{"id":70,"date":"2018-02-05T01:43:02","date_gmt":"2018-02-05T06:43:02","guid":{"rendered":"http:\/\/wp.clahealthcare.com\/?page_id=70"},"modified":"2022-05-17T11:18:36","modified_gmt":"2022-05-17T15:18:36","slug":"sign-up-today","status":"publish","type":"page","link":"https:\/\/www.clahealthcare.com\/index.php\/sign-up-today\/","title":{"rendered":"Sign Up Today!"},"content":{"rendered":"<!-- Loading overlay with spinner and message for coupon lookup -->\n<div id=\"hidepage\" style=\"display:none; position: fixed; top: 0; left: 0; width: 100%; height: 100%; background-color: rgba(255, 255, 255, 0.6); backdrop-filter: blur(10px); z-index: 1000; text-align: center;\">\n    <div id=\"loadingOverlay\" style=\"display: flex; justify-content: center; align-items: center; height: 100vh; text-align: center;\">\n        <div id=\"processingMessage\" style=\"color: #333333; font-size: 18px; font-weight: bold; text-shadow: 0px 0px 5px rgba(255, 255, 255, 0.8); margin-bottom: 20px;\">\n            <p>Looking that coupon up for you, please wait...<\/p>\n        <\/div>\n        <div class=\"spinner\" id=\"spinner\" style=\"width: 50px; height: 50px; border: 6px solid rgba(255, 255, 255, 0.8); border-top: 6px solid #3498db; border-radius: 50%; animation: spin 2s linear infinite;\"><\/div>\n    <\/div>\n<\/div>\n\n<!-- Loading wait screen with image, spinner and message for between steps -->\n<div id=\"waitScreen\" style=\"display:none; position: fixed; top: 0; left: 0; width: 100%; height: 100%; background-color: rgba(255, 255, 255, 0); backdrop-filter: blur(3px); z-index: 10000; display: flex; justify-content: center; align-items: center;\">\n\t<div id=\"waitScreenOverlay\" style=\"display: flex; justify-content: center; align-items: center; height: 100vh; text-align: center;\">\n\t\t<div class=\"spinner\" id=\"waitScreenSpinner\" style=\"width: 50px; height: 50px; border: 6px solid rgba(0, 0, 0, 0.1); border-top: 6px solid #3498db; border-radius: 50%; animation: spin 1s linear infinite; margin-bottom: 20px;\"><\/div>\n\t\t<p style=\"color: #333333; font-size: 18px; font-weight: bold; text-shadow: 0px 0px 5px rgba(255, 255, 255, 0.8);\">Your request is being processed.<\/p>\n        <p>(This could take a minute, so please be patient. The screen will be displayed automatically when it is finished.)<\/p>\n        <img decoding=\"async\" src=\"https:\/\/www.clahealthcare.com\/wp-content\/plugins\/JoinCLA\/public\/partials\/images\/waitafewseconds.jpg\" width=\"150\" height=\"145\" border=\"0\" alt=\"Waiting...\">\n    <\/div>\n<\/div>\n\n<div class=\"bodynormal\">\n\n    <table style=\"height: 100%\" width=\"100%\" border=\"0\" cellpadding=\"0\" cellspacing=\"0\">\n        <tr>\n            <td valign=\"top\" width=\"100%\" align=\"center\">\n                <table style=\"height: 100%\" width=\"832\" border=\"0\" cellpadding=\"0\" cellspacing=\"0\">\n                    <tr>\n                        <td rowspan=\"100%\" width=\"22\">&nbsp;<\/td>\n                            <td width=\"788\" valign=\"top\">&nbsp;<br clear=\"all\">\n\n                            <!-- MAIN CONTENT AREA -->\n\n                            \n\t\t\t<!-- ENROLLMENT STEP 1 CONTENT AREA -->\n\t\t\t<form method=\"post\">\n\t\t\t<span class=\"headerblue\">Join Today!<\/span><span class=\"body\"><p>Join Chiropractic Lifecare of America today to start enjoying affordable, easy to access, quality chiropractic care for the whole family.&nbsp; Remember, there is no risk to you.&nbsp; We will refund the full cost of your membership - at any time - if you use your Chiropractic Lifecare Card during the membership year and\n\t\t\t\t\t\t\t\t\t\t\tdo not save at least the cost of your membership.