{"id":11,"date":"2019-09-10T12:30:06","date_gmt":"2019-09-10T12:30:06","guid":{"rendered":"https:\/\/chapters.theprimetimersww.com\/centralvirginia\/register\/"},"modified":"2026-04-03T14:42:56","modified_gmt":"2026-04-03T18:42:56","slug":"register","status":"publish","type":"page","link":"https:\/\/chapters.theprimetimersww.com\/centralvirginia\/register\/","title":{"rendered":"Register"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"11\" class=\"elementor elementor-11\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-c3c1ce5 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"c3c1ce5\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-801e7a9\" data-id=\"801e7a9\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-dc51457 elementor-widget elementor-widget-heading\" data-id=\"dc51457\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">New Member Registration Form<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-39afee8 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"39afee8\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-6e65778\" data-id=\"6e65778\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-d4f4713 elementor-widget elementor-widget-text-editor\" data-id=\"d4f4713\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h5>Complete the form below to request membership in Prime Timers of Central Virginia.<\/h5>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-1d7243b elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"1d7243b\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2400482\" data-id=\"2400482\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6fb51c4 elementor-widget__width-initial elementor-widget elementor-widget-wpforms\" data-id=\"6fb51c4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"wpforms.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"wpforms-container wpforms-container-full wpforms-render-modern\" id=\"wpforms-10487\"><form id=\"wpforms-form-10487\" class=\"wpforms-validate wpforms-form\" data-formid=\"10487\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/centralvirginia\/wp-json\/wp\/v2\/pages\/11\" data-token=\"cf715e91711c3f9001dc6dd0d7abb425\" data-token-time=\"1775551802\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div id=\"wpforms-error-noscript\" style=\"display: none;\">Please enable JavaScript in your browser to complete this form.<\/div><div class=\"wpforms-field-container\"><div id=\"wpforms-10487-field_8-container\" class=\"wpforms-field wpforms-field-layout\" data-field-id=\"8\"><div class=\"wpforms-field-layout-columns wpforms-field-layout-preset-67-33\"><div class=\"wpforms-layout-column wpforms-layout-column-67\" ><div id=\"wpforms-10487-field_7-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"7\"><label class=\"wpforms-field-label\" for=\"wpforms-10487-field_7\">First Name <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-10487-field_7\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][7]\" aria-errormessage=\"wpforms-10487-field_7-error\" required><\/div><div id=\"wpforms-10487-field_9-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"9\"><label class=\"wpforms-field-label\" for=\"wpforms-10487-field_9\">Middle, Middle Initial, or (Known As)<\/label><input type=\"text\" id=\"wpforms-10487-field_9\" class=\"wpforms-field-medium\" name=\"wpforms[fields][9]\" aria-errormessage=\"wpforms-10487-field_9-error\" aria-describedby=\"wpforms-10487-field_9-description\" ><div id=\"wpforms-10487-field_9-description\" class=\"wpforms-field-description\">Use parentheses if specifying your nickname.<\/div><\/div><div id=\"wpforms-10487-field_10-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"10\"><label class=\"wpforms-field-label\" for=\"wpforms-10487-field_10\">Last Name <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-10487-field_10\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][10]\" aria-errormessage=\"wpforms-10487-field_10-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-33\" ><div id=\"wpforms-10487-field_41-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"41\"><fieldset><legend class=\"wpforms-field-label\">Keep my member profile private?  <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-10487-field_41\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-10487-field_41_1\" name=\"wpforms[fields][41]\" value=\"Yes\" aria-errormessage=\"wpforms-10487-field_41_1-error\" aria-describedby=\"wpforms-10487-field_41-description\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-10487-field_41_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1 wpforms-selected\"><input type=\"radio\" id=\"wpforms-10487-field_41_2\" name=\"wpforms[fields][41]\" value=\"No\" aria-errormessage=\"wpforms-10487-field_41_2-error\" aria-describedby=\"wpforms-10487-field_41-description\" required  checked='checked'><label class=\"wpforms-field-label-inline\" for=\"wpforms-10487-field_41_2\">No<\/label><\/li><\/ul><div id=\"wpforms-10487-field_41-description\" class=\"wpforms-field-description\">Most members do not request private profiles. Those who select \"Yes\" will not see their name on the list of members published for all members.