Creating Space For Wisdom

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  <td>Checkbox-legal</td>
  <td><input type="hidden" id="custom_field_2" name="custom_field_2" value="mm_cb_off" />
<input type="checkbox" id="custom_field_2" name="custom_field_2" value="mm_cb_on" />
</td>
</tr>
<tr>
  <td></td>
  <td>
  <input type='submit' name='submit' value='Sign Up' />
  <input type='hidden' name='membership_level' value='11' />
  </td>
</tr>
</table>
</form>