<\/p>\n\t\t\t\t\t\t\t\t\t<p>Here&#39s how your family membership will help you, starting today:<br>\n\t\t\t\t\t\t\t\t\t\t<span class=\"bodylist\">50% off initial exams, consultation and diagnostics<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"bodylist\">50% off the cost of in-house x-rays<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"bodylist\">Minimum of 20% discount on spinal adjustments<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"bodylist\">Up to 50% discount on other chiropractic services<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"bodylist\">Unlimited visits for you and your family<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"bodylist\">No pre-existing conditions withheld<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"bodylist\">Additionally covers all immediate family members listed on your tax form as dependents.<\/span>\n\t\t\t\t\t\t\t\t\t<\/p><p>Joining is quick and easy.  Just fill out the form and click the submit button.<\/p><p>You&#39ll receive your confirmation by e-mail, and your full membership kit by mail in 4-6 weeks, but you can start using your Chiropractic Lifecare of America membership right away!  Just print your e-mail confirmation and use it as your temporary membership card.<\/p><p>If you have any questions, we&#39re always here to help at:  <b>(800) 775-7900<\/b>.<\/p><p>Use this simple form to sign up now or call us toll free to sign up by phone.&nbsp;  Fields marked with an asterisk (<span class=\"formred\">*<\/span>) are required.<\/p>\n                                <table cellpadding=\"4\" cellspacing=\"0\" border=\"0\" width=\"100%\">\n\t\t\t\t<tr><td colspan=\"4\"><hr><\/td><\/tr>\n\t\t\t\t<tr>\n\t\t\t\t\t<td valign=\"top\" align=\"left\" colspan=\"4\"><span class=\"headergreen\"><b>Renewing your membership?&nbsp;&nbsp;&nbsp;<\/b><\/span>&nbsp;&nbsp;&nbsp;<span class=\"formblue\">If so, check this box: <\/span> <input name=\"member_renewal\" class=\"formblue\" type=\"checkbox\" onClick=\"javascript:SetRenewals(this); return true;\">\n\t\t\t\t\t<\/td>\n\t\t\t\t<\/tr>\n\n\n\n\t\t\t\t<tr id=\"RenewalBox1\" style=\"display: none;\">\n\t\t\t\t\t<td colspan=4>\n\t\t\t\t\t\t<table border=\"0\" width=\"100%\" align=\"center\">\n\t\t\t\t\t\t\t<td valign=\"center\" align=\"right\"><span class=\"formblue\">Your current User ID:<\/span><\/td>\n\t\t\t\t\t\t\t<td valign=\"center\"><input type=\"text\" size=\"26\" maxlength=\"50\" name=\"member_current_userid\" value=\"\" onKeyup=\"autotab(this, event, document.forms[0].member_current_password)\"><\/td>\n\t\t\t\t\t\t\t<td valign=\"center\"><span class=\"formblue\">Your current Password:<\/span><\/td>\n\t\t\t\t\t\t\t<td valign=\"center\"><input type=\"text\" size=\"26\" maxlength=\"50\" name=\"member_current_password\" value=\"\" onKeyup=\"autotab(this, event, document.forms[0].member_name_first)\"><\/td>\n\t\t\t\t\t\t<\/table>\n\t\t\t\t\t<\/td>\n\t\t\t\t<\/tr>\n\n\t\t\t\t<tr id=\"RenewalBox2\" style=\"display: none;\">\n\t\t\t\t\t<td colspan=\"5\"><span class=\"smallgreen\" align=\"center\">Your UserID and Password should be printed on your renewal reminder. &nbsp;\n\t\t\t\t\tMake sure to enter it exactly as printed.&nbsp; Pay special attention to any Upper\/Lower Case, numbers or special characters and do not include add any spaces.&nbsp;\n\t\t\t\t\tIf your reminder did not have your UserID and Password printed on it, <a href=\"http:\/\/www.clahealthcare.com\/contact\/index.html\">Contact Us<\/a> to get your logon  information or to renew by phone.<\/td><\/tr>\n\n\t\t\t\t<tr><td colspan=\"4\"><hr><\/td><\/tr>\n\n\t\t\t\t<tr id=\"FormRow1\"><td valign=\"top\" align=\"left\" colspan=\"4\"><span class=\"headergreen\"><b id=\"AboutYou\">About You:<\/b><\/span><\/td><\/tr>\n\t\t\t\t<tr id=\"FormRow2\">\n\t\t\t\t\t<td valign=\"middle\" align=\"right\" width=\"160\" style=\"text-align:right;\"><span class=\"formblue\">Your name:<\/span><\/td>\n\t\t\t\t\t<td valign=\"middle\" align=\"right\" width=\"80\" style=\"text-align:right;\"><span class=\"formred\">*<\/span><span class=\"formblue\">First:<\/span><\/td>\n\t\t\t\t\t<td valign=\"middle\" colspan=\"2\">\n\t\t\t\t\t\t<table cellpadding=\"2\" cellspacing=\"0\" border=\"0\">\n\t\t\t\t\t\t\t<tr>\n\t\t\t\t\t\t\t\t<td valign=\"middle\"><input