(null,r)}if("filter"==o)return r[0]},removeHook:function(o,n,r,t){if(null!=gform.hooks[o][n])for(var i=gform.hooks[o][n],e=i.length-1;0<=e;e--)null!=t&&t!=i[e].tag||null!=r&&r!=i[e].priority||i.splice(e,1)}}}</script>
<div class='gf_browser_unknown gform_wrapper dark-form_wrapper gform_legacy_markup_wrapper' id='gform_wrapper_69' ><form method='post' enctype='multipart/form-data' id='gform_69' class='dark-form gform_legacy_markup' action='/category/retail/' >
<div class='gform_body gform-body'><ul id='gform_fields_69' class='gform_fields top_label form_sublabel_below description_above'><li id="field_69_1" class="gfield gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible" ><label class='gfield_label' for='input_69_1' >First Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_1' id='input_69_1' type='text' value='' class='medium' aria-required="true" aria-invalid="false" /> </div></li><li id="field_69_2" class="gfield gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible" ><label class='gfield_label' for='input_69_2' >Last Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_2' id='input_69_2' type='text' value='' class='medium' aria-required="true" aria-invalid="false" /> </div></li><li id="field_69_3" class="gfield gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible" ><label class='gfield_label' for='input_69_3' >Company Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_69_3' type='text' value='' class='medium' aria-required="true" aria-invalid="false" /> </div></li><li id="field_69_5" class="gfield gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible" ><label class='gfield_label' for='input_69_5' >Email Address<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_69_5' type='text' value='' class='medium' aria-required="true" aria-invalid="false" /> </div></li></ul></div>
<div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_69' class='gform_button button' value='WATCH NOW' onclick='if(window["gf_submitting_69"]){return false;} window["gf_submitting_69"]=true; ' onkeypress='if( event.keyCode == 13 ){ if(window["gf_submitting_69"]){return false;} window["gf_submitting_69"]=true; jQuery("#gform_69").trigger("submit",[true]); }' />
<input type='hidden' class='gform_hidden' name='is_submit_69' value='1' />
<input type='hidden' class='gform_hidden' name='gform_submit' value='69' />
<input type='hidden' class='gform_hidden' name='gform_unique_id' value='' />
<input type='hidden' class='gform_hidden' name='state_69' value='WyJbXSIsImMxZjQ3OGIzYzYxNGMzZjExOGFiNDdkZGQzMWViNjhiIl0=' />
<input type='hidden' class='gform_hidden' name='gform_target_page_number_69' id='gform_target_page_number_69' value='0' />
<input type='hidden' class='gform_hidden' name='gform_source_page_number_69' id='gform_source_page_number_69' value='1' />
<input type='hidden' name='gform_field_values' value='' />
</div>
</form>
</div>
