<!DOCTYPE html>
<html lang="en">
<head>
  <meta charset="UTF-8">
  <title>Freedom Boat Club Lead Form</title>
  <meta name="viewport" content="width=device-width, initial-scale=1">
  <style>
    body {
      font-family: Arial, sans-serif;
      background-color: #f8f8f8;
      padding: 20px;
    }
    .y-form {
      background: white;
      padding: 20px;
      border-radius: 6px;
      max-width: 500px;
      margin: 0 auto;
      box-shadow: 0 0 10px rgba(0,0,0,0.1);
    }
    .form-control {
      width: 100%;
      padding: 10px;
      margin-bottom: 15px;
      box-sizing: border-box;
    }
    .presentation-btn {
      background-color: #0074cc;
      color: white;
      padding: 12px 20px;
      border: none;
      cursor: pointer;
      width: 100%;
      font-size: 16px;
      border-radius: 4px;
    }
    .presentation-btn:hover {
      background-color: #005fa3;
    }
    span {
      font-size: 11px;
      color: #555;
    }
  </style>

<style>.grecaptcha-badge { z-index:99999; }</style></head>
<body>

  <form id='i-recatcha' method="post" class="y-form" name="Request Information" action="https://post.salesoptima.com/wcmpost.aspx">
  <div class="g-recaptcha" 
       data-sitekey="6LfqOqAUAAAAANrSJEIFBRfy3WNIYfNMlV995CiY"
       data-size="invisible"
      data-callback="formSubmit">
    </div>
    <input type="text" name="txtFirstName" placeholder="First Name" class="form-control" required />
    <input type="text" name="txtLastName" placeholder="Last Name" class="form-control" required />
    <input type="email" name="txtEmail" placeholder="Email" class="form-control" required />
    <input type="tel" name="txtMobile" placeholder="Mobile Number" class="form-control"
      pattern="^([0-9]( |-)?)?(\(?[0-9]{3}\)?|[0-9]{3})( |-)?([0-9]{3}( |-)?[0-9]{4}|[a-zA-Z0-9]{7})$"
      title="Phone Number (Format: 999-999-9999)" required />

   <div style='padding-bottom:10px;'>
<select class="form-control mb-7" name="LinkCode" id="LinkCode" required>
<option value="">-Select Location-</option>
<option value="H2REXZ1WARERGSEXAJJNHDYNW9YN">DE - Bear</option>
<option value="CN4UTTGGOQ4OP/J1GHK6GOPMMEUN">DE - Dewey Beach</option>
<option value="BBMVCYNUBQ2EJOVYMM/ZLJ5WRXAN">DE - Lewes</option>
<option value="MNMLLKMNOBWMLF7JEGSOLEZSB1EN">DE - Long Neck</option>
<option value="KIZBUF/AMVSD0YOVRNHCYLA/P/AN">DC - Washington, D.C.</option>
<option value="O2JAVWHZ2NNLP3/Y3PZBTY4WA4IN">MD - Annapolis</option>
<option value="BD3I4W5VETR32HD8FRKBBAPQI4ON">MD - Baltimore</option>
<option value="T/TRTXGCD2JPEUXRLR3GHUAEZN0N">MD - Deale</option>
<option value="X3P8MPED9MPGKJG19YKUKXKLXWEN">MD - Edgewater</option>
<option value="XPBMYKPQIFVJAHE2IBHYNXO4OSAN">MD - Kent Island</option>
<option value="8DGVXYXTUIRGXDWW2ZPTWTDGRKUN">NJ - Cape May</option>
<option value="VA6B/SXUTXHUIG4MVUJK7OZWEJSN">NJ - Delran</option>
<option value="PRXFAWNSXQTVWL28XKJFFWRYDD4N">NJ - Sea Isle City</option>
<option value="B9TNQJJLPKJMWVKBGHSJABV5MOYN">NJ - Somers Point</option>
<option value="X7JARJKCSLNTHTEPHWBO4YCGO4YN">NJ - Jersey City</option>
<option value="PGUP3HX/PM/XAI2XW6UK/H2D5PKN">NY - Haverstraw</option>
<option value="N3VTCOC1EP9BPZF5ILRXXZVTBB0N">NY - Ossining</option>
<option value="KYPJWZ0DMQD1TV6QRXWI4IVXCOQN">NY - Piermont</option>
</select>
</div>

