{"id":207199,"date":"2018-11-15T08:51:20","date_gmt":"2018-11-15T13:51:20","guid":{"rendered":"https:\/\/easywater.com\/residential\/?page_id=207199"},"modified":"2023-03-04T16:59:00","modified_gmt":"2023-03-04T21:59:00","slug":"product-registration","status":"publish","type":"page","link":"https:\/\/easywater.com\/residential\/product-registration\/","title":{"rendered":"Product Registration"},"content":{"rendered":"[et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.16&#8243; background_color=&#8221;#2d79ad&#8221; use_background_color_gradient=&#8221;on&#8221; background_color_gradient_direction=&#8221;90deg&#8221; background_color_gradient_stops=&#8221;#2d79ad 0%|#80c9f7 100%&#8221; background_color_gradient_start=&#8221;#2d79ad&#8221; background_color_gradient_end=&#8221;#80c9f7&#8243; background_image=&#8221;https:\/\/easywater.com\/residential\/wp-content\/uploads\/sites\/2\/2018\/11\/dot-pat-4.png&#8221; background_size=&#8221;initial&#8221; background_position=&#8221;bottom_center&#8221; background_repeat=&#8221;repeat-x&#8221; custom_margin=&#8221;|0px|100px|0px&#8221; custom_padding=&#8221;0px|0px|54px|0px&#8221; bottom_divider_style=&#8221;wave2&#8243; bottom_divider_color=&#8221;#ffffff&#8221; bottom_divider_flip=&#8221;horizontal&#8221; bottom_divider_height_tablet=&#8221;70px&#8221; bottom_divider_height_phone=&#8221;50px&#8221; bottom_divider_height_last_edited=&#8221;on|phone&#8221; custom_css_main_element=&#8221;overflow: visible !important;||z-index: 9999;&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.16&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221; max_width=&#8221;1200px&#8221; custom_padding=&#8221;||60px|&#8221; use_custom_width=&#8221;on&#8221; custom_width_px=&#8221;1200px&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;|||&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_text _builder_version=&#8221;4.16&#8243; text_font=&#8221;Open Sans||||||||&#8221; text_font_size=&#8221;22px&#8221; text_line_height=&#8221;1.6em&#8221; header_font=&#8221;Alfa Slab One||||||||&#8221; header_text_align=&#8221;center&#8221; header_text_color=&#8221;#ffffff&#8221; header_font_size=&#8221;55px&#8221; text_orientation=&#8221;center&#8221; background_layout=&#8221;dark&#8221; custom_margin=&#8221;50px|||&#8221; custom_margin_tablet=&#8221;-30px||-20px|&#8221; custom_margin_phone=&#8221;-65px||-50px|&#8221; custom_margin_last_edited=&#8221;on|tablet&#8221; custom_padding=&#8221;|15%|30px|15%&#8221; custom_padding_tablet=&#8221;|5%|20px|5%&#8221; custom_padding_phone=&#8221;|0px|10px|0px&#8221; custom_padding_last_edited=&#8221;on|desktop&#8221; animation_direction=&#8221;top&#8221; text_font_size_tablet=&#8221;18px&#8221; text_font_size_phone=&#8221;16px&#8221; text_font_size_last_edited=&#8221;on|phone&#8221; text_line_height_tablet=&#8221;&#8221; text_line_height_phone=&#8221;&#8221; text_line_height_last_edited=&#8221;on|phone&#8221; header_font_size_tablet=&#8221;&#8221; header_font_size_phone=&#8221;40px&#8221; header_font_size_last_edited=&#8221;on|phone&#8221; global_colors_info=&#8221;{}&#8221;]\n<h1>Product Registration<\/h1>\n[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;0px|||&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;0px|||&#8221; global_colors_info=&#8221;{}&#8221; column_structure=&#8221;1_2,1_2&#8243;][et_pb_column type=&#8221;1_2&#8243; _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;|||&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_image src=&#8221;https:\/\/easywater.com\/staged-residential\/wp-content\/uploads\/sites\/2\/2018\/09\/girl-drinking-water.jpg&#8221; align_tablet=&#8221;center&#8221; align_last_edited=&#8221;on|desktop&#8221; disabled_on=&#8221;on|on|off&#8221; _builder_version=&#8221;4.16&#8243; custom_margin=&#8221;||55px|&#8221; border_radii=&#8221;on|3px|3px|3px|3px&#8221; box_shadow_style=&#8221;preset3&#8243; box_shadow_color=&#8221;#b9c2cc&#8221; global_colors_info=&#8221;{}&#8221; align_phone=&#8221;center&#8221;][\/et_pb_image][\/et_pb_column][et_pb_column type=&#8221;1_2&#8243; _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;|||&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_text _builder_version=&#8221;4.20.0&#8243; text_font=&#8221;Open Sans||||||||&#8221; text_font_size=&#8221;16px&#8221; header_2_font=&#8221;Open Sans|700|||||||&#8221; header_2_text_color=&#8221;#464f56&#8243; header_2_font_size=&#8221;30px&#8221; header_2_line_height=&#8221;1.1em&#8221; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; sticky_enabled=&#8221;0&#8243;]\n<h2>Register your products today!<\/h2>\n<p>Please fill out the form below to register your EasyWater product(s). After submitting, you will receive an email with a copy of your registration for your records.\u00a0\u00a0<\/p>\n<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 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          <p class='gform_description'><\/p>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_11' class='sidebar' action='\/residential\/wp-json\/wp\/v2\/pages\/207199' data-formid='11' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_11' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_11_1\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_1'>Your 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_11_1' type='text' value='' class='large'    placeholder='Your Name' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_10\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_10'>Address<\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_11_10' type='text' value='' class='large'    placeholder='Street Address'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_11\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_11'>City<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_11_11' type='text' value='' class='large'    placeholder='City' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_12\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_12'>State<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_12' id='input_11_12' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>State<\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select><\/div><\/div><div