Emarsys Form

<div class="emarsys-form">
    <form name="ProfileForm" onsubmit="return CheckInputs();" action="https://link.info.thefa.com/u/register.php" method="get">

        <input type="hidden" name="CID" value="789193440"><input type="hidden" name="SID" value=""><input type="hidden" name="UID" value=""><input type="hidden" name="f" value="2036"><input type="hidden" name="p" value="2"><input type="hidden" name="a" value="r"><input type="hidden" name="el" value=""><input type="hidden" name="llid" value=""><input type="hidden" name="c" value=""><input type="hidden" name="counted" value=""><input type="hidden" name="RID" value=""><input type="hidden" name="mailnow" value="">First Name:<input type="text" name="inp_1" maxlength="60" value=""><br>

        Last Name:<input type="text" name="inp_2" maxlength="60" value=""><br>

        ZIP Code:<input type="text" name="inp_13" maxlength="16" value=""><br>

        Email:<input type="text" name="inp_3" maxlength="255" value=""><br>

        Phone:<input type="text" name="inp_15" maxlength="60" value=""><br>

        Date of Birth:<select name="inp_4[]">
            <option value=""> </option>
            <option style="font-size:11px">1</option>
            <option style="font-size:11px">2</option>
            <option style="font-size:11px">3</option>
            <option style="font-size:11px">4</option>
            <option style="font-size:11px">5</option>
            <option style="font-size:11px">6</option>
            <option style="font-size:11px">7</option>
            <option style="font-size:11px">8</option>
            <option style="font-size:11px">9</option>
            <option style="font-size:11px">10</option>
            <option style="font-size:11px">11</option>
            <option style="font-size:11px">12</option>
            <option style="font-size:11px">13</option>
            <option style="font-size:11px">14</option>
            <option style="font-size:11px">15</option>
            <option style="font-size:11px">16</option>
            <option style="font-size:11px">17</option>
            <option style="font-size:11px">18</option>
            <option style="font-size:11px">19</option>
            <option style="font-size:11px">20</option>
            <option style="font-size:11px">21</option>
            <option style="font-size:11px">22</option>
            <option style="font-size:11px">23</option>
            <option style="font-size:11px">24</option>
            <option style="font-size:11px">25</option>
            <option style="font-size:11px">26</option>
            <option style="font-size:11px">27</option>
            <option style="font-size:11px">28</option>
            <option style="font-size:11px">29</option>
            <option style="font-size:11px">30</option>
            <option style="font-size:11px">31</option>
        </select>.<select name="inp_4[]">
            <option value=""> </option>
            <option value="1">January</option>
            <option value="2">February</option>
            <option value="3">March</option>
            <option value="4">April</option>
            <option value="5">May</option>
            <option value="6">June</option>
            <option value="7">July</option>
            <option value="8">August</option>
            <option value="9">September</option>
            <option value="10">October</option>
            <option value="11">November</option>
            <option value="12">December</option>
        </select>.<input type="text" name="inp_4[]" value="" size="4" maxlength="4"><br>

        Are you a Brent resident?<select name="inp_24505" size="1">
            <option value="">Please Choose</option>
            <option value="1">Yes</option>
            <option value="2">No</option>
        </select><br>

        Number of people in your residence?<input type="text" maxlength="255" name="inp_24506" value=""><br>

        I am interested in…:

        <input type="checkbox" name="inp_24509[]" value="1">Football Matches

        <input type="checkbox" name="inp_24509[]" value="2">Concerts

        <input type="checkbox" name="inp_24509[]" value="3">Both<br>

        <input tabindex="882" type="checkbox" name="optin" value="y">Please tick if you would like to be contacted about
        complimentary tickets for Wembley Stadium events and updates from The FA Group*, including messages about partners
        in accordance with our Privacy Policy.

        *The FA Group includes The Football Association, Wembley Stadium and St George's Park<br>

        <input aria-label="Register" tabindex="993" type="button" onclick="javascript:SubmitIt()" name="submit1" value="Register">
    </form>

    <script language="javascript">
        function onbeforesubmit() {
            return true;
        }
    </script>