type=\"text\" size=\"15\" name=\"member_name_first\" value=\"\" onKeyup=\"autotab(this, event, document.forms[0].member_name_middle)\"><\/td>\n\t\t\t\t\t\t\t\t\t<td valign=\"middle\" style=\"text-align:right;\"><span class=\"formblue\">Middle:<\/span><\/td>\n\t\t\t\t\t\t\t\t\t<td valign=\"middle\"><input type=\"text\" size=\"15\" maxlength=\"15\" name=\"member_name_middle\" value=\"\" onKeyDown=\"return goodchars(event,'ABCDEFGHIJKLMNOPQRSTUVWXYZ')\" onKeyup=\"autotab(this, event, document.forms[0].member_name_last)\"><\/td>\n\t\t\t\t\t\t\t\t\t<td valign=\"middle\" style=\"text-align:right;\"><span class=\"formred\">*<\/span><span class=\"formblue\">Last:<\/span><input type=\"text\" size=\"15\" name=\"member_name_last\" value=\"\"><\/td>\n\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t<\/table>\n\t\t\t\t\t<\/td>\n\t\t\t\t<\/tr>\n\n\t\t\t\t<tr id=\"FormRow3\">\n\t\t\t\t\t<td valign=\"center\" align=\"right\" style=\"text-align:right;\"><span class=\"formblue\">Your address:<\/span><\/td>\n\t\t\t\t\t<td valign=\"center\" align=\"right\" style=\"text-align:right;\"><span class=\"formred\">*<\/span><span class=\"formblue\">Street:<\/span><\/td>\n\t\t\t\t\t<td valign=\"center\" colspan=\"2\">\n\t\t\t\t\t\t<table cellpadding=\"2\" cellspacing=\"0\" border=\"0\">\n\t\t\t\t\t\t\t<tr><td valign=\"top\"><input type=\"text\" size=\"40\" name=\"member_address2\" value=\"\"><\/td><\/tr>\n\t\t\t\t\t\t<\/table>\n\t\t\t\t\t<\/td>\n\t\t\t\t<\/tr>\n\n\n\t\t\t\t<tr id=\"FormRow4\">\n\t\t\t\t\t<td valign=\"top\" align=\"right\">&nbsp;<\/td>\n\t\t\t\t\t<td valign=\"top\" align=\"right\">&nbsp;<\/td>\n\t\t\t\t\t<td valign=\"center\" colspan=\"2\">\n\t\t\t\t\t\t<table cellpadding=\"2\" cellspacing=\"0\" border=\"0\">\n\t\t\t\t\t\t\t<tr><td valign=\"center\"><input type=\"text\" size=\"40\" name=\"member_address1\" value=\"\"><\/td><\/tr>\n\t\t\t\t\t\t<\/table>\n\t\t\t\t\t<\/td>\n\t\t\t\t<\/tr>\n\n\n\t\t\t\t<tr valign=\"center\" id=\"FormRow5\">\n\t\t\t\t\t<td valign=\"center\" align=\"right\">&nbsp;<\/td>\n\t\t\t\t\t<td valign=\"center\" align=\"right\" style=\"text-align:right;\"><span class=\"formred\">*<\/span><span class=\"formblue\">City:<\/span><\/td>\n\t\t\t\t\t<td valign=\"center\" colspan=\"2\">\n\t\t\t\t\t\t<table cellpadding=\"2\" cellspacing=\"0\" border=\"0\" valign=\"center\">\n\t\t\t\t\t\t\t<tr valign=\"center\">\n\t\t\t\t\t\t\t\t<td valign=\"center\"><input type=\"text\" size=\"20\" name=\"member_city\" value=\"\"><\/td>\n\t\t\t\t\t\t\t\t<td valign=\"center\"><span class=\"formred\">*<\/span><span class=\"formblue\">State:<\/span><\/td>\n\t\t\t\t\t\t\t\t<td valign=\"center\"><select name=\"member_state\" onkeydown=\"typeAhead();\" onChange=\"document.forms[0].member_zip.focus(); return true;\"><option label=\"Select\" value=\"Select\" selected>Select<\/option><option label=\"AL\" value=\"AL\">Alabama<\/option><option label=\"AK\" value=\"AK\">Alaska<\/option><option label=\"AZ\" value=\"AZ\">Arizona<\/option><option label=\"AR\" value=\"AR\">Arkansas<\/option><option label=\"CA\" value=\"CA\">California<\/option><option label=\"CO\" value=\"CO\">Colorado<\/option><option label=\"CT\" value=\"CT\">Connecticut<\/option><option label=\"DE\" value=\"DE\">Delaware<\/option><option label=\"DC\" value=\"DC\">District Of Columbia<\/option><option label=\"FL\" value=\"FL\">Florida<\/option><option label=\"GA\" value=\"GA\">Georgia<\/option><option label=\"HI\" value=\"HI\">Hawaii<\/option><option label=\"ID\" value=\"ID\">Idaho<\/option><option label=\"IL\" value=\"IL\">Illinois<\/option><option label=\"IN\" value=\"IN\">Indiana<\/option><option label=\"IA\" value=\"IA\">Iowa<\/option><option label=\"KS\" value=\"KS\">Kansas<\/option><option label=\"KY\" value=\"KY\">Kentucky<\/option><option label=\"LA\" value=\"LA\">Louisiana<\/option><option label=\"ME\" value=\"ME\">Maine<\/option><option label=\"MD\" value=\"MD\">Maryland<\/option><option label=\"MA\" value=\"MA\">Massachusetts<\/option><option