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<form class="fitpro-listbuilder" method="POST" action="https://fitproconnect.com/Api/PublicContact/Subscribe/">
<div data-style-group="Main" style="border: 0px solid rgb(255, 255, 255); padding: 20px; max-width: 280px; font-family: Tahoma, Verdana, Segoe, sans-serif; margin: 0px auto; background: 0px center; box-sizing: border-box; font-weight: normal; font-style: normal; position: relative;" data-sortable-column="" data-main-column="" data-default-input-style="1" data-default-button-style="2">
<input type="hidden" name="ListBuilderID" value="15b650f0-d4ac-42fb-9946-0039179ad517">
<div data-replace-content-item="" data-item-name="First Name Input" data-item-type="input" data-can-edit="true" data-can-remove="false" data-can-move="true" data-disable-drag="true"><div><input type="text" value="" placeholder="First Name" name="SubscriberFirstName" onblur="fitProListBuilder.blur(this)" onfocus="fitProListBuilder.focus(this)" required="" data-required-name="First Name" style="box-shadow: none; width: 110%; margin-bottom: 10px; box-sizing: border-box; font-size: 15px; border: 1px solid rgb(153, 153, 153); color: rgb(0, 0, 0); padding: 10px; font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;"></div></div><div data-replace-content-item="" data-item-name="Phone Input" data-item-type="input" data-can-edit="true" data-can-remove="false" data-can-move="true" data-disable-drag="true"><input type="text" value="" placeholder="Phone Number" name="SubscriberPhone" onblur="fitProListBuilder.blur(this)" onfocus="fitProListBuilder.focus(this)" required="" data-required-name="Phone Number" style="box-shadow: none; width: 110%; margin-bottom: 10px; box-sizing: border-box; font-size: 15px; border: 1px solid rgb(153, 153, 153); color: rgb(0, 0, 0); padding: 10px; font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;"></div><div data-replace-content-item="" data-item-name="Email Input" data-item-type="input" data-can-edit="true" data-can-remove="false" data-can-move="true">
<input type="email" value="" placeholder="Email Address" name="SubscriberEmail" onblur="fitProListBuilder.blur(this)" onfocus="fitProListBuilder.focus(this)" required="" data-required-type="email" data-required-name="Email Address" style="box-shadow:none; font-size:15px; border:1px solid #999; color:#000; padding:10px; width:110%; margin-bottom:10px; box-sizing:border-box">
</div>
<div data-replace-content-item="" data-item-name="Submit Button" data-item-type="submit" data-can-edit="true" data-can-remove="false" data-can-move="true"><input type="submit" value="REGISTER NOW" style="outline: none; padding: 15px; width: 110%; text-align: center; box-sizing: border-box; cursor: pointer; background: 0px center; color: rgb(84, 141, 212); font-family: Tahoma, Verdana, Segoe, sans-serif; font-weight: normal; font-style: normal; font-size: 24px; border-width: 2px; border-color: rgb(84, 141, 212); border-style: solid;" data-default-label="SUBSCRIBE"></div>
<div data-replace-content-item="" data-item-name="Security Notice" data-item-type="security" data-can-edit="true" data-can-remove="true" data-can-move="true" style="font-size: 14px; text-align: center; color: rgb(255, 255, 255);">
<div style="padding:10px 10px 15px 10px;">
<svg version="1.1" id="Layer_1" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" x="0px" y="0px" viewBox="0 0 20 30" enable-background="new 0 0 20 30" xml:space="preserve" style="padding-right:5px; position:relative; top:6px; width:20px; height:25px">
<path fill="#dcb700" d="M17.4,12.2c0-1.6,0-1.8,0-4.2C17.4,3.6,14,0,9.8,0C5.6,0,2.3,3.6,2.2,8.1c0,4.2,0,2.5,0,4.2H0v13.5
c0,0.8,0.7,1.5,1.5,1.5h16.7c0.8,0,1.5-0.7,1.5-1.5V12.2H17.4z M10.3,20v1.9h-1V20c-0.5-0.2-0.8-0.7-0.8-1.3c0-0.8,0.6-1.4,1.4-1.4
c0.8,0,1.4,0.6,1.4,1.4C11.2,19.3,10.8,19.8,10.3,20z M14.7,12.2H4.9l0-4.2c0-3,2.2-5.5,4.9-5.5c2.7,0,4.9,2.4,4.9,5.5
C14.7,9.5,14.8,10.8,14.7,12.2z"></path>
</svg>
<span>We respect your privacy. Your info will never be shared.</span>
</div>
</div>
</div>
</form>