@extends('layouts.app')

@section('content')
<div class="container">
    <div class="row">
        <div class="col-md-8 col-md-offset-2">
            <div class="panel panel-default">
                <div class="panel-heading heading">Register</div>
                <div class="panel-body">
                    <form class="form-horizontal" role="form" method="POST" action="{{Request::url()}}">
                        {{ csrf_field() }}

                        <div class="form-group {{ $errors->has('name') ? ' has-error' : '' }}">
                            <label for="name" class="col-md-4 control-label">School/Company/Affiliation</label>

                            <div class="col-md-6">
                                <input id="name" type="text" class="form-control" name="name" value="{{ old('name') }}" required autofocus>

                                @if ($errors->has('name'))
                                    <span class="help-block">
                                        <strong>{{ $errors->first('name') }}</strong>
                                    </span>
                                @endif
                            </div>
                        </div>

                        <div class="form-group{{ $errors->has('email') ? ' has-error' : '' }}">
                            <label for="email" class="col-md-4 control-label">E-mail Address</label>

                            <div class="col-md-6">
                                <input id="email" type="email" class="form-control" name="email" value="{{ old('email') }}" required>

                                @if ($errors->has('email'))
                                    <span class="help-block">
                                        <strong>{{ $errors->first('email') }}</strong>
                                    </span>
                                @endif
                            </div>
                        </div>

                        <div class="form-group{{ $errors->has('password') ? ' has-error' : '' }}">
                            <label for="password" class="col-md-4 control-label">Password</label>

                            <div class="col-md-6">
                                <input id="password" type="password" class="form-control" name="password" required>

                                @if ($errors->has('password'))
                                    <span class="help-block">
                                        <strong>{{ $errors->first('password') }}</strong>
                                    </span>
                                @endif
                            </div>
                        </div>

                        <div class="form-group{{ $errors->has('password_confirmation') ? ' has-error' : '' }}">
                            <label for="password-confirm" class="col-md-4 control-label">Confirm Password</label>

                            <div class="col-md-6">
                                <input id="password-confirm" type="password" class="form-control" name="password_confirmation" required>

                                @if ($errors->has('password_confirmation'))
                                    <span class="help-block">
                                        <strong>{{ $errors->first('password_confirmation') }}</strong>
                                    </span>
                                @endif
                            </div>
                        </div>

                        <div class="form-group{{ $errors->has('coach') ? ' has-error' : '' }}">
                            <label for="country" class="col-md-4 control-label">School/Organization Director</label>

                            <div class="col-md-6">
                                <input id="country" type="text" class="form-control" name="coach" value="{{ old('coach') }}" required>

                                @if ($errors->has('coach'))
                                    <span class="help-block">
                                        <strong>{{ $errors->first('coach') }}</strong>
                                    </span>
                                @endif
                            </div>
                        </div>

                        <div class="form-group{{ $errors->has('coach_sec') ? ' has-error' : '' }}">
                            <label for="country" class="col-md-4 control-label">Choreographer</label>

                            <div class="col-md-6">
                                <input id="country" type="text" class="form-control" name="coach_sec" value="{{ old('coach_sec') }}">

                                @if ($errors->has('coach_sec'))
                                    <span class="help-block">
                                        <strong>{{ $errors->first('coach_sec') }}</strong>
                                    </span>
                                @endif
                                <span class="help">If multiple, enter all names separated by comma (,).</span>
                            </div>
                        </div>

                        <div class="form-group{{ $errors->has('country') ? ' has-error' : '' }}">
                            <label for="country" class="col-md-4 control-label">Country</label>

                            <div class="col-md-6">
                                <input id="country" type="text" class="form-control" name="country" value="{{ old('country') }}" required>

                                @if ($errors->has('country'))
                                    <span class="help-block">
                                        <strong>{{ $errors->first('country') }}</strong>
                                    </span>
                                @endif
                            </div>
                        </div>

                        <div class="form-group{{ $errors->has('city') ? ' has-error' : '' }}">
                            <label for="city" class="col-md-4 control-label">City</label>

                            <div class="col-md-6">
                                <input id="city" type="text" class="form-control" name="city" value="{{ old('city') }}" required>

                                @if ($errors->has('city'))
                                    <span class="help-block">
                                        <strong>{{ $errors->first('city') }}</strong>
                                    </span>
                                @endif
                            </div>
                        </div>

                        <div class="form-group{{ $errors->has('address') ? ' has-error' : '' }}">
                            <label for="country" class="col-md-4 control-label">Address</label>

                            <div class="col-md-6">
                                <input id="address" type="text" class="form-control" name="address" value="{{ old('address') }}" required>

                                @if ($errors->has('address'))
                                    <span class="help-block">
                                        <strong>{{ $errors->first('address') }}</strong>
                                    </span>
                                @endif
                            </div>
                        </div>

                        <div class="form-group{{ $errors->has('zip') ? ' has-error' : '' }}">
                            <label for="zip" class="col-md-4 control-label">ZIP/Postal Code</label>

                            <div class="col-md-6">
                                <input id="zip" type="text" class="form-control" name="zip" value="{{ old('zip') }}" required>

                                @if ($errors->has('zip'))
                                    <span class="help-block">
                                        <strong>{{ $errors->first('zip') }}</strong>
                                    </span>
                                @endif
                            </div>
                        </div>

                        <div class="form-group{{ $errors->has('phone') ? ' has-error' : '' }}">
                            <label for="phone" class="col-md-4 control-label">Phone Number</label>

                            <div class="col-md-6">
                                <input id="phone" type="text" class="form-control" name="phone" value="{{ old('phone') }}" required>

                                @if ($errors->has('phone'))
                                    <span class="help-block">
                                        <strong>{{ $errors->first('phone') }}</strong>
                                    </span>
                                @endif
                                <span class="help">In international format, e.g. +44XXXXXXXXX</span>
                            </div>
                        </div>

                        <div class="form-group{{ $errors->has('terms') ? ' has-error' : '' }}">
                            <label for="name" class="col-md-4 control-label"></label>

                            <div class="col-md-6">
                                <div class="form-control-static">
                                <input id="terms" type="checkbox" name="terms" value="1" required>
                                    {{--I have read and agree to the competition's rules and terms found here: <a href="{{url('terms_bg.pdf')}}">Bulgarian</a>, <a href="{{url('terms_en.pdf')}}">English</a>--}}
                                    I declare that the personal information on this page has been provided voluntarily and consent that it will only be used for purposes regarding the direct participation in the Choreography Award by mOvmnt IDC Competition. No personal information will be shared with or sold to any third party.
                                </div>
                                @if ($errors->has('terms'))
                                    <span class="help-block">
                                        <strong>{{ $errors->first('terms') }}</strong>
                                    </span>
                                @endif
                            </div>
                        </div>

                        <div class="form-group">
                            <div class="col-md-6 col-md-offset-4">
                                <button type="submit" class="btn my-btn-primary">
                                    Register
                                </button>
                            </div>
                        </div>
                    </form>
                </div>
            </div>
        </div>
    </div>
</div>
@endsection