label=\"MI\" value=\"MI\">Michigan<\/option><option label=\"MN\" value=\"MN\">Minnesota<\/option><option label=\"MS\" value=\"MS\">Mississippi<\/option><option label=\"MO\" value=\"MO\">Missouri<\/option><option label=\"MT\" value=\"MT\">Montana<\/option><option label=\"NE\" value=\"NE\">Nebraska<\/option><option label=\"NV\" value=\"NV\">Nevada<\/option><option label=\"NH\" value=\"NH\">New Hampshire<\/option><option label=\"NJ\" value=\"NJ\">New Jersey<\/option><option label=\"NM\" value=\"NM\">New Mexico<\/option><option label=\"NY\" value=\"NY\">New York<\/option><option label=\"NC\" value=\"NC\">North Carolina<\/option><option label=\"ND\" value=\"ND\">North Dakota<\/option><option label=\"OH\" value=\"OH\">Ohio<\/option><option label=\"OK\" value=\"OK\">Oklahoma<\/option><option label=\"OR\" value=\"OR\">Oregon<\/option><option label=\"PA\" value=\"PA\">Pennsylvania<\/option><option label=\"RI\" value=\"RI\">Rhode Island<\/option><option label=\"SC\" value=\"SC\">South Carolina<\/option><option label=\"SD\" value=\"SD\">South Dakota<\/option><option label=\"TN\" value=\"TN\">Tennessee<\/option><option label=\"TX\" value=\"TX\">Texas<\/option><option label=\"UT\" value=\"UT\">Utah<\/option><option label=\"VT\" value=\"VT\">Vermont<\/option><option label=\"VA\" value=\"VA\">Virginia<\/option><option label=\"WA\" value=\"WA\">Washington<\/option><option label=\"WV\" value=\"WV\">West Virginia<\/option><option label=\"WI\" value=\"WI\">Wisconsin<\/option><option label=\"WY\" value=\"WY\">Wyoming<\/option><\/select><\/td>\n\t\t\t\t\t\t\t\t<td valign=\"center\"><span class=\"formred\">*<\/span><span class=\"formblue\">Zip:<\/span><\/td>\n\t\t\t\t\t\t\t\t<td valign=\"center\"><input type=\"text\" size=\"10\" maxlength=\"10\" name=\"member_zip\" value=\"\" onKeyup=\"autotab(this, event, document.forms[0].member_phone1_area)\"><\/td>\n\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t<\/table>\n\t\t\t\t\t<\/td>\n\t\t\t\t<\/tr>\n\n\t\t\t\t<tr id=\"FormRow6\">\n\t\t\t\t\t<td valign=\"center\" align=\"right\" style=\"text-align:right;\"><span class=\"formblue\">Your phone:<\/span><\/td>\n\t\t\t\t\t<td valign=\"center\" align=\"right\" style=\"text-align:right;\"><span class=\"formred\">*<\/span><span class=\"formblue\">Home:<\/span><\/td>\n\t\t\t\t\t<td valign=\"center\" colspan=\"2\">\n\t\t\t\t\t\t<table cellpadding=\"2\" cellspacing=\"0\" border=\"0\">\n\t\t\t\t\t\t\t<tr>\n\t\t\t\t\t\t\t\t<td valign=\"center\"><input type=\"text\" size=\"3\" maxlength=\"3\" name=\"member_phone1_area\"\t\tonKeyDown=\"return goodchars(event,'0123456789')\" value=\"\" onKeyup=\"autotab(this, event, document.forms[0].member_phone1_exchange)\"><\/td><td valign=\"center\">-<\/td>\n\t\t\t\t\t\t\t\t<td valign=\"center\"><input type=\"text\" size=\"3\" maxlength=\"3\" name=\"member_phone1_exchange\"\tonKeyDown=\"return goodchars(event,'0123456789')\" value=\"\" onKeyup=\"autotab(this, event, document.forms[0].member_phone1_number)\"><\/td><td valign=\"center\">-<\/td>\n\t\t\t\t\t\t\t\t<td valign=\"center\"><input type=\"text\" size=\"4\" maxlength=\"4\" name=\"member_phone1_number\"\tonKeyDown=\"return goodchars(event,'0123456789')\" value=\"\" onKeyup=\"autotab(this, event, document.forms[0].member_phone2_area)\"><\/td>\n\t\t\t\t\t\t\t\t<td width=50>&nbsp;<br><\/td>\n\t\t\t\t\t\t\t\t<td valign=\"center\"><span class=\"formblue\">Work:<\/span><\/td>\n\t\t\t\t\t\t\t\t<td valign=\"center\"><input type=\"text\" size=\"3\" maxlength=\"3\" name=\"member_phone2_area\"\t\tonKeyDown=\"return goodchars(event,'0123456789')\" value=\"\" onKeyup=\"autotab(this, event, document.forms[0].member_phone2_exchange)\"><\/td><td valign=\"center\">-<\/td>\n\t\t\t\t\t\t\t\t<td valign=\"center\"><input type=\"text\" size=\"3\" maxlength=\"3\" name=\"member_phone2_exchange\"\tonKeyDown=\"return goodchars(event,'0123456789')\" value=\"\" onKeyup=\"autotab(this, event, document.forms[0].member_phone2_number)\"><\/td><td valign=\"center\">-<\/td>\n\t\t\t\t\t\t\t\t<td valign=\"center\"><input