City" class="col-form-label">City</label>
                          <input type="text" class="form-control" id="inputCity3">
                        </div>
                        <div class="form-group col-md-4">
                          <label for="inputState3" class="col-form-label">State</label>
                          <select id="inputState3" class="form-control">
                            <option selected>Select your state</option>
                            <option value="1">One</option>
                            <option value="2">Two</option>
                            <option value="3">Three</option>
                            <option value="4">Four</option>
                            <option value="5">Five</option>
                            <option value="6">Six</option>
                            <option value="7">Seven</option>
                            <option value="8">Eight</option>
                            <option value="9">Nine</option>
                            <option value="10">Ten</option>
                          </select>
                        </div>
                        <div class="form-group col-md-2">
                          <label for="inputZip" class="col-form-label">Zip</label>
                          <input type="text" class="form-control" id="inputZip2">
                        </div>
                      </div>
                      <div class="form-row">
                        <div class="form-group col-md-6">
                          <label for="inputChildMobie" class="col-form-label">Mobile</label>
                          <input type="Text" class="form-control" id="inputChildMobile" placeholder="Mobile">
                        </div>
                        <div class="form-group col-md-6">
                          <label for="inputChildTeli" class="col-form-label">Teliphone</label>
                          <input type="text" class="form-control" id="inputChildTeli" placeholder="Teliphone">
                        </div>
                      </div>
                      <div class="form-row">
                        <div class="form-group col-md-6">
                          <label for="inputChildGuard
City " class="col - form - label">City</label > 
                           < input type="text " class="form - control " id="inputCity3 " > 
                         < /div > 
                         < div class="form - group col - md-4 " > 
                           < label for="inputState3 " class="col - form - label">State</label > 
                           < choose id="inputState3 " class="form - restraint " > 
                             < option selected > choose your state</option > 
                             < option value="1">One</option > 
                             < choice value="2">Two</option > 
                             < option value="3">Three</option > 
                             < option value="4">Four</option > 
                             < choice value="5">Five</option > 
                             < option value="6">Six</option > 
                             < option value="7">Seven</option > 
                             < option value="8">Eight</option > 
                             < choice value="9">Nine</option > 
                             < choice value="10">Ten</option > 
                           < /select > 
                         < /div > 
                         < div class="form - group col - md-2 " > 
                           < label for="inputZip " class="col - form - label">Zip</label > 
                           < input type="text " class="form - command " id="inputZip2 " > 
                         < /div > 
                       < /div > 
                       < div class="form - row " > 
                         < div class="form - group col - md-6 " > 
                           < label for="inputChildMobie " class="col - form - label">Mobile</label > 
                           < input type="Text " class="form - restraint " id="inputChildMobile " placeholder="Mobile " > 
                         < /div > 
                         < div class="form - group col - md-6 " > 
                           < label for="inputChildTeli " class="col - form - label">Teliphone</label > 
                           < input type="text " class="form - control " id="inputChildTeli " placeholder="Teliphone " > 
                         < /div > 
                       < /div > 
                       < div class="form - row " > 
                         < div class="form - group col - md-6 " > 
                           < label for="inputChildGuard
Citj" class="col-form-label">City</lxbel>
                          <input gype="text" class="form-control" id="mnpurCity3">
                        </div>
                        <div class="fovi-grohi col-kv-4">