id=\"field_11_5\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_5'>Zip Code<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_11_5' type='text' value='' class='large'    placeholder='Zip Code' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_13\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_13'>Age Range<\/label><div class='ginput_container ginput_container_select'><select name='input_13' id='input_11_13' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select Age Range<\/option><option value='18-24' >18-24<\/option><option value='25-34' >25-34<\/option><option value='35-44' >35-44<\/option><option value='45-54' >45-54<\/option><option value='55-64' >55-64<\/option><option value='65+' >65+<\/option><\/select><\/div><\/div><div id=\"field_11_4\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_4'>Email Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_4' id='input_11_4' type='email' value='' class='large'   placeholder='Email Address' aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_11_3\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_3'>Phone Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_3' id='input_11_3' type='tel' value='' class='large'  placeholder='Phone Number' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_14\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_14'>How did you hear about us?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_14' id='input_11_14' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' >-<\/option><option value='First Choice' >Radio<\/option><option value='Second Choice' >Internet<\/option><option value='Third Choice' >TV<\/option><option value='Friend\/Neighbor' >Friend\/Neighbor<\/option><option value='Home Show' >Home Show<\/option><option value='Plumber\/Dealer' >Plumber\/Dealer<\/option><option value='Other' >Other<\/option><\/select><\/div><\/div><div id=\"field_11_15\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_15'>Purchased Via:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_15' id='input_11_15' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='-' >-<\/option><option value='EasyWater Direct' >EasyWater Direct<\/option><option value='Local Dealer' >Local Dealer<\/option><\/select><\/div><\/div><div id=\"field_11_16\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_16'>Dealer Name<\/label><div class='ginput_container ginput_container_text'><input name='input_16' id='input_11_16' type='text' value='' class='large'    placeholder='Dealer Name (If Applicable)'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_11_17\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Select Your Product(s)<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_11_17'><div class='gchoice gchoice_11_17_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.1' type='checkbox'  value='No-Salt Conditioner'  id='choice_11_17_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_17_1' id='label_11_17_1' class='gform-field-label gform-field-label--type-inline'>No-Salt Conditioner<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_17_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.2' type='checkbox'  value='RevitaLife'  id='choice_11_17_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_17_2' id='label_11_17_2' class='gform-field-label gform-field-label--type-inline'>RevitaLife<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_17_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.3' type='checkbox'  value='IronShield'  id='choice_11_17_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_17_3' id='label_11_17_3' class='gform-field-label gform-field-label--type-inline'>IronShield<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_17_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.4' type='checkbox'  value='IronShield Cartridge'  id='choice_11_17_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_17_4' id='label_11_17_4' class='gform-field-label gform-field-label--type-inline'>IronShield Cartridge<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_17_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.5' type='checkbox'  value='ToxinShield'  id='choice_11_17_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_17_5' id='label_11_17_5' class='gform-field-label gform-field-label--type-inline'>ToxinShield<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_17_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.6' type='checkbox'  value='ToxinShield Cartridge'  id='choice_11_17_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_17_6' id='label_11_17_6' class='gform-field-label gform-field-label--type-inline'>ToxinShield Cartridge<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_17_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.7' type='checkbox'  value='LeadShield'  id='choice_11_17_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_17_7' id='label_11_17_7' class='gform-field-label gform-field-label--type-inline'>LeadShield<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_17_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.8' type='checkbox'  value='BacteriaShield'  id='choice_11_17_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_17_8' id='label_11_17_8' class='gform-field-label gform-field-label--type-inline'>BacteriaShield<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_17_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.9' type='checkbox'  value='AcidShield'  id='choice_11_17_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_17_9' id='label_11_17_9' class='gform-field-label gform-field-label--type-inline'>AcidShield<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_17_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.11' type='checkbox'  value='SedimentShield'  id='choice_11_17_11'   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} );} ); \n\/* ]]> *\/\n<\/script>\n\n[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; module_id=&#8221;quote&#8221; module_class=&#8221;product-slider&#8221; _builder_version=&#8221;4.16&#8243; background_color=&#8221;#deecf5&#8243; use_background_color_gradient=&#8221;on&#8221; background_color_gradient_direction=&#8221;90deg&#8221; background_color_gradient_stops=&#8221;#2d79ad 