function ap_validate_3153() {
   var form = document.ap_form_3153;
   var regexp_38219 = /^[a-zA-Z]+(([\'\,\.\-][a-zA-Z])?[a-zA-Z]*)*$/;
   var regexp_38218 = /^[a-zA-Z]+(([\'\,\.\-][a-zA-Z])?[a-zA-Z]*)*$/;
   var regexp_38220 = /^(([A-Za-z0-9]+_+)|([A-Za-z0-9]+\-+)|([A-Za-z0-9]+\.+)|([A-Za-z0-9]+\++))*[A-Za-z0-9]+@((\w+\-+)|(\w+\.))*\w{1,63}\.[a-zA-Z]{2,6}$/;
   var regexp_38221 = /^((\+\d{1,3}(-| )?\(?\d\)?(-| )?\d{1,3})|(\(?\d{2,3}\)?))(-| )?(\d{3,4})(-| )?(\d{4})(( x| ext)\d{1,5}){0,1}$/;
    if (form.name === ""){
      alert( "There was an error on this form." );
    } else if (form.ap_field_38219.value === ""){
      alert( "Please enter all required fields: Last Name " );
    } else if (!regexp_38219.test(form.ap_field_38219.value)){
      form.ap_field_38219.focus();
      form.ap_field_38219.select();
      alert( "Please correct required field: Last Name" );
    } else if (form.ap_field_38218.value === ""){
      alert( "Please enter all required fields: First Name " );
    } else if (!regexp_38218.test(form.ap_field_38218.value)){
      form.ap_field_38218.focus();
      form.ap_field_38218.select();
      alert( "Please correct required field: First Name" );
    } else if (form.ap_field_38220.value === ""){
      alert( "Please enter all required fields: Email " );
    } else if (!regexp_38220.test(form.ap_field_38220.value)){
      form.ap_field_38220.focus();
      form.ap_field_38220.select();
      alert( "Please correct required field: Email" );
    } else if (form.ap_field_38221.value === ""){
      alert( "Please enter all required fields: Mobile Phone " );
    } else if (!regexp_38221.test(form.ap_field_38221.value)){
      form.ap_field_38221.focus();
      form.ap_field_38221.select();
      alert( "Please correct required field: Mobile Phone" );
    } else {
      document.ap_form_3153.submit();
    }
 }

function showForm(){
var formHTML = '<div style="width:600px; background: white; border: 1px #ccc; display:block; float:left; padding:5px;">       <div style="width:95%; float:left; clear:both;">            <span style="font: bold 1.5em helvetica;"></span>       </div>       <div style="width:95%;float:left; clear:both;margin:0px 0px 7px 0px;">            <span style="font: bold 1.25em helvetica;">Complete this short form to receive a FREE 7-Day VIP Membership and experience all that Gold"s Gym Silver Spring has to offer at NO COST.  <P>  <B>(SILVER SPRING LOCATION ONLY)</B>  <P></span>       </div>  <form name="ap_form_3153" ID="ap_form_3153" method="post" action="https://www.aimcrm.com/remote/form_post.php" enctype="multipart/form-data"><input type="hidden" name="action" value="feedback_visitor_add"><input type="hidden" name="org_id" value="878"><input type="hidden" name="f_id" value="3153"><div style="width:95%; float:left; clear:both;margin:  0px 0px 3px 0px;">            <span style="width:35%; float:left;margin: 0px 0px 0px 5px; ">                 <span style=" font-weight:bold;float: left;">Last Name<span style="font-size:7pt;color:red;">*</span></span>                 <span style=" font:italic helvetica smaller normal; float: left;"></span>            </span>            <span style="width:60%; float:left;"><input type="text" id="ap_field_38219" name="ap_field_38219" value="" style="" /></span>       </div>  <div style="width:95%; float:left; clear:both;margin:  0px 0px 3px 0px;">            <span style="width:35%; float:left;margin: 0px 0px 0px 5px; ">                 <span style=" font-weight:bold;float: left;">First Name<span style="font-size:7pt;color:red;">*</span></span>                 <span style=" font:italic helvetica smaller normal; float: left;"></span>            </span>            <span style="width:60%; float:left;"><input type="text" id="ap_field_38218" name="ap_field_38218" value="" style="" /></span>       </div>  <div style="width:95%; float:left; clear:both;margin:  0px 0px 3px 0px;">            <span style="width:35%; float:left;margin: 0px 0px 0px 5px; ">                 <span style=" font-weight:bold;float: left;">Email<span style="font-size:7pt;color:red;">*</span></span>                 <span style=" font:italic helvetica smaller normal; float: left;"></span>            </span>            <span style="width:60%; float:left;"><input type="text" id="ap_field_38220" name="ap_field_38220" value="" style="" /></span>       </div>  <div style="width:95%; float:left; clear:both;margin:  0px 0px 3px 0px;">            <span style="width:35%; float:left;margin: 0px 0px 0px 5px; ">                 <span style=" font-weight:bold;float: left;">Mobile Phone<span style="font-size:7pt;color:red;">*</span></span>                 <span style=" font:italic helvetica smaller normal; float: left;"></span>            </span>            <span style="width:60%; float:left;"><input type="text" id="ap_field_38221" name="ap_field_38221" value="" style="" /></span>       </div>  <div style="width:95%; float:left; clear:both;margin:  0px 0px 3px 0px;">            <span style="width:35%; float:left;margin: 0px 0px 0px 5px; ">                 <span style=" font-weight:bold;float: left;">Best Time to Call</span>                 <span style=" font:italic helvetica smaller normal; float: left;"></span>            </span>            <span style="width:60%; float:left;"><input type="text" id="ap_field_38222" name="ap_field_38222" value="" style="" /></span>       </div>  <div style="width:95%; float:left; clear:both;margin:  0px 0px 3px 0px;">            <span style="width:35%; float:left;margin: 0px 0px 0px 5px; ">                 <span style=" font-weight:bold;float: left;">Comments/Questions</span>                 <span style=" font:italic helvetica smaller normal; float: left;"></span>            </span>            <span style="width:60%; float:left;"><textarea id="ap_field_38223" name="ap_field_38223" style=""></textarea></span>       </div>  <div>            <span><input name="Submit" type="button" value="Submit" onclick="ap_validate_3153()"><p><span style="font-size:8pt;color:red;">* Required Field</span><a href="http://www.aimcrm.com" style="text-decoration:none;border:none;" title="lead management"><div style="font-size:8pt;color:black;"></div></a></p></span>       </div>  </div></form>';
if(!formShown){
     document.writeln(formHTML);
}
formShown=true;
}
var formShown = false;
showForm();