\n\nContinuing on this form below, you can designate other personal information as only available to the Board and staff and not to the general membership.<\/div><\/fieldset><\/div><\/div><\/div><\/div><div id=\"wpforms-10487-field_11-container\" class=\"wpforms-field wpforms-field-layout\" data-field-id=\"11\"><div class=\"wpforms-field-layout-columns wpforms-field-layout-preset-67-33\"><div class=\"wpforms-layout-column wpforms-layout-column-67\" ><div id=\"wpforms-10487-field_54-container\" class=\"wpforms-field wpforms-field-date-time\" data-field-id=\"54\"><fieldset><legend class=\"wpforms-field-label\">Date of Birth <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-date-dropdown-wrap wpforms-field-medium\"><select name=\"wpforms[fields][54][date][m]\" id=\"wpforms-10487-field_54-month\" class=\"wpforms-field-date-time-date-month wpforms-field-required\" aria-label=\"Month\"  required><option value=\"\" class=\"placeholder\" selected disabled>MM<\/option><option value=\"1\" >1<\/option><option value=\"2\" >2<\/option><option value=\"3\" >3<\/option><option value=\"4\" >4<\/option><option value=\"5\" >5<\/option><option value=\"6\" >6<\/option><option value=\"7\" >7<\/option><option value=\"8\" >8<\/option><option value=\"9\" >9<\/option><option value=\"10\" >10<\/option><option value=\"11\" >11<\/option><option value=\"12\" >12<\/option><\/select><select name=\"wpforms[fields][54][date][d]\" id=\"wpforms-10487-field_54-day\" class=\"wpforms-field-date-time-date-day wpforms-field-required\" aria-label=\"Day\"  required><option value=\"\" class=\"placeholder\" selected disabled>DD<\/option><option value=\"1\" >1<\/option><option value=\"2\" >2<\/option><option value=\"3\" >3<\/option><option value=\"4\" >4<\/option><option value=\"5\" >5<\/option><option value=\"6\" >6<\/option><option value=\"7\" >7<\/option><option value=\"8\" >8<\/option><option value=\"9\" >9<\/option><option value=\"10\" >10<\/option><option value=\"11\" >11<\/option><option value=\"12\" >12<\/option><option value=\"13\" >13<\/option><option value=\"14\" >14<\/option><option value=\"15\" >15<\/option><option value=\"16\" >16<\/option><option value=\"17\" >17<\/option><option value=\"18\" >18<\/option><option value=\"19\" >19<\/option><option value=\"20\" >20<\/option><option value=\"21\" >21<\/option><option value=\"22\" >22<\/option><option value=\"23\" >23<\/option><option value=\"24\" >24<\/option><option value=\"25\" >25<\/option><option value=\"26\" >26<\/option><option value=\"27\" >27<\/option><option value=\"28\" >28<\/option><option value=\"29\" >29<\/option><option value=\"30\" >30<\/option><option value=\"31\" >31<\/option><\/select><select name=\"wpforms[fields][54][date][y]\" id=\"wpforms-10487-field_54-year\" class=\"wpforms-field-date-time-date-year wpforms-field-required\" aria-label=\"Year\"  required><option value=\"\" class=\"placeholder\" selected disabled>YYYY<\/option><option value=\"2027\" >2027<\/option><option value=\"2026\" >2026<\/option><option value=\"2025\" >2025<\/option><option value=\"2024\" >2024<\/option><option value=\"2023\" >2023<\/option><option value=\"2022\" >2022<\/option><option value=\"2021\" >2021<\/option><option value=\"2020\" >2020<\/option><option value=\"2019\" >2019<\/option><option value=\"2018\" >2018<\/option><option value=\"2017\" >2017<\/option><option value=\"2016\" >2016<\/option><option value=\"2015\" >2015<\/option><option value=\"2014\" >2014<\/option><option value=\"2013\" >2013<\/option><option value=\"2012\" >2012<\/option><option value=\"2011\" >2011<\/option><option value=\"2010\" >2010<\/option><option value=\"2009\" >2009<\/option><option value=\"2008\" >2008<\/option><option value=\"2007\" >2007<\/option><option value=\"2006\" >2006<\/option><option value=\"2005\" >2005<\/option><option value=\"2004\" >2004<\/option><option value=\"2003\" >2003<\/option><option value=\"2002\" >2002<\/option><option value=\"2001\" >2001<\/option><option value=\"2000\" >2000<\/option><option value=\"1999\" >1999<\/option><option value=\"1998\" >1998<\/option><option value=\"1997\" >1997<\/option><option value=\"1996\" >1996<\/option><option value=\"1995\" >1995<\/option><option value=\"1994\" >1994<\/option><option value=\"1993\" >1993<\/option><option value=\"1992\" >1992<\/option><option value=\"1991\" >1991<\/option><option value=\"1990\" >1990<\/option><option value=\"1989\" >1989<\/option><option value=\"1988\" >1988<\/option><option