type=\"text\" size=\"4\" maxlength=\"4\" name=\"member_phone2_number\"\tonKeyDown=\"return goodchars(event,'0123456789')\" value=\"\" onKeyup=\"autotab(this, event, document.forms[0].member_email)\"><\/td>\n\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t<\/table>\n\t\t\t\t\t<\/td>\n\t\t\t\t<\/tr>\n\n\t\t\t\t<tr id=\"FormRow7\"><td colspan=\"4\"><hr><\/td><\/tr>\n\t\t\t\t<tr id=\"FormRow8\"><td valign=\"top\" align=\"left\" colspan=\"4\"><span class=\"headergreen\"><b id=\"YourLogon\">Create Your Logon:<\/b><\/span><\/td><\/tr>\n\t\t\t\t<tr id=\"FormRow9\">\n\t\t\t\t\t<td colspan=\"4\">\n\t\t\t\t\t\t<table border=\"0\">\n\t\t\t\t\t\t\t<tr>\n\t\t\t\t\t\t\t\t<td valign=\"center\" align=\"right\" width=\"30\">&nbsp;<\/td>\n\t\t\t\t\t\t\t\t<td valign=\"center\" align=\"right\" width=\"175\" style=\"text-align:right;\"><span class=\"formred\">*<\/span><span class=\"formblue\">E-mail Address:<\/span><\/td>\n\t\t\t\t\t\t\t\t<td valign=\"center\" align=\"left\"><input type=\"text\" size=\"26\" maxlength=\"50\" name=\"member_email\" value=\"\"><\/td>\n\t\t\t\t\t\t\t\t<td valign=\"center\" align=\"right\" width=\"200\" style=\"text-align:right;\"><span class=\"formred\">*<\/span><span class=\"formblue\">Verify E-mail:<\/span><\/td>\n\t\t\t\t\t\t\t\t<td valign=\"center\" align=\"left\"><input type=\"text\" size=\"26\" maxlength=\"50\" name=\"member_email_verify\" value=\"\"><\/td>\n\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t\t<tr>\n\t\t\t\t\t\t\t\t<td><\/td>\n\t\t\t\t\t\t\t\t<td valign=\"center\" colspan=\"4\"><span class=\"smallgreen\" align=\"center\"><b>Please ensure your e-mail address is correct.  This will be the address where we send your email welcome packet, your login User ID, and our primary way of contacting you!<\/b><\/span><\/td>\n\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t\t<tr><td colspan=\"5\" height=\"20\" width=\"10\">&nbsp;<\/td><\/tr>\n\t\t\t\t\t\t\t<tr>\n\t\t\t\t\t\t\t\t<td><\/td>\n\t\t\t\t\t\t\t\t<td valign=\"center\" align=\"right\" style=\"text-align:right;\"><span class=\"formred\">*<\/span><span class=\"formblue\">Password:<\/span><\/td>\n\t\t\t\t\t\t\t\t<td valign=\"center\"><input type=\"password\" size=\"26\" maxlength=\"50\" name=\"member_password\" value=\"\"><\/td>\n\t\t\t\t\t\t\t\t<td valign=\"center\" align=\"right\" style=\"text-align:right;\"><span class=\"formred\">*<\/span><span class=\"formblue\">Verify Password:<\/span><\/td>\n\t\t\t\t\t\t\t\t<td valign=\"center\"><input type=\"password\" size=\"26\" maxlength=\"50\" max name=\"member_password_verify\" value=\"\"><\/td>\n\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t\t<tr>\n\t\t\t\t\t\t\t\t<td><\/td>\n\t\t\t\t\t\t\t\t<td valign=\"center\" colspan=\"5\"><span class=\"smallgreen\" align=\"center\">Your password is very important.  Make sure to keep it in a safe place.  Your password should not be based on any personal names or any dictionary words and <b>must<\/b> contain at least 8 characters which include upper case and lower case letters as well as at least one number or special character.<\/span><\/td>\n\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t<\/table>\n\t\t\t\t\t<\/td>\n\t\t\t\t<\/tr>\n\t\t\t\t<tr id=\"FormRow10\"><td colspan=\"4\"><hr><\/td><\/tr>\n\t\t\t\t<tr id=\"FormRow11\">\n\t\t\t\t\t<td valign=\"center\" align=\"left\" colspan=\"4\" height=\"37\"><span class=\"headergreen\"><b>Payment Information:<\/b><\/span><\/td>\n\t\t\t\t<\/tr>\n\n\t\t\t\t<tr id=\"FormRow12\">\n\t\t\t\t\t<td colspan=\"100%\">\n\t\t\t\t\t\t<table cellpadding=\"2\" cellspacing=\"0\" border=\"0\">\n\t\t\t\t\t\t\t<tr>\n\t\t\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t\t\t<table cellpadding=\"2\" cellspacing=\"0\" border=\"0\">\n\n\t\t\t\t\t\t\t\t\t<tr\">\n\t\t\t\t\t\t\t\t\t\t<td valign=\"center\" align=\"right\">&nbsp;<\/td>\n\t\t\t\t\t\t\t\t\t\t<td valign=\"center\" align=\"right\" height=\"37\" style=\"text-align:right;\"><span class=\"formblue\">Coupon Code:<\/span><\/td>\n\t\t\t\t\t\t\t\t\t\t<td