{{ block title }}
    Please answer these final questions
{{ endblock }}
{{ block content }}

    {{ formfield 'fire_on_actual_property' label="Has there been a fire on your actual property (not your property within the game), since January 1st, 2021?" }}
   If so, did you experience any of the following:
    {{ formfield 'damage_to_actual_home' }}
    {{ formfield 'damage_to_other_physical_structure' }}
    {{ formfield 'damage_to_actual_forest' }}
    {{ formfield 'damage_to_other' }}
    {{ formfield 'other_damage' label="If you selected yes for damage to other, please elaborate. If not, enter N/A." }}
    Please enter the following:
    {{ formfield 'first_name' }}
    {{ formfield 'last_name' }}
    {{ formfield 'email' }}
    {{ next_button }}

{{ endblock }}