value=\"1987\" >1987<\/option><option value=\"1986\" >1986<\/option><option value=\"1985\" >1985<\/option><option value=\"1984\" >1984<\/option><option value=\"1983\" >1983<\/option><option value=\"1982\" >1982<\/option><option value=\"1981\" >1981<\/option><option value=\"1980\" >1980<\/option><option value=\"1979\" >1979<\/option><option value=\"1978\" >1978<\/option><option value=\"1977\" >1977<\/option><option value=\"1976\" >1976<\/option><option value=\"1975\" >1975<\/option><option value=\"1974\" >1974<\/option><option value=\"1973\" >1973<\/option><option value=\"1972\" >1972<\/option><option value=\"1971\" >1971<\/option><option value=\"1970\" >1970<\/option><option value=\"1969\" >1969<\/option><option value=\"1968\" >1968<\/option><option value=\"1967\" >1967<\/option><option value=\"1966\" >1966<\/option><option value=\"1965\" >1965<\/option><option value=\"1964\" >1964<\/option><option value=\"1963\" >1963<\/option><option value=\"1962\" >1962<\/option><option value=\"1961\" >1961<\/option><option value=\"1960\" >1960<\/option><option value=\"1959\" >1959<\/option><option value=\"1958\" >1958<\/option><option value=\"1957\" >1957<\/option><option value=\"1956\" >1956<\/option><option value=\"1955\" >1955<\/option><option value=\"1954\" >1954<\/option><option value=\"1953\" >1953<\/option><option value=\"1952\" >1952<\/option><option value=\"1951\" >1951<\/option><option value=\"1950\" >1950<\/option><option value=\"1949\" >1949<\/option><option value=\"1948\" >1948<\/option><option value=\"1947\" >1947<\/option><option value=\"1946\" >1946<\/option><option value=\"1945\" >1945<\/option><option value=\"1944\" >1944<\/option><option value=\"1943\" >1943<\/option><option value=\"1942\" >1942<\/option><option value=\"1941\" >1941<\/option><option value=\"1940\" >1940<\/option><option value=\"1939\" >1939<\/option><option value=\"1938\" >1938<\/option><option value=\"1937\" >1937<\/option><option value=\"1936\" >1936<\/option><option value=\"1935\" >1935<\/option><option value=\"1934\" >1934<\/option><option value=\"1933\" >1933<\/option><option value=\"1932\" >1932<\/option><option value=\"1931\" >1931<\/option><option value=\"1930\" >1930<\/option><option value=\"1929\" >1929<\/option><option value=\"1928\" >1928<\/option><option value=\"1927\" >1927<\/option><option value=\"1926\" >1926<\/option><option value=\"1925\" >1925<\/option><option value=\"1924\" >1924<\/option><option value=\"1923\" >1923<\/option><option value=\"1922\" >1922<\/option><option value=\"1921\" >1921<\/option><option value=\"1920\" >1920<\/option><\/select><\/div><\/fieldset><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-33\" ><div id=\"wpforms-10487-field_42-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"42\"><fieldset><legend class=\"wpforms-field-label\">Birthday Privacy? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-10487-field_42\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-10487-field_42_1\" name=\"wpforms[fields][42]\" value=\"Yes\" aria-errormessage=\"wpforms-10487-field_42_1-error\" aria-describedby=\"wpforms-10487-field_42-description\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-10487-field_42_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1 wpforms-selected\"><input type=\"radio\" id=\"wpforms-10487-field_42_2\" name=\"wpforms[fields][42]\" value=\"No\" aria-errormessage=\"wpforms-10487-field_42_2-error\" aria-describedby=\"wpforms-10487-field_42-description\" required  checked='checked'><label class=\"wpforms-field-label-inline\" for=\"wpforms-10487-field_42_2\">No<\/label><\/li><\/ul><div id=\"wpforms-10487-field_42-description\" class=\"wpforms-field-description\">Choosing \"Yes\" will keep your birthday private to the general membership and we will not publish your birthday on the monthly Member Calendar. We required your date of birth when you register and is retained for reference only by the Board and the membership coordinator.<\/div><\/fieldset><\/div><\/div><\/div><\/div><div id=\"wpforms-10487-field_16-container\" class=\"wpforms-field wpforms-field-layout\" data-field-id=\"16\"><div class=\"wpforms-field-layout-columns wpforms-field-layout-preset-67-33\"><div class=\"wpforms-layout-column wpforms-layout-column-67\" ><div id=\"wpforms-10487-field_55-container\" class=\"wpforms-field wpforms-field-date-time\" data-field-id=\"55\"><fieldset><legend class=\"wpforms-field-label\">Date of Anniversary<\/legend><div class=\"wpforms-field-date-dropdown-wrap wpforms-field-medium\"><select name=\"wpforms[fields][55][date][m]\" id=\"wpforms-10487-field_55-month\" class=\"wpforms-field-date-time-date-month\" aria-label=\"Month\" ><option value=\"\" class=\"placeholder\" selected disabled>MM<\/option><option value=\"1\" >1<\/option><option value=\"2\" >2<\/option><option