valign=\"center\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"coupon-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"text\" id=\"coupon_code\" size=\"19\" maxlength=\"19\" name=\"coupon_code\" value=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t<button type=\"button\" id=\"apply_coupon_btn\">Apply Coupon<\/button>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t\t\t\t<tr>\n\t\t\t\t\t\t\t\t\t\t<td valign=\"center\" align=\"right\">&nbsp;<\/td>\n\t\t\t\t\t\t\t\t\t\t<td valign=\"center\" align=\"right\" colspan=2\">\n\t\t\t\t\t\t\t\t\t\t\t<span id=\"coupon_message\" class=\"subheadgreen\"><\/span>\n\t\t\t\t\t\t\t\t\t\t\t<span id=\"new_price_message\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t<tr>\n\t\t\t\t\t\t\t\t\t\t<td valign=\"center\" align=\"right\" width=\"50\">&nbsp;<\/td>\n\t\t\t\t\t\t\t\t\t\t<td valign=\"center\" align=\"right\" width=\"225\" height=\"37\" style=\"text-align:right;\"><span class=\"formred\">*<\/span><span class=\"formblue\">Card Type:<\/span><\/td>\n\t\t\t\t\t\t\t\t\t\t<td valign=\"center\">\n\t\t\t\t\t\t\t\t\t\t\t<select name=\"Ecom_Payment_Card_Type\" id=\"Ecom_Payment_Card_Type\" onChange=\"checkCreditCardImage('https:\/\/www.clahealthcare.com\/wp-content\/plugins\/JoinCLA\/public\/partials\/images\/cv_amex_card.gif', 'https:\/\/www.clahealthcare.com\/wp-content\/plugins\/JoinCLA\/public\/partials\/images\/cvv_visa_card.gif');\" document.forms[0].member_payment_card_number.focus();\">\n\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"\"   >- Select One -<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"VI\" >VISA<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"MC\" >Master Card<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"AM\" >American Express<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"DI\" >Discover<\/option>\n\t\t\t\t\t\t\t\t\t\t\t<\/select>\n\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t\t\t\t<tr>\n\t\t\t\t\t\t\t\t\t\t<td valign=\"center\" align=\"right\">&nbsp;<\/td>\n\t\t\t\t\t\t\t\t\t\t<td valign=\"center\" align=\"right\" height=\"37\" style=\"text-align:right;\"><span class=\"formred\">*<\/span><span class=\"formblue\">Card Number:<\/span><\/td>\n\t\t\t\t\t\t\t\t\t\t<td valign=\"center\"><input type=\"text\" size=\"16\" maxlength=\"16\" name=\"member_payment_card_number\" onKeyDown=\"return goodchars(event,'0123456789')\" value=\"\"><\/td>\n\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t\t\t\t<tr>\n\t\t\t\t\t\t\t\t\t\t<td valign=\"center\" align=\"right\">&nbsp;<\/td>\n\t\t\t\t\t\t\t\t\t\t<td valign=\"center\" align=\"right\" height=\"37\" style=\"text-align:right;\"><span class=\"formred\">*<\/span><span class=\"formblue\">Card Verification Number:<\/span><\/td>\n\t\t\t\t\t\t\t\t\t\t<td valign=\"center\"><input type=\"text\" size=\"4\" maxlength=\"4\" name=\"Ecom_Payment_Card_Verification\" onKeyDown=\"return goodchars(event,'0123456789')\" value=\"\"><\/td>\n\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t\t\t\t<tr>\n\t\t\t\t\t\t\t\t\t\t<td valign=\"center\" align=\"right\">&nbsp;<\/td>\n\t\t\t\t\t\t\t\t\t\t<td valign=\"center\" align=\"right\" height=\"37\" style=\"text-align:right;\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"formred\">*<\/span><span class=\"formblue\">Expiration Date (MM\/YYYY):<\/span>\n\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t<td valign=\"center\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"expiration-date-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t<select name=\"expdatemonth\" onChange=\"document.forms[0].expdateyear.focus();\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"\"    selected>---<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"01\" >01 - Jan<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"02\" >02 - Feb<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"03\" >03 - Mar<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"04\" >04 - Apr<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"05\" >05 - May<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"06\" >06 - Jun<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"07\" >07 - Jul<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"08\" >08 - Aug<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"09\" >09 - Sep<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"10\" >10 - Oct<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"11\" >11 - Nov<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"12\" >12 - Dec<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t<\/select>\n\t\t\t\t\t\t\t\t\t\t\t\t<span>\/<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<select name=\"expdateyear\" onChange=\"document.forms[0].Agree_to_join.focus();\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"\"      selected>----<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"2024\" >2024<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"2025\" >2025<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"2026\" >2026<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"2027\" >2027<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"2028\" >2028<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"2029\" >2029<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"2030\" >2030<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"2031\" >2031<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"2032\" >2032<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"2033\" >2033<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"2034\" >2034<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"2035\" >2035<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"2036\" >2036<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t<\/select>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t\t\t\t<tr>\n\t\t\t\t\t\t\t\t\t\t<td valign=\"center\" align=\"right\">&nbsp;<\/td>\n\t\t\t\t\t\t\t\t\t\t<td valign=\"center\" align=\"right\" colspan=2\"><input name=\"Automatic_Renewal\" type=\"checkbox\" value=\"Y\"  checked>&nbsp;<span class=\"formblue\">Please renew my membership automatically.<\/span><\/td>\n\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t\t\t\t<\/table>\n\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t<td valign=\"center\" align=\"right\" width=\"40\">&nbsp;<\/td>\n\t\t\t\t\t\t\t\t<td valign=\"center\" align=\"center\" rowspan=\"4\"><img decoding=\"async\" name=\"creditcard\" id=\"creditcard\" src=\"https:\/\/www.clahealthcare.com\/wp-content\/plugins\/JoinCLA\/public\/partials\/images\/cvv_visa_card.gif\" width=\"259\" height=\"181\" border=\"0\"><\/td>\n\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t<\/table>\n\t\t\t\t\t<\/td>\n\t\t\t\t<\/tr>\n\t\t\t\t<tr id=\"FormRow13\"><td colspan=\"4\"><hr><\/td><\/tr>\n\t\t\t\t<tr id=\"FormRow14\"><td valign=\"top\" align=\"left\" colspan=\"4\"><span class=\"headergreen\"><b id=\"Enrollment\">Process Enrollment:<\/b><\/span><\/td><\/tr>\n\t\t\t\t<tr id=\"FormRow15\">\n\t\t\t\t\t<td colspan=\"4\">\n\t\t\t\t\t\t<table border=\"0\" style=\"text-align:right;\">\n\t\t\t\t\t\t\t<tr>\n\t\t\t\t\t\t\t\t<td><center>\n\t\t\t\t\t\t\t\t\t<table border=\"0\">\n\t\t\t\t\t\t\t\t\t\t<tr><td valign=\"center\" align=\"right\" width=\"160\" style=\"text-align:right;\"><input name=\"Agree_to_join\" type=\"checkbox\" value=\"Y\" ><\/td><td valign=\"center\" colspan=\"2\">&nbsp;<span class=\"formred\">*<\/span><span class=\"formblue\">I agree that my credit card will be charged for my annual membership.<\/span><\/td><\/tr>\n\t\t\t\t\t\t\t\t\t\t<tr><td valign=\"center\" align=\"right\" width=\"160\" style=\"text-align:right;\"><input name=\"Read_legal\" type=\"checkbox\" value=\"Y\"><\/td><td valign=\"center\" colspan=\"2\">&nbsp;<span class=\"formred\">*<\/span><span class=\"formblue\">I have read and agree to the <a href=\"https:\/\/www.clahealthcare.com\/index.php\/legal-notices\/\" target=\"_blank\">Terms of Membership<\/a>.