//<script type="text/javascript" language="javascript">

	document.writeln('	<fieldset>');
	document.writeln('		<legend></legend>');
	
			document.writeln('<p><P>Fill out the form below to register for a weekly drawing for a pair of day passes to the Canyons!</P><P>&nbsp;</P></p>');
		
		document.writeln('	<form name="customForm53655" action="/CustomFormProcess.asp" method="post" onsubmit="return ValidateCustomForm(this,0)">');
		document.writeln('  <input type="hidden" name="Title" value="The Canyons - Pair of Day Passes" />');
		document.writeln('	<input type="hidden" name="ID" value="53655" />');
		document.writeln('	<input type="hidden" name="nConfirmationNum" value="620" />');
		document.writeln('	<input type="hidden" name="NumQuestions" value="0" />');
		document.writeln('	<scr' + 'ipt language="javascript" src="/jsfiles/incCustomFormValidate.js"></sc' + 'ript>');
	
	

//</script>


		document.writeln('			<input type="hidden" name="Question0" value="Would you like to receive information from the Canyons on events and specials?" />');
		document.writeln('			<input type="hidden" name="QuestionRequired0" value="1" />');
		document.writeln('		<div class="formRow">');
		document.write('			<label for="Question0answer">Would you like to receive information from the Canyons on events and specials?');
		
				document.write(' <span  class="Headline">*</span>');
		
		document.write('</label>\r\n');
	document.writeln('		<select name="Question0answer" id="Question0answer">	<option value="Yes">Yes	<option value="No">No</select>');document.writeln('		</div>');
			//document.writeln('		<div class="formRow">');
			//document.writeln('			<p>Log-in to 101.9 Interactive and you can have forms like this filled out for you.');
			//document.writeln('			To join 101.9 Interactive, just fill out the information below.</p>');
			//document.writeln('		</div>');
		
			
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			document.writeln('			<input type="checkbox" checked="checked" name="bJoinClub" value="yes" id="yesClub" />');
			document.writeln('			<label for="yesClub" class="inline">It is ok for KENZ-FM to email me periodically.</label>');
			document.writeln('		</div>');

			
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			document.writeln('			<input type="checkbox" checked="checked" name="nMailType" value="1" id="yesHTML" />');
			document.writeln('			<label for="yesHTML" class="inline">Send email in HTML format (when available)</label>');
			document.writeln('		</div>');
	
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