value=\"3\" >3<\/option><option value=\"4\" >4<\/option><option value=\"5\" >5<\/option><option value=\"6\" >6<\/option><option value=\"7\" >7<\/option><option value=\"8\" >8<\/option><option value=\"9\" >9<\/option><option value=\"10\" >10<\/option><option value=\"11\" >11<\/option><option value=\"12\" >12<\/option><\/select><select name=\"wpforms[fields][55][date][d]\" id=\"wpforms-10487-field_55-day\" class=\"wpforms-field-date-time-date-day\" aria-label=\"Day\" ><option value=\"\" class=\"placeholder\" selected disabled>DD<\/option><option value=\"1\" >1<\/option><option value=\"2\" >2<\/option><option value=\"3\" >3<\/option><option value=\"4\" >4<\/option><option value=\"5\" >5<\/option><option value=\"6\" >6<\/option><option value=\"7\" >7<\/option><option value=\"8\" >8<\/option><option value=\"9\" >9<\/option><option value=\"10\" >10<\/option><option value=\"11\" >11<\/option><option value=\"12\" >12<\/option><option value=\"13\" >13<\/option><option value=\"14\" >14<\/option><option value=\"15\" >15<\/option><option value=\"16\" >16<\/option><option value=\"17\" >17<\/option><option value=\"18\" >18<\/option><option value=\"19\" >19<\/option><option value=\"20\" >20<\/option><option value=\"21\" >21<\/option><option value=\"22\" >22<\/option><option value=\"23\" >23<\/option><option value=\"24\" >24<\/option><option value=\"25\" >25<\/option><option value=\"26\" >26<\/option><option value=\"27\" >27<\/option><option value=\"28\" >28<\/option><option value=\"29\" >29<\/option><option value=\"30\" >30<\/option><option value=\"31\" >31<\/option><\/select><select name=\"wpforms[fields][55][date][y]\" id=\"wpforms-10487-field_55-year\" class=\"wpforms-field-date-time-date-year\" aria-label=\"Year\" ><option value=\"\" class=\"placeholder\" selected disabled>YYYY<\/option><option value=\"2027\" >2027<\/option><option value=\"2026\" >2026<\/option><option value=\"2025\" >2025<\/option><option value=\"2024\" >2024<\/option><option value=\"2023\" >2023<\/option><option value=\"2022\" >2022<\/option><option value=\"2021\" >2021<\/option><option value=\"2020\" >2020<\/option><option value=\"2019\" >2019<\/option><option value=\"2018\" >2018<\/option><option value=\"2017\" >2017<\/option><option value=\"2016\" >2016<\/option><option value=\"2015\" >2015<\/option><option value=\"2014\" >2014<\/option><option value=\"2013\" >2013<\/option><option value=\"2012\" >2012<\/option><option value=\"2011\" >2011<\/option><option value=\"2010\" >2010<\/option><option value=\"2009\" >2009<\/option><option value=\"2008\" >2008<\/option><option value=\"2007\" >2007<\/option><option value=\"2006\" >2006<\/option><option value=\"2005\" >2005<\/option><option value=\"2004\" >2004<\/option><option value=\"2003\" >2003<\/option><option value=\"2002\" >2002<\/option><option value=\"2001\" >2001<\/option><option value=\"2000\" >2000<\/option><option value=\"1999\" >1999<\/option><option value=\"1998\" >1998<\/option><option value=\"1997\" >1997<\/option><option value=\"1996\" >1996<\/option><option value=\"1995\" >1995<\/option><option value=\"1994\" >1994<\/option><option value=\"1993\" >1993<\/option><option value=\"1992\" >1992<\/option><option value=\"1991\" >1991<\/option><option value=\"1990\" >1990<\/option><option value=\"1989\" >1989<\/option><option value=\"1988\" >1988<\/option><option value=\"1987\" >1987<\/option><option value=\"1986\" >1986<\/option><option value=\"1985\" >1985<\/option><option value=\"1984\" >1984<\/option><option value=\"1983\" >1983<\/option><option value=\"1982\" >1982<\/option><option value=\"1981\" >1981<\/option><option value=\"1980\" >1980<\/option><option value=\"1979\" >1979<\/option><option value=\"1978\" >1978<\/option><option value=\"1977\" >1977<\/option><option value=\"1976\" >1976<\/option><option value=\"1975\" >1975<\/option><option value=\"1974\" >1974<\/option><option value=\"1973\" >1973<\/option><option value=\"1972\" >1972<\/option><option value=\"1971\" >1971<\/option><option value=\"1970\" >1970<\/option><option value=\"1969\" >1969<\/option><option value=\"1968\" >1968<\/option><option value=\"1967\" >1967<\/option><option value=\"1966\" >1966<\/option><option value=\"1965\" >1965<\/option><option value=\"1964\" >1964<\/option><option value=\"1963\" >1963<\/option><option value=\"1962\" >1962<\/option><option value=\"1961\" >1961<\/option><option value=\"1960\" >1960<\/option><option value=\"1959\" >1959<\/option><option value=\"1958\" >1958<\/option><option value=\"1957\" >1957<\/option><option value=\"1956\" >1956<\/option><option value=\"1955\" >1955<\/option><option value=\"1954\" >1954<\/option><option value=\"1953\" >1953<\/option><option value=\"1952\" >1952<\/option><option value=\"1951\" >1951<\/option><option value=\"1950\" >1950<\/option><option value=\"1949\" >1949<\/option><option