    <input type="hidden" name="txtAddTag" value="info.fbc-PH_Extension" />
    <input type="hidden" name="txtClass1" value="22401" />
    <input type="hidden" name="txtClass5" value="0" />
    <input type="hidden" name="txtClass2" value="19871" />
    <input type="hidden" name="txtClass4" value="10616" />
    <input type="hidden" name="txtClass7" value="3590" />
    <input type="hidden" name="txtContactSettings" value="3" />
    <input type="hidden" name="txtContactOverWrite" value="0" />
    <span>Valid mobile number required to view info.</span>
    <button class="presentation-btn" type="submit">View Presentation Now!</button>
  <input name='txtCheckToken' type='hidden' value='pykkkzxjdldkzjhjzpepe' /></form>

<script>
  document.addEventListener("DOMContentLoaded", function() {
    const linkCodeSelect = document.getElementById("LinkCode");
    const txtClass5 = document.querySelector("input[name='txtClass5']");

    linkCodeSelect.addEventListener("change", function() {
      switch (this.value) {
        case "H2REXZ1WARERGSEXAJJNHDYNW9YN": txtClass5.value = "8750"; break;
        case "CN4UTTGGOQ4OP/J1GHK6GOPMMEUN": txtClass5.value = "9051"; break;
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        case "MNMLLKMNOBWMLF7JEGSOLEZSB1EN": txtClass5.value = "8610"; break;
        case "KIZBUF/AMVSD0YOVRNHCYLA/P/AN": txtClass5.value = "8478"; break;
        case "O2JAVWHZ2NNLP3/Y3PZBTY4WA4IN": txtClass5.value = "8350"; break;
        case "BD3I4W5VETR32HD8FRKBBAPQI4ON": txtClass5.value = "8477"; break;
        case "T/TRTXGCD2JPEUXRLR3GHUAEZN0N": txtClass5.value = "8578"; break;
        case "X3P8MPED9MPGKJG19YKUKXKLXWEN": txtClass5.value = "8886"; break;
        case "XPBMYKPQIFVJAHE2IBHYNXO4OSAN": txtClass5.value = "8763"; break;
        case "8DGVXYXTUIRGXDWW2ZPTWTDGRKUN": txtClass5.value = "8744"; break;
        case "VA6B/SXUTXHUIG4MVUJK7OZWEJSN": txtClass5.value = "8821"; break;
        case "PRXFAWNSXQTVWL28XKJFFWRYDD4N": txtClass5.value = "8973"; break;
        case "B9TNQJJLPKJMWVKBGHSJABV5MOYN": txtClass5.value = "8676"; break;
        case "X7JARJKCSLNTHTEPHWBO4YCGO4YN": txtClass5.value = "9146"; break;
        case "PGUP3HX/PM/XAI2XW6UK/H2D5PKN": txtClass5.value = "8817"; break;
        case "N3VTCOC1EP9BPZF5ILRXXZVTBB0N": txtClass5.value = "8818"; break;
        case "KYPJWZ0DMQD1TV6QRXWI4IVXCOQN": txtClass5.value = "8851"; break;
        default: txtClass5.value = "0"; break;
      }
    });
  });
</script>



  <script>
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  	$("#i-recatcha").submit(function (event) {
  		grecaptcha.execute();
  
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  	var first = true;
  	$("form,form input,form textarea,form button,form select").focus(function() {
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  		$.getScript("https://www.google.com/recaptcha/api.js");
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  function formSubmit(response) {
  	//submit the form which now includes a g-recaptcha-response input
  	$("#i-recatcha").unbind().submit();
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  </script></body>
</html>