    <script language="javascript">
        var error;
        var form_lanuage = 'en';

        function is_0_valid() {
            count = 0;
            if (document.ProfileForm.optin) {
                if (document.ProfileForm.optin.checked) {
                    if (document.getElementsByName('interest[]')) {
                        if (document.getElementsByName('interest[]').length > 0) {
                            Interest = document.getElementsByName('interest[]');
                            for (i = 0; i < Interest.length; i++) {
                                if (Interest[i].checked)
                                    ++count;
                            }
                            if (count == 0) {
                                error += "Interests:";
                                return false;
                            }
                        }
                    }
                }
            }
            return true;
        }

        function is_1_valid(input) {
            if (input == "") {
                error += "First Name: missing data!\n";
                return false;
            }
            return true;
        }

        function is_2_valid(input) {
            if (input == "") {
                error += "Last Name: missing data!\n";
                return false;
            }
            return true;
        }

        function is_13_valid(input) {
            if (input == "") {
                error += "ZIP Code: missing data!\n";
                return false;
            }
            return true;
        }

        function is_3_valid(input) {
            if (input == "") {
                error += "Email: missing data!\n";
                return false;
            }
            return true;
        }

        function is_15_valid(input) {
            if (input == "") {
                error += "Phone: missing data!\n";
                return false;
            }
            return true;
        }

        function is_4_valid(day, month, year) {
            if (day == "" || month == "" || year == "") {
                error += "Date of Birth: missing data!\n";
                return false;
            }
            return true;
        }

        function is_24505_valid(input) {
            if (input == "") {
                error += "Are you a Brent resident?: missing data!\n";
                return false;
            }
            return true;
        }

        function is_24506_valid(input) {
            if (input == "") {
                error += "Number of people in your residence?: missing data!\n";
                return false;
            }
            return true;
        }

        function is_24509_valid(count) {
            if (count == 0) {
                error += "I am interested in…: missing data!\n";
                return false;
            }
            return true;
        }

        function CheckInputs() {
            var check_ok = true;
            error = "Wrong input!\n";
            check_ok = (is_0_valid('null') && check_ok);
            check_ok = (is_1_valid(document.ProfileForm.inp_1.value) && check_ok);
            check_ok = (is_2_valid(document.ProfileForm.inp_2.value) && check_ok);
            check_ok = (is_13_valid(document.ProfileForm.inp_13.value) && check_ok);
            check_ok = (is_3_valid(document.ProfileForm.inp_3.value) && check_ok);
            check_ok = (is_15_valid(document.ProfileForm.inp_15.value) && check_ok);
            check_ok = (is_4_valid(FieldWithName(document.ProfileForm, "inp_4[]", 0).options[FieldWithName(document.ProfileForm, "inp_4[]", 0).selectedIndex].text, FieldWithName(document.ProfileForm, "inp_4[]", 1).options[FieldWithName(document.ProfileForm, "inp_4[]", 1).selectedIndex].value, FieldWithName(document.ProfileForm, "inp_4[]", 2).value) && check_ok);
            check_ok = (is_24505_valid(document.ProfileForm.inp_24505.options[document.ProfileForm.inp_24505.selectedIndex].value) && check_ok);
            check_ok = (is_24506_valid(document.ProfileForm.inp_24506.value) && check_ok);
            check_ok = (is_24509_valid(NumChecked(document.ProfileForm, "inp_24509[]")) && check_ok);
            if (check_ok == false)
                alert(error);
            return check_ok;
        }
    </script>

    <script language="javascript">
        function SubmitIt() {
            if (CheckInputs() == true) {
                if (window.onbeforesubmit)
                    onbeforesubmit();
                document.ProfileForm.submit();
            }
        }

        function MailIt() {
            if (CheckInputs()) {
                if ((document.ProfileForm.subject.value == '') || (document.ProfileForm.msg.value == ''))
                    alert('Bitte f\u00fcr Sie die Nachrichtenfelder aus!');
                else
                    document.ProfileForm.submit();
            }
        }

        function FieldWithName(frm, fieldname, numofield) {
            if (!numofield)
                numofield = 0;
            field_count = 0;
            for (i = 0; i < frm.elements.length; ++i) {
                if (frm.elements[i].name == fieldname) {
                    if (field_count == numofield)
                        return frm.elements[i];
                    else
                        field_count++;
                }
            }
        }

        function NumChecked(frm, fieldname) {
            var count = 0;
            for (i = 0; i < frm.elements.length; ++i) {
                if (frm.elements[i].name == fieldname && frm.elements[i].checked == true)
                    ++count;
            }
            return count;
        }

        function NumSel(field) {
            var count = 0;
            for (i = 0; i < field.length; ++i)
                if (field[i].selected == true) ++count;
            return count;
        }
    </script>

    <script language="javascript">
        var multiFields = new Array();
        var dateFields = new Array();
        multiFields["interest[]"] = "interest"
        multiFields["optin"] = "optin"
        var arr_optin = new Array();
        arr_optin["True"] = "y";
        var arr_interest = new Array();
        dateFields["inp_4[]"] = 1;
        multiFields["inp_24509[]"] = 24509;
        arr_24509 = new Array();
        arr_24509["Football Matches"] = "1";
        arr_24509["Concerts"] = "2";
        arr_24509["Both"] = "3";
    </script>

    <script language="javascript" src="https://link.info.thefa.com/u/nprefill.js" type="text/javascript"></script>
</div>