value=\"1948\" >1948<\/option><option value=\"1947\" >1947<\/option><option value=\"1946\" >1946<\/option><option value=\"1945\" >1945<\/option><option value=\"1944\" >1944<\/option><option value=\"1943\" >1943<\/option><option value=\"1942\" >1942<\/option><option value=\"1941\" >1941<\/option><option value=\"1940\" >1940<\/option><option value=\"1939\" >1939<\/option><option value=\"1938\" >1938<\/option><option value=\"1937\" >1937<\/option><option value=\"1936\" >1936<\/option><option value=\"1935\" >1935<\/option><option value=\"1934\" >1934<\/option><option value=\"1933\" >1933<\/option><option value=\"1932\" >1932<\/option><option value=\"1931\" >1931<\/option><option value=\"1930\" >1930<\/option><option value=\"1929\" >1929<\/option><option value=\"1928\" >1928<\/option><option value=\"1927\" >1927<\/option><option value=\"1926\" >1926<\/option><option value=\"1925\" >1925<\/option><option value=\"1924\" >1924<\/option><option value=\"1923\" >1923<\/option><option value=\"1922\" >1922<\/option><option value=\"1921\" >1921<\/option><option value=\"1920\" >1920<\/option><\/select><\/div><div id=\"wpforms-10487-field_55-description\" class=\"wpforms-field-description\">Will be published on the PTCV Monthly Calendar unless made private.<\/div><\/fieldset><\/div><div id=\"wpforms-10487-field_19-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-trigger\" data-field-id=\"19\"><label class=\"wpforms-field-label\" for=\"wpforms-10487-field_19\">Husband\/Partner Name<\/label><input type=\"text\" id=\"wpforms-10487-field_19\" class=\"wpforms-field-medium\" name=\"wpforms[fields][19]\" aria-errormessage=\"wpforms-10487-field_19-error\" ><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-33\" ><div id=\"wpforms-10487-field_43-container\" class=\"wpforms-field wpforms-field-radio wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"43\" style=\"display:none;\"><fieldset><legend class=\"wpforms-field-label\">Anniversary Privacy?<\/legend><ul id=\"wpforms-10487-field_43\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-10487-field_43_1\" name=\"wpforms[fields][43]\" value=\"Yes\" aria-errormessage=\"wpforms-10487-field_43_1-error\" aria-describedby=\"wpforms-10487-field_43-description\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-10487-field_43_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-10487-field_43_2\" name=\"wpforms[fields][43]\" value=\"No\" aria-errormessage=\"wpforms-10487-field_43_2-error\" aria-describedby=\"wpforms-10487-field_43-description\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-10487-field_43_2\">No<\/label><\/li><\/ul><div id=\"wpforms-10487-field_43-description\" class=\"wpforms-field-description\">Choose \"Yes\" to keep this information private.<\/div><\/fieldset><\/div><\/div><\/div><\/div><div id=\"wpforms-10487-field_20-container\" class=\"wpforms-field wpforms-field-layout\" data-field-id=\"20\"><div class=\"wpforms-field-layout-columns wpforms-field-layout-preset-67-33\"><div class=\"wpforms-layout-column wpforms-layout-column-67\" ><div id=\"wpforms-10487-field_21-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"21\"><label class=\"wpforms-field-label\" for=\"wpforms-10487-field_21\">Email address<\/label><input type=\"email\" id=\"wpforms-10487-field_21\" class=\"wpforms-field-medium\" name=\"wpforms[fields][21]\" spellcheck=\"false\" aria-errormessage=\"wpforms-10487-field_21-error\" aria-describedby=\"wpforms-10487-field_21-description\" ><div id=\"wpforms-10487-field_21-description\" class=\"wpforms-field-description\">If you have an email, please do not leave this field blank. If you do, you will not receive email updates. You can opt to receive paper copies. See below.<\/div><\/div><div id=\"wpforms-10487-field_46-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"46\"><fieldset><legend class=\"wpforms-field-label\">Paper copies via U.S. Mail? (extra $15\/year dues) <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-10487-field_46\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-10487-field_46_1\" name=\"wpforms[fields][46]\" value=\"Yes\" aria-errormessage=\"wpforms-10487-field_46_1-error\" aria-describedby=\"wpforms-10487-field_46-description\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-10487-field_46_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1 wpforms-selected\"><input type=\"radio\" id=\"wpforms-10487-field_46_2\" name=\"wpforms[fields][46]\" value=\"No\" aria-errormessage=\"wpforms-10487-field_46_2-error\" aria-describedby=\"wpforms-10487-field_46-description\" required  checked='checked'><label class=\"wpforms-field-label-inline\" for=\"wpforms-10487-field_46_2\">No<\/label><\/li><\/ul><div id=\"wpforms-10487-field_46-description\" class=\"wpforms-field-description\">The extra $15 dues help us cover the costs of inks and postage. <\/div><\/fieldset><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-33\" ><div id=\"wpforms-10487-field_44-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"44\"><fieldset><legend class=\"wpforms-field-label\">Emailed Member Updates? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-10487-field_44\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1 wpforms-selected\"><input type=\"radio\" id=\"wpforms-10487-field_44_1\" name=\"wpforms[fields][44]\" value=\"Yes\" aria-errormessage=\"wpforms-10487-field_44_1-error\" aria-describedby=\"wpforms-10487-field_44-description\" required  checked='checked'><label class=\"wpforms-field-label-inline\" for=\"wpforms-10487-field_44_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-10487-field_44_2\" name=\"wpforms[fields][44]\" value=\"No\" aria-errormessage=\"wpforms-10487-field_44_2-error\" aria-describedby=\"wpforms-10487-field_44-description\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-10487-field_44_2\">No<\/label><\/li><\/ul><div id=\"wpforms-10487-field_44-description\" class=\"wpforms-field-description\">Choose \"No\" if you do not want us to email you periodic Member Updates.<\/div><\/fieldset><\/div><div id=\"wpforms-10487-field_45-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"45\"><fieldset><legend class=\"wpforms-field-label\">Email Privacy <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-10487-field_45\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-10487-field_45_1\" name=\"wpforms[fields][45]\" value=\"Yes\" aria-errormessage=\"wpforms-10487-field_45_1-error\" aria-describedby=\"wpforms-10487-field_45-description\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-10487-field_45_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1 wpforms-selected\"><input type=\"radio\" id=\"wpforms-10487-field_45_2\" name=\"wpforms[fields][45]\" value=\"No\" aria-errormessage=\"wpforms-10487-field_45_2-error\" aria-describedby=\"wpforms-10487-field_45-description\" required  checked='checked'><label class=\"wpforms-field-label-inline\" for=\"wpforms-10487-field_45_2\">No<\/label><\/li><\/ul><div id=\"wpforms-10487-field_45-description\" class=\"wpforms-field-description\">If you choose \"Yes\", only the Board and staff will be able to see email address and it won't be available to the general membership.<\/div><\/fieldset><\/div><\/div><\/div><\/div><div id=\"wpforms-10487-field_25-container\" class=\"wpforms-field wpforms-field-layout\" data-field-id=\"25\"><div class=\"wpforms-field-layout-columns wpforms-field-layout-preset-67-33\"><div class=\"wpforms-layout-column wpforms-layout-column-67\" ><div id=\"wpforms-10487-field_26-container\" class=\"wpforms-field wpforms-field-phone\" data-field-id=\"26\"><label class=\"wpforms-field-label\" for=\"wpforms-10487-field_26\">Main Phone (landline or cell) <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"tel\" id=\"wpforms-10487-field_26\" class=\"wpforms-field-medium wpforms-field-required wpforms-masked-input\" data-inputmask=\"&#039;mask&#039;: &#039;(999) 999-9999&#039;\" data-rule-us-phone-field=\"true\" data-inputmask-inputmode=\"tel\" name=\"wpforms[fields][26]\" aria-label=\"Main Phone (landline or cell)\" aria-errormessage=\"wpforms-10487-field_26-error\" aria-describedby=\"wpforms-10487-field_26-description\" required><div id=\"wpforms-10487-field_26-description\" class=\"wpforms-field-description\">This field is required.<\/div><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-33\" ><div id=\"wpforms-10487-field_47-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"47\"><fieldset><legend class=\"wpforms-field-label\">Main Phone Privacy? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-10487-field_47\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-10487-field_47_1\" name=\"wpforms[fields][47]\" value=\"Yes\" aria-errormessage=\"wpforms-10487-field_47_1-error\" aria-describedby=\"wpforms-10487-field_47-description\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-10487-field_47_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1 wpforms-selected\"><input type=\"radio\" id=\"wpforms-10487-field_47_2\" name=\"wpforms[fields][47]\" value=\"No\" aria-errormessage=\"wpforms-10487-field_47_2-error\" aria-describedby=\"wpforms-10487-field_47-description\" required  checked='checked'><label class=\"wpforms-field-label-inline\" for=\"wpforms-10487-field_47_2\">No<\/label><\/li><\/ul><div id=\"wpforms-10487-field_47-description\" class=\"wpforms-field-description\">If you choose \"Yes\", only the Board and staff will be able to see this phone number and it won't be available to the general membership.