<!-- Begin Mailchimp Signup Form -->
<link href="//cdn-images.mailchimp.com/embedcode/classic-10_7.css" rel="stylesheet" type="text/css">
<style type="text/css">
#mc_embed_signup{background:#fff; clear:left; font:14px Helvetica,Arial,sans-serif; }
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<div id="mc_embed_signup">
<form action="https://GraceIs.us19.list-manage.com/subscribe/post?u=d3f786da5f4e30e9b0f23ae3a&id=e08962a434" method="post" id="mc-embedded-subscribe-form" name="mc-embedded-subscribe-form" class="validate" target="_blank" novalidate>
<div id="mc_embed_signup_scroll">
<h2>Subscribe</h2>
<div class="indicates-required"><span class="asterisk">*</span> indicates required</div>
<div class="mc-field-group">
<label for="mce-EMAIL">Email Address <span class="asterisk">*</span>
</label>
<input type="email" value="" name="EMAIL" class="required email" id="mce-EMAIL">
</div>
<div class="mc-field-group">
<label for="mce-FNAME">First Name </label>
<input type="text" value="" name="FNAME" class="" id="mce-FNAME">
</div>
<div class="mc-field-group">
<label for="mce-LNAME">Last Name </label>
<input type="text" value="" name="LNAME" class="" id="mce-LNAME">
</div>
<div class="mc-field-group size1of2">
<label for="mce-BIRTHDAY-month">Birthday </label>
<div class="datefield">
<span class="subfield monthfield"><input class="birthday " type="text" pattern="[0-9]*" value="" placeholder="MM" size="2" maxlength="2" name="BIRTHDAY[month]" id="mce-BIRTHDAY-month"></span> /
<span class="subfield dayfield"><input class="birthday " type="text" pattern="[0-9]*" value="" placeholder="DD" size="2" maxlength="2" name="BIRTHDAY[day]" id="mce-BIRTHDAY-day"></span>
<span class="small-meta nowrap">( mm / dd )</span>
</div>
</div> <div id="mce-responses" class="clear">
<div class="response" id="mce-error-response" style="display:none"></div>
<div class="response" id="mce-success-response" style="display:none"></div>
</div> <!-- real people should not fill this in and expect good things - do not remove this or risk form bot signups-->
<div style="position: absolute; left: -5000px;" aria-hidden="true"><input type="text" name="b_d3f786da5f4e30e9b0f23ae3a_e08962a434" tabindex="-1" value=""></div>
<div class="clear"><input type="submit" value="Subscribe" name="subscribe" id="mc-embedded-subscribe" class="button"></div>
</div>
</form>
</div>
<script type='text/javascript' src='//s3.amazonaws.com/downloads.mailchimp.com/js/mc-validate.js'></script><script type='text/javascript'>(function($) {window.fnames = new Array(); window.ftypes = new Array();fnames[0]='EMAIL';ftypes[0]='email';fnames[1]='FNAME';ftypes[1]='text';fnames[2]='LNAME';ftypes[2]='text';fnames[3]='ADDRESS';ftypes[3]='address';fnames[4]='PHONE';ftypes[4]='phone';fnames[5]='BIRTHDAY';ftypes[5]='birthday';}(jQuery));var $mcj = jQuery.noConflict(true);</script>
<!--End mc_embed_signup-->