$(document).ready(function() {
	$('input[type=image]').filter('[value=1]').bind('click', function(e) { VerifyOrder(e); });
});

function VerifyOrder(e)
{
	var country = $('input[name=country]').val();
	if(country != 'US') {
		alert("The free trial offer is available to US residents only.");
		e.preventDefault();
		return false;
	}
}