<\/span><\/td><\/tr>\n\t\t\t\t\t\t\t\t\t\t<tr><td valign=\"center\" align=\"right\" style=\"text-align:right;\"><input name=\"Read_privacy\" type=\"checkbox\" value=\"Y\"><\/td><td valign=\"center\" colspan=\"2\">&nbsp;<span class=\"formred\">*<\/span><span class=\"formblue\">I have read and agree to the <a href=\"https:\/\/www.clahealthcare.com\/index.php\/privacy-policy\/\" target=\"_blank\">Privacy Policy<\/a>.<\/span><\/td><\/tr>\n\t\t\t\t\t\t\t\t\t<\/table>\n\t\t\t\t\t\t\t\t<\/center><\/td>\n\t\t\t\t\t\t\t\t<td width=\"60\">&nbsp;<\/td>\n\t\t\t\t\t\t\t\t<td><div class=\"AuthorizeNetSeal\"><script type=\"text\/javascript\" language=\"javascript\">var ANS_customer_id=\"320084e8-cf97-460a-9a01-94b3b1c037ff\";<\/script><script type=\"text\/javascript\" language=\"javascript\" src=\"\/\/VERIFY.AUTHORIZE.NET\/anetseal\/seal.js\" ><\/script><\/div><\/td>\n\t\t\t\t\t\t\t<\/tr>\n\t\t\t\t\t\t<\/table>\n\t\t\t\t\t<\/td>\n\t\t\t\t<\/tr>\n\n\t\t\t\t<tr><td colspan=\"4\" align=\"center\"><center><input type=\"submit\" id=\"SubmitButton\" value=\"Click here to submit this form and process your enrollment!\"><\/center><\/td><\/tr>\n\t\t\t\t<tr>\n\t\t\t\t\t<td colspan=\"4\"><\/td>\n\t\t\t\t\t<\/tr>\n\n\t\t\t\t<\/table>\n\n\t\t\t\t<input type=\"hidden\" name=\"page_displayed\" id=\"page_displayed\" value=\"Y\">\n\t\t\t\t<input type=\"hidden\" name=\"renewal_active\" id=\"renewal_active\" value=\"N\">\n\t\t\t\t<input type=\"hidden\" name=\"member_renewal\" id=\"memberRenewal\" value=\"N\">\n\t\t\t\t<input type=\"hidden\" name=\"years_from_expire\" id=\"years_from_expire\" value=\"0\">\n\t\t\t\t<input type=\"hidden\" name=\"months_from_expire\" id=\"months_from_expire\" value=\"0\">\n\t\t\t\t<input type=\"hidden\" name=\"days_from_expire\" id=\"days_from_expire\" value=\"0\">\n\t\t\t\t<input type=\"hidden\" name=\"member_account_number\" value=\"\">\n\t\t\t\t<input type=\"hidden\" name=\"member_account_checkdigit\" value=\"\">\n\t\t\t\t<\/form>\n\t\t\t<\/td>\n\t\t\t<td rowspan=\"100%\" width=\"22\">&nbsp;<br><\/td>\n\t\t<\/tr><\/table><\/td><\/tr>\n\t\t        <\/table>\n    <\/table>\n<\/div>\n<!-- Hide the wait screen when the page is rendered -->\n<script type=\"text\/javascript\">\n\tfunction hideWaitScreen() {\n\t\tdocument.getElementById('waitScreen').style.display = 'none';\n\t}\n\n\t\/\/ Ensure hideWaitScreen is called after the page is fully loaded\n\twindow.onload = function() {\n\t\thideWaitScreen(); \/\/ Hide the wait screen after the page reloads\n\t};\n<\/script>\n\n","protected":false},"excerpt":{"rendered":" <a class=\"more-link\" href=\"https:\/\/www.clahealthcare.com\/index.php\/sign-up-today\/\"><span class=\"more-msg\">Continue reading &rarr;<\/span><\/a>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"sfsi_plus_gutenberg_text_before_share":"","sfsi_plus_gutenberg_show_text_before_share":"","sfsi_plus_gutenberg_icon_type":"","sfsi_plus_gutenberg_icon_alignemt":"","sfsi_plus_gutenburg_max_per_row":"","footnotes":""},"wf_page_folders":[],"class_list":["post-70","page","type-page","status-publish","hentry"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.clahealthcare.com\/index.php\/wp-json\/wp\/v2\/pages\/70","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.clahealthcare.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.clahealthcare.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.clahealthcare.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.clahealthcare.com\/index.php\/wp-json\/wp\/v2\/comments?post=70"}],"version-history":[{"count":4,"href":"https:\/\/www.clahealthcare.com\/index.php\/wp-json\/wp\/v2\/pages\/70\/revisions"}],"predecessor-version":[{"id":271,"href":"https:\/\/www.clahealthcare.com\/index.php\/wp-json\/wp\/v2\/pages\/70\/revisions\/271"}],"wp:attachment":[{"href":"https:\/\/www.clahealthcare.com\/index.php\/wp-json\/wp\/v2\/media?parent=70"}],"wp:term":[{"taxonomy":"wf_page_folders","embeddable":true,"href":"https:\/\/www.clahealthcare.com\/index.php\/wp-json\/wp\/v2\/wf_page_folders?post=70"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}