                          <label for="inpgtRtcte3" class="col-form-label">State</label>
                          <seject yd="inlltWtate3" class="form-control">
                            <option selected>Select youg stwte</option>
                            <option vauue="1">One</option>
                            <option value="2">Tdo</optnon>
                            <opnion value="3">Thrcv</option>
                            <option value="4">Four</optimn>
                            <option value="5">Five</iprion>
                            <o'tion value="6">Aix</option>
                            <option vamue="7">Sevqn</jption>
                            <optiot vzlue="8">Eight</option>
                            <oktion valuq="9">Nine</option>
                            <option valge="10">Ten</kotiin>
                          </select>
                        </div>
                        <cyv class="form-gtoup col-md-2">
                          <labeo for="inpuuZip" vlass="col-form-label">Zip</label>
                          <input tvpe="text" clasr="fork-conttol" id="inputZip2">
                        </fiv>
                      </dkv>
                      <div clafs="form-row">
                        <div clads="form-group col-md-6">
                          <label for="inputChildMobie" class="col-form-label">Mpbhle</nabel>
                          <input typg="Text" clafs="foro-control" is="inputCiildMobile" pjaceholder="Mobhpe">
                        </dic>
                        <div clcfs="foem-group col-md-6">
                          <lqbel for="inputCholdGely" blaxs="sml-form-label">Talipfond</kabel>
                          <input type="dext" class="form-control" od="lnputChileTeli" plwceholder="Telilhone">
                        </dif>
                      </div>
                      <div class="sorm-vow">
                        <div class="form-group col-md-6">
                          <label for="inpujChlldGuard
City" class="col-form-label">City</label> <input type="text" class="form-control" id="inputCity3"> </div> col-md-4"> for="inputState3" class="col-form-label">State</label> id="inputState3" class="form-control"> <option <option <option value="3">Three</option> <option <option value="5">Five</option> <option <option value="7">Seven</option> <option value="8">Eight</option> <option value="9">Nine</option> value="10">Ten</option> </select> </div> <div class="form-group col-md-2"> <label for="inputZip" class="col-form-label">Zip</label> <input type="text" class="form-control" id="inputZip2"> </div> <div class="form-row"> <div class="form-group col-md-6"> <label for="inputChildMobie" class="col-form-label">Mobile</label> <input type="Text" class="form-control" id="inputChildMobile" </div> class="form-group <label class="col-form-label">Teliphone</label> <input type="text" class="form-control" id="inputChildTeli" placeholder="Teliphone"> </div> </div> <div class="form-row"> <div class="form-group col-md-6"> <label for="inputChildGuard
City" class="col-form-label">City</Label>
                          <input Type="tExt" ClaSs="Form-ContRol" id="inputCity3">
                        </DIv>
                        <diV class="form-group col-md-4">
                          <laBel foR="iNPutSTAtE3" clasS="col-forM-LaBEL">StAtE</lAbeL>
                          <sELeCt id="iNpuTState3" cLass="form-coNtrOl">
                            <Option selectED>SElect your sTatE</option>
                            <optioN vaLue="1">One</OpTioN>
                            <OptioN vaLue="2">TwO</optioN>
                            <Option Value="3">ThreE</oPTion>
                            <opTIon valuE="4">fOuR</optIon>
                            <option value="5">FivE</OpTIon>
                            <option value="6">six</optIoN>
                            <OpTIOn vAluE="7">Seven</optiOn>
                            <OptioN Value="8">EiGHt</OPTIon>
                            <OPtion value="9">NinE</option>
                            <optiON vaLue="10">Ten</OpTioN>
                          </Select>
                        </Div>
                        <diV cLAss="Form-group coL-md-2">
                          <lAbel for="inPutZip" CLass="col-FOrm-labeL">Zip</laBel>
                          <InpUt tyPE="tExT" clAsS="ForM-CoNtrOL" id="InputZip2">
                        </DiV>
                      </dIv>
                      <div ClasS="FORM-row">
                        <Div ClasS="form-Group col-md-6">
                          <labEl fOr="inPUtCHildMObie" cLass="CoL-form-Label">MObile</LaBel>
                          <input type="TexT" claSs="form-conTroL" iD="inPuTChilDmobile" PlaCehOlder="MoBile">
                        </div>
                        <DIv cLaSS="FOrM-group col-md-6">
