Edinburgh Sign Up

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<form action="https://belushis.us14.list-manage.com/subscribe/post?u=e49c083913d86b536012e6cc6&amp;id=965e1c9764" method="post" id="mc-embedded-subscribe-form" name="mc-embedded-subscribe-form" class="validate" target="_blank" novalidate>
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	<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>
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	<input type="email" value="" name="EMAIL" class="required email" id="mce-EMAIL">
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<div class="mc-field-group">
	<label for="mce-FNAME">Name  <span class="asterisk">*</span>
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	<input type="text" value="" name="FNAME" class="required" id="mce-FNAME">
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<div class="mc-field-group input-group">
    <strong>Join the Belushi's Club </strong>
    <ul><li><input type="radio" value="Sign me up for exclusive offers and discounts" name="MMERGE2" id="mce-MMERGE2-0"><label for="mce-MMERGE2-0">Sign me up for exclusive offers and discounts</label></li>
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