100 lines
6.7 KiB
PHP
100 lines
6.7 KiB
PHP
@extends('front.basic.layout')
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@section('title', 'Connexion')
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@section('content')
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<div class="container">
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<div class="row justify-content-center">
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<div class="col-md-8">
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<div class="card">
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<div class="card-header">Inscription</div>
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<div class="card-body">
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@if ($errors->any())
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<div class="alert alert-danger">
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<ul>
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@foreach ($errors->all() as $error)
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<li>{{ $error }}</li>
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@endforeach
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</ul>
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</div>
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@endif
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<form method="POST" action="{{ route('register') }}">
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@csrf
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<div class="form-group row">
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<label class="col-md-6 col-form-label">Civilité <span class="required-asterisk">*</span></label>
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<select name="civility" class="custom-select col-md-6">
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<option value="1">Mr</option>
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<option value="2">Mme</option>
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<option value="3">Mlle</option>
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</select>
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</div>
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<div class="form-group row">
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<label class="col-md-6 col-form-label">Nom <span class="required-asterisk">*</span></label>
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<input type="text" name="lastname" class="form-control col-md-6" placeholder="Nom" required>
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</div>
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<div class="form-group row">
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<label class="col-md-6 col-form-label">Prénom <span class="required-asterisk">*</span></label>
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<input type="text" name="firstname" class="form-control col-md-6" placeholder="Prénom" required>
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</div>
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<div class="form-group row">
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<label class="col-md-6 col-form-label">Date de naissance <span class="required-asterisk">*</span></label>
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<input type="date" name="birth_date" class="form-control col-md-6" placeholder="Date de naissance" required>
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</div>
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<div class="form-group row">
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<label class="col-md-6 col-form-label">Email <span class="required-asterisk">*</span></label>
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<input type="text" name="email" class="form-control col-md-6" placeholder="Email" required>
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</div>
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<div class="form-group row">
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<label class="col-md-6 col-form-label">Nom d'utilisateur <span class="required-asterisk">*</span></label>
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<input type="text" name="username" class="form-control col-md-6" placeholder="Nom d'utilisateur" required>
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</div>
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<div class="form-group row">
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<label class="col-md-6 col-form-label">Mot de passe <span class="required-asterisk">*</span></label>
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<input type="password" name="password" class="form-control col-md-6" placeholder="Mot de passe" required>
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</div>
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<div class="form-group row">
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<label class="col-md-6 col-form-label">Confirmer le mot de passe <span class="required-asterisk">*</span></label>
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<input id="password-confirm" type="password" class="form-control col-md-6"
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name="password_confirmation" required autocomplete="new-password" placeholder="Confirmer le mot de passe">
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</div>
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<div class="form-group row">
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<label class="col-md-6 col-form-label">Adresse <span class="required-asterisk">*</span></label>
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<input type="text" name="address" class="form-control col-md-6" placeholder="Adresse" required>
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</div>
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<div class="form-group row">
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<label class="col-md-6 col-form-label">Adresse complémentaire</label>
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<input type="text" name="address2" class="form-control col-md-6" placeholder="Adresse complémentaire">
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</div>
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<div class="form-group row">
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<label class="col-md-6 col-form-label">Ville <span class="required-asterisk">*</span></label>
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<input type="text" name="town" class="form-control col-md-6" placeholder="Ville" required>
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</div>
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<div class="form-group row">
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<label class="col-md-6 col-form-label">Code postal <span class="required-asterisk">*</span></label>
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<input type="text" name="postal_code" class="form-control col-md-6" placeholder="Code postal" required>
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</div>
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<div class="form-group row">
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<label class="col-md-6 col-form-label">Pays <span class="required-asterisk">*</span></label>
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<input type="text" name="country" class="form-control col-md-6" placeholder="Pays" required>
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</div>
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<div class="form-group text-center">
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<label class="col-form-label">
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<input type="checkbox" name="news" class="form-checkbox">
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Je souhaitre m'inscrire à la newsletter {{$settingsGlobal->name}}
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</label><br/>
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<label class="col-form-label">
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<input type="checkbox" name="reglement" class="form-checkbox" required>
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J'ai lu et j'accepte le <a href="{{route('reglement')}}">règlement</a>
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</label>
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</div>
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<div class="text-center">
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<button type="submit" class="btn btn-primary">Valider</button>
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</div>
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</form>
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</div>
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</div>
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</div>
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</div>
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</div>
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@endsection
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