RUSH JOB! FIX SIMPLE JAVASCRIPT BUG. HELP ME!!

I had some custom java coding done for a client website www.TheSafetyPledge.com. If you see in the attached pictures it allowed me to move 8 check boxes above the form. I use a third party platform to build this website and only have the ability to paste custom code and don't have FTP access to anything. I have attached the piece of code someone provided me and it worked great until I attempted to add another check box. It moves the check box to the right place, but I can't complete the form. If I remove the 8th check box I added the form works again. The 8th check is the first one and is listed below. ALWAYS ‘REPORT IT AND NOT IGNORE IT’ RECOGNIZING OUR FAIR AND JUST REPORTING CULTURE- HELPING TO REMOVE THE STIGMA AND FEAR OF PUNITIVE ACTIONS, DISCIPLINE, AND JOB LOSS IF AN ACCIDENT OCCURS. I have attached screen shoots of the form and what it looks like before and after I add the attached code. I need someone that can help me fix this bug so form works with 8th checkbox. I need this fixed in the next 4 hours!!!!