0%|#80c9f7 100%&#8221; background_color_gradient_start=&#8221;#2d79ad&#8221; background_color_gradient_end=&#8221;#80c9f7&#8243; background_image=&#8221;https:\/\/easywater.com\/residential\/wp-content\/uploads\/sites\/2\/2018\/11\/dot-pat-4.png&#8221; background_size=&#8221;initial&#8221; background_position=&#8221;bottom_center&#8221; background_repeat=&#8221;repeat-x&#8221; custom_margin=&#8221;|||&#8221; top_divider_style=&#8221;wave2&#8243; top_divider_color=&#8221;#ffffff&#8221; top_divider_height_tablet=&#8221;70px&#8221; 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id='input_1_4' type='email' value='' class='large'   placeholder='Email Address' aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_1_5\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_5'>Zip Code<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_1_5' type='text' value='' class='large'    placeholder='Zip Code' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_1_6\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter field_sublabel_below gfield--no-description 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Please fill out the form below to register your EasyWater product(s). After submitting, you will receive an email with a copy of your registration for your records.\u00a0\u00a0 \n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework sidebar_wrapper' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_11' >\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Product Registration Form<\/h2>\n                            <p class='gform_description'><\/p>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_11' class='sidebar' action='\/residential\/wp-json\/wp\/v2\/pages\/207199' data-formid='11' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_11' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_11_1\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_1'>Your 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_11_1' type='text' value='' class='large'    placeholder='Your Name' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_10\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_10'>Address<\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_11_10' type='text' value='' class='large'    placeholder='Street Address'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_11\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_11'>City<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_11_11' type='text' value='' class='large'    placeholder='City' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_12\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_12'>State<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_12' id='input_11_12' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>State<\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select><\/div><\/div><div id=\"field_11_5\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_5'>Zip Code<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_11_5' type='text' value='' class='large'    placeholder='Zip Code' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_13\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_13'>Age Range<\/label><div class='ginput_container ginput_container_select'><select name='input_13' id='input_11_13' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select Age Range<\/option><option value='18-24' >18-24<\/option><option value='25-34' >25-34<\/option><option value='35-44' >35-44<\/option><option value='45-54' >45-54<\/option><option value='55-64' >55-64<\/option><option value='65+' >65+<\/option><\/select><\/div><\/div><div id=\"field_11_4\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_4'>Email Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_4' id='input_11_4' type='email' value='' class='large'   placeholder='Email Address' aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_11_3\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_3'>Phone Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_3' id='input_11_3' type='tel' value='' class='large'  placeholder='Phone Number' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_14\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_14'>How did you hear about us?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_14' id='input_11_14' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' >-<\/option><option value='First Choice' >Radio<\/option><option value='Second Choice' >Internet<\/option><option value='Third Choice' >TV<\/option><option value='Friend\/Neighbor' >Friend\/Neighbor<\/option><option value='Home Show' >Home Show<\/option><option value='Plumber\/Dealer' >Plumber\/Dealer<\/option><option value='Other' >Other<\/option><\/select><\/div><\/div><div id=\"field_11_15\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_15'>Purchased Via:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_15' id='input_11_15' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='-' >-<\/option><option value='EasyWater Direct' >EasyWater Direct<\/option><option value='Local Dealer' >Local Dealer<\/option><\/select><\/div><\/div><div id=\"field_11_16\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_16'>Dealer Name<\/label><div class='ginput_container ginput_container_text'><input name='input_16' id='input_11_16' type='text' value='' class='large'    placeholder='Dealer Name (If Applicable)'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_11_17\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Select Your Product(s)<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_11_17'><div class='gchoice gchoice_11_17_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.1' type='checkbox'  value='No-Salt Conditioner'  id='choice_11_17_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_17_1' id='label_11_17_1' class='gform-field-label gform-field-label--type-inline'>No-Salt Conditioner<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_17_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.2' type='checkbox'  value='RevitaLife'  