<\/div><\/fieldset><\/div><\/div><\/div><\/div><div id=\"wpforms-10487-field_28-container\" class=\"wpforms-field wpforms-field-layout\" data-field-id=\"28\"><div class=\"wpforms-field-layout-columns wpforms-field-layout-preset-67-33\"><div class=\"wpforms-layout-column wpforms-layout-column-67\" ><div id=\"wpforms-10487-field_29-container\" class=\"wpforms-field wpforms-field-phone\" data-field-id=\"29\"><label class=\"wpforms-field-label\" for=\"wpforms-10487-field_29\">Alternate Phone<\/label><input type=\"tel\" id=\"wpforms-10487-field_29\" class=\"wpforms-field-medium wpforms-masked-input\" data-inputmask=\"&#039;mask&#039;: &#039;(999) 999-9999&#039;\" data-rule-us-phone-field=\"true\" data-inputmask-inputmode=\"tel\" name=\"wpforms[fields][29]\" aria-label=\"Alternate Phone\" aria-errormessage=\"wpforms-10487-field_29-error\" ><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-33\" ><div id=\"wpforms-10487-field_49-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"49\"><fieldset><legend class=\"wpforms-field-label\">Alternate Phone Privacy?<\/legend><ul id=\"wpforms-10487-field_49\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-10487-field_49_1\" name=\"wpforms[fields][49]\" value=\"Yes\" aria-errormessage=\"wpforms-10487-field_49_1-error\" aria-describedby=\"wpforms-10487-field_49-description\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-10487-field_49_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-10487-field_49_2\" name=\"wpforms[fields][49]\" value=\"No\" aria-errormessage=\"wpforms-10487-field_49_2-error\" aria-describedby=\"wpforms-10487-field_49-description\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-10487-field_49_2\">No<\/label><\/li><\/ul><div id=\"wpforms-10487-field_49-description\" class=\"wpforms-field-description\">If you choose \"Yes\", only the Board and staff will be able to see this phone number and it won't be available to the general membership.<\/div><\/fieldset><\/div><\/div><\/div><\/div>\t\t<div id=\"wpforms-10487-field_1-container\"\n\t\t\tclass=\"wpforms-field wpforms-field-text\"\n\t\t\tdata-field-type=\"text\"\n\t\t\tdata-field-id=\"1\"\n\t\t\t>\n\t\t\t<label class=\"wpforms-field-label\" for=\"wpforms-10487-field_1\" >or profile You<\/label>\n\t\t\t<input type=\"text\" id=\"wpforms-10487-field_1\" class=\"wpforms-field-medium\" name=\"wpforms[fields][1]\" >\n\t\t<\/div>\n\t\t<div id=\"wpforms-10487-field_34-container\" class=\"wpforms-field wpforms-field-layout\" data-field-id=\"34\"><div class=\"wpforms-field-layout-rows wpforms-field-large\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-67\"><div id=\"wpforms-10487-field_36-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"36\"><label class=\"wpforms-field-label\" for=\"wpforms-10487-field_36\">Street Address <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-10487-field_36\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][36]\" aria-errormessage=\"wpforms-10487-field_36-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-33\"><div id=\"wpforms-10487-field_37-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"37\"><label class=\"wpforms-field-label\" for=\"wpforms-10487-field_37\">Apt. #<\/label><input type=\"text\" id=\"wpforms-10487-field_37\" class=\"wpforms-field-medium wpforms-limit-characters-enabled\" data-form-id=\"10487\" data-field-id=\"37\" data-text-limit=\"20\" name=\"wpforms[fields][37]\" aria-errormessage=\"wpforms-10487-field_37-error\" maxlength=\"20\" ><\/div><\/div><\/div><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-67\"><div id=\"wpforms-10487-field_38-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"38\"><label class=\"wpforms-field-label\" for=\"wpforms-10487-field_38\">City <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-10487-field_38\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][38]\" aria-errormessage=\"wpforms-10487-field_38-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-33\"><div id=\"wpforms-10487-field_39-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"39\"><label class=\"wpforms-field-label\" for=\"wpforms-10487-field_39\">State <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-10487-field_39\" class=\"wpforms-field-medium wpforms-field-required wpforms-limit-characters-enabled\" data-form-id=\"10487\" data-field-id=\"39\" data-text-limit=\"2\" name=\"wpforms[fields][39]\" value=\"VA\" aria-errormessage=\"wpforms-10487-field_39-error\" maxlength=\"2\" required><\/div><\/div><\/div><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-67\"><div id=\"wpforms-10487-field_40-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"40\"><label class=\"wpforms-field-label\" for=\"wpforms-10487-field_40\">Zip Code <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-10487-field_40\" class=\"wpforms-field-medium wpforms-field-required wpforms-masked-input