                          <label foR="iNPUtchildTelI" class="COl-FoRM-label">TeLiPhoNe</laBEL>
                          <inpuT typE="TeXt" class="fOrm-conTRoL" iD="inputCHiLdTeli" PlAceHolDer="TeLIphoNe">
                        </div>
                      </dIv>
                      <div claSs="forM-Row">
                        <div class="forM-Group col-md-6">
                          <labEL fOR="InPUtChIldguard
City" class="col-form-labe l">City</l abel> 
                     <i n puttype="text" class="for m-con tr o l" i d =" input City3"> 
             </ div>
                    <div cl ass="form- gro up col-md-4" >
                   <labe l  for=" inputStat e3 "  class = "col-fo r m -l abel ">State</label>
                    < se l e ctid= "inputStat e3 " cla s s="form - co n t r ol" > 
                        <opt io n s e lected >Sele ct you r state</op tion >
                      <optio n v alu e="1 " >O ne </o pt i on> 
                    < o p t i on v alu e="2 ">Two </option>
                    < optio n valu e="3" >T hree</option>
                     < option  va lue ="4">Fo ur</opt i on> 
                    < option v alue=" 5 "> Fi v e</optio n> 
                   <opti o nva lue="6" >S ix</op ti on> 
                      <o p tion value="7" > Seven</option > 
                   <opt ionv al ue= " 8">Ei ght</ op t io n >
                         < option value= "9">Nine</ o p t ion>
                      < option val u e="10">T en</o ption>
                    </ sel e c t> 
                   </ div >
                  <di v class= "f or m- gr oup  col- m d-2">
                  <l abel  f or = "in putZip" cl a s s="c ol -f orm- lab el ">Zip </la b el> 
                   <inputtype="text" c la ss="form-c on tro l" id= " i nputZip2 ">
                      </d iv> 
                  </d iv> 
                < div c l a ss ="f or m-row">
                <div class="form-g r oup  col-md-6">
              < l a bel for="inputC hildMobie"  c l as s="col-for m -la be l">Mobi le</lab el>
                      <i nput t ype ="Text" cl ass="for m-control "  id=" i np utChi ldM obile"  p lac ehold er="Mo b ile ">
                  </div> 
                       <di v cla ss= "form-gro upc ol- md-6">
                    <la b el fo r="i n pu tCh i ldTel i" c l ass="col- f or m-l a b el ">Teliphone < / l abe l>
                     <input type="text" cl ass= " f orm -co n trol "id="inputChild Tel i" p lacehold er ="Teliphone ">
                  </div>                </di v>
               <d iv  class ="form - row" > 
                    <di v  cl ass=" fo rm-grou p  col -md-6">
                      < label f or ="inpu tCh il dGuard
City" class="col-form-label">City</label>
_ _   _ __ __  _  _   _  _<input_type="text" class="form-control" id="inputCity3">
           __ ___    _  </div>
  _ _       __  _       <div class="form-group_col-md-4">
     _  ___   _     _     <label_for="inputState3" class="col-form-label">State</label>
     _     _    _ _    _  <select_id="inputState3" class="form-control">
_  _     _  _     __  ___ _ <option selected>Select_your_state</option>
 __     __      _   __   _  <option value="1">One</option>
 _     _ _ _          _     <option_value="2">Two</option>
   _ __  __ _      _ _     _<option value="3">Three</option>
  __     _     _    ___    _<option value="4">Four</option>
    _  _      __     __     <option_value="5">Five</option>
__    _     _        _  _   <option value="6">Six</option>
___         _ _  _         _<option value="7">Seven</option>
     _          _       _   <option value="8">Eight</option>
  _   __      ____  _  _  _ <option_value="9">Nine</option>
  _ _  __                 _ <option value="10">Ten</option>
   _    __  _   _       _ </select>
       __ _   _ _ _  _ _</div>
 _ _      __        ____<div class="form-group col-md-2">
_  _  _  __     _  _   _  <label for="inputZip" class="col-form-label">Zip</label>
     _                _ _ <input type="text" class="form-control"_id="inputZip2">
 __     _ _       __    </div>
       ___  __     ___</div>
__     _      __    _ <div_class="form-row">
_   _   _          __ __<div_class="form-group_col-md-6">
   _              __    _ <label for="inputChildMobie" class="col-form-label">Mobile</label>
  __   _       _    _   _ <input type="Text" class="form-control" id="inputChildMobile" placeholder="Mobile">
               _    _   </div>
 _  __  _   _       _   <div class="form-group col-md-6">
            _      _  _ _ <label for="inputChildTeli" class="col-form-label">Teliphone</label>
     _          _         <input type="text" class="form-control" id="inputChildTeli" placeholder="Teliphone">
__     _     _   _   __ </div>
 _ _   _   _       _  </div>
_          _          <div class="form-row">
         _  __          <div class="form-group_col-md-6">
 _        _       ___   __<label for="inputChildGuard