id='choice_11_17_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_17_2' id='label_11_17_2' class='gform-field-label gform-field-label--type-inline'>RevitaLife<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_17_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.3' type='checkbox'  value='IronShield'  id='choice_11_17_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_17_3' id='label_11_17_3' class='gform-field-label gform-field-label--type-inline'>IronShield<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_17_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.4' type='checkbox'  value='IronShield Cartridge'  id='choice_11_17_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_17_4' id='label_11_17_4' class='gform-field-label gform-field-label--type-inline'>IronShield Cartridge<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_17_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.5' type='checkbox'  value='ToxinShield'  id='choice_11_17_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_17_5' id='label_11_17_5' class='gform-field-label gform-field-label--type-inline'>ToxinShield<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_17_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.6' type='checkbox'  value='ToxinShield Cartridge'  id='choice_11_17_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_17_6' id='label_11_17_6' class='gform-field-label gform-field-label--type-inline'>ToxinShield Cartridge<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_17_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.7' type='checkbox'  value='LeadShield'  id='choice_11_17_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_17_7' id='label_11_17_7' class='gform-field-label gform-field-label--type-inline'>LeadShield<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_17_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.8' type='checkbox'  value='BacteriaShield'  id='choice_11_17_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_17_8' id='label_11_17_8' class='gform-field-label gform-field-label--type-inline'>BacteriaShield<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_17_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.9' type='checkbox'  value='AcidShield'  id='choice_11_17_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_17_9' id='label_11_17_9' class='gform-field-label gform-field-label--type-inline'>AcidShield<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_17_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.11' type='checkbox'  value='SedimentShield'  id='choice_11_17_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_17_11' id='label_11_17_11' class='gform-field-label gform-field-label--type-inline'>SedimentShield<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_17_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.12' type='checkbox'  value='SedimentShield Cartridge'  id='choice_11_17_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_17_12' id='label_11_17_12' class='gform-field-label gform-field-label--type-inline'>SedimentShield Cartridge<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_17_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.13' type='checkbox'  value='SimplySoft'  id='choice_11_17_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_17_13' id='label_11_17_13' class='gform-field-label gform-field-label--type-inline'>SimplySoft<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_17_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.14' type='checkbox'  value='Nexus'  id='choice_11_17_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_17_14' id='label_11_17_14' class='gform-field-label gform-field-label--type-inline'>Nexus<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_11_19\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_19'>Serial Number(s)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_19' id='input_11_19' type='text' value='' class='large'    placeholder='Enter Serial Number(s)' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_18\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_18'>Installation Date<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_18' id='input_11_18' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_11_18_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_11_18_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_11_18' class='gform_hidden' value='https:\/\/easywater.com\/residential\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><fieldset id=\"field_11_21\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--has-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >SMS Consent<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_11_21'><div class='gchoice gchoice_11_21_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.1' type='checkbox'  value='I consent to receive SMS\/Text messages from EasyWater. (Optional)'  id='choice_11_21_1'   aria-describedby=\"gfield_description_11_21\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_11_21_1' id='label_11_21_1' class='gform-field-label gform-field-label--type-inline'>I consent to receive SMS\/Text messages from EasyWater. (Optional)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_11_21'><p style=\"font-size:12px; line-height:18px; margin:auto; margin-top:-10px;\">\n  Message and data rates may apply. Message frequency may vary. Reply STOP to opt out or HELP for more information. \n  See our <a style=\"text-decoration:underline;\" href=\"https:\/\/easywater.com\/residential\/privacy\">Privacy Policy<\/a> for details.\n<\/p><\/div><\/fieldset><div id=\"field_11_20\" class=\"gfield gfield--type-captcha gfield--input-type-captcha gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_20'>CAPTCHA<\/label><div id='input_11_20' class='ginput_container ginput_recaptcha' data-sitekey='6Ld2x38pAAAAAMDKTruTjGs7N_OvRf-vjlKuewqe'  data-theme='light' data-tabindex='0'  data-badge=''><\/div><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_11' class='gform_button button gform-button--width-full' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='REGISTER 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