wpforms-limit-characters-enabled\" data-rule-inputmask-incomplete=\"1\" data-inputmask-mask=\"99999[-9999]\" data-form-id=\"10487\" data-field-id=\"40\" data-text-limit=\"10\" name=\"wpforms[fields][40]\" placeholder=\"5-digit zip or zip + 4\" aria-errormessage=\"wpforms-10487-field_40-error\" maxlength=\"10\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-33\"><div id=\"wpforms-10487-field_48-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"48\"><fieldset><legend class=\"wpforms-field-label\">Address Privacy <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-10487-field_48\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-10487-field_48_1\" name=\"wpforms[fields][48]\" value=\"Yes\" aria-errormessage=\"wpforms-10487-field_48_1-error\" aria-describedby=\"wpforms-10487-field_48-description\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-10487-field_48_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1 wpforms-selected\"><input type=\"radio\" id=\"wpforms-10487-field_48_2\" name=\"wpforms[fields][48]\" value=\"No\" aria-errormessage=\"wpforms-10487-field_48_2-error\" aria-describedby=\"wpforms-10487-field_48-description\" required  checked='checked'><label class=\"wpforms-field-label-inline\" for=\"wpforms-10487-field_48_2\">No<\/label><\/li><\/ul><div id=\"wpforms-10487-field_48-description\" class=\"wpforms-field-description\">If you choose \"Yes\", only the Board and staff will be able to see your address and it won't be available to the general membership.<\/div><\/fieldset><\/div><\/div><\/div><\/div><\/div><div id=\"wpforms-10487-field_56-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"56\"><label class=\"wpforms-field-label\" for=\"wpforms-10487-field_56\">Tell Us About You<\/label><textarea id=\"wpforms-10487-field_56\" class=\"wpforms-field-medium\" name=\"wpforms[fields][56]\" aria-errormessage=\"wpforms-10487-field_56-error\" aria-describedby=\"wpforms-10487-field_56-description\" ><\/textarea><div id=\"wpforms-10487-field_56-description\" class=\"wpforms-field-description\">If you like, tell our members anything about you such as why you joined, what your activities and interests are, anything else you'd like to share with our group. You can update this any time on our Member Profile Update form.<\/div><\/div><script>\n\t\t\t\t( function() {\n\t\t\t\t\tconst style = document.createElement( 'style' );\n\t\t\t\t\tstyle.appendChild( document.createTextNode( '#wpforms-10487-field_1-container { position: absolute !important; overflow: hidden !important; display: inline !important; height: 1px !important; width: 1px !important; z-index: -1000 !important; padding: 0 !important; } #wpforms-10487-field_1-container input { visibility: hidden; } #wpforms-conversational-form-page #wpforms-10487-field_1-container label { counter-increment: none; }' ) );\n\t\t\t\t\tdocument.head.appendChild( style );\n\t\t\t\t\tdocument.currentScript?.remove();\n\t\t\t\t} )();\n\t\t\t<\/script><\/div><!-- .wpforms-field-container --><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"10487\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/chapters.theprimetimersww.com\/centralvirginia\/wp-json\/wp\/v2\/pages\/11\"><input type=\"hidden\" name=\"url_referer\" value=\"\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-10487\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Join Prime Timers of Central Virginia\" aria-live=\"assertive\" value=\"wpforms-submit\">Join Prime Timers of Central Virginia<\/button><\/div><\/form><\/div>  <!-- .wpforms-container -->\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>New Member Registration Form Complete the form below to request membership in Prime Timers of Central Virginia. Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this&hellip; <\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-11","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/chapters.theprimetimersww.com\/centralvirginia\/wp-json\/wp\/v2\/pages\/11","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/chapters.theprimetimersww.com\/centralvirginia\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/chapters.theprimetimersww.com\/centralvirginia\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/chapters.theprimetimersww.com\/centralvirginia\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/chapters.theprimetimersww.com\/centralvirginia\/wp-json\/wp\/v2\/comments?post=11"}],"version-history":[{"count":5,"href":"https:\/\/chapters.theprimetimersww.com\/centralvirginia\/wp-json\/wp\/v2\/pages\/11\/revisions"}],"predecessor-version":[{"id":10587,"href":"https:\/\/chapters.theprimetimersww.com\/centralvirginia\/wp-json\/wp\/v2\/pages\/11\/revisions\/10587"}],"wp:attachment":[{"href":"https:\/\/chapters.theprimetimersww.com\/centralvirginia\/wp-json\/wp\/v2\/media?parent=11"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}