@extends('layouts.site_layout')

@section('content')
<section class="py-5 my-4">

    <div class="container">
        <div class="row">
            <div class="col-md-1"></div>
            <div class="col-md-10">
                <div class="card shadow-sm border-0">
                    <div class="card-body p-4 p-md-5">
                        <!-- <h3 class="fs-30 text_black fw-bold mb-4">Full Member Access Registration </h3> -->
                        <h3 class="fs-30 text_black fw-bold mb-4"> {{ $eventName[0] }} ( {{ $startDate }}, {{ $endDate }} ) </h3>
                        <p class="fs-16 text_black">Please fill in the below details:</p>
                        <div class="mt-3">
                            <div class="form-check mb-3">
                                <input class="form-check-input" type="radio" name="member" id="member" checked>
                                <label class="form-check-label" for="">
                                    Non-IESA Member
                                </label>
                            </div>

                        </div>
                        <!-- <div class="row">
                            <div class="col-md-8 mb-3"> -->
                        <form action="{{url('users-registration/')}}" method="POST" enctype="multipart/form-data">
                            @csrf
                            <div class="row">
                                @if(Session::has('success'))
                                <div class="alert alert-success">
                                    {{ Session::get('success') }}
                                    @php
                                    Session::forget('success');
                                    @endphp
                                </div>
                                @endif
                                <div class="col-md-6 mb-3">
                                    <label for="name" class="form-label">First Name*</label>
                                    <input type="text" class="form-control shadow-none fs-14" id="firstname" placeholder="First Name" name="name" value="{{ old('name') }}">
                                    @if ($errors->has('name'))
                                    <span class="text-danger">{{ $errors->first('name') }}</span>
                                    @endif
                                </div>
                                <div class="col-md-6 mb-3">
                                    <label for="lastname" class="form-label">Last Name*</label>
                                    <input type="text" class="form-control shadow-none fs-14" id="lastname" placeholder="Last Name" name="lastname" value="{{ old('lastname') }}">
                                    @if ($errors->has('lastname') > 2)
                                    <span class="text-danger">Last name is Greater than 2!</span>
                                    @else
                                    <span class="text-danger">{{ $errors->first('lastname') }}</span>
                                    @endif
                                </div>
                                <!-- <div class="col-md-6 mb-3">
                                        <label for="membership" class="form-label">Membership Number*</label>
                                        <input type="text" class="form-control shadow-none fs-14" id="membership"
                                            placeholder="Enter your membership number">
                                    </div> -->
                                <div class="col-md-6 mb-3">
                                    <label for="company" class="form-label">Company*</label>
                                    <input type="text" class="form-control shadow-none fs-14" id="company" placeholder="Enter your Company Name" name="company" value="{{ old('company') }}">
                                    @if ($errors->has('company'))
                                    <span class="text-danger"> The company field is required </span>
                                    @endif
                                </div>

                                <div class="col-md-6 mb-3">
                                    <label for="email" class="form-label">Email*</label>
                                    <input type="email" class="form-control shadow-none fs-14" id="email" placeholder="Email id" name="email" value="{{ old('email') }}">
                                    @if ($errors->has('email'))
                                    <span id="email_err" class="text-danger"> {{ $errors->first('email') }} </span>
                                    @endif
                                </div>
                                <div class="col-md-6 mb-3">
                                    <label for="number" class="form-label">Phone No*</label>
                                    <input type="number" class="form-control shadow-none fs-14" id="phone_number" placeholder="Your Phone Number" name="phone_number" value="{{ old('phone_number') }}">
                                    @if ($errors->has('phone_number'))
                                    <span class="text-danger"> {{ $errors->first('phone_number') }} </span>
                                    @endif
                                </div>

                                <div class="col-md-6 mb-3">
                                    <label for="state" class="form-label">State*</label>
                                    <input type="text" class="form-control shadow-none fs-14" id="state" placeholder="Enter your State Name" name="state" value="{{ old('state') }}">
                                    @if ($errors->has('state'))
                                    <span class="text-danger"> The state field is required </span>
                                    @endif
                                </div>
                                <!-- @if ($errors->has('state_name'))
                                <span class="text-danger"> State name is required! </span>
                                @endif -->


                                <!-- </div> -->
                                <div class="col-md-6 mb-3">
                                    <label for="city" class="form-label">City*</label>
                                    <input type="text" class="form-control shadow-none fs-14" id="city" placeholder="Enter your City Name" name="city" value="{{ old('city') }}">
                                    @if ($errors->has('city'))
                                    <span class="text-danger"> The city field is required </span>
                                    @endif
                                </div>
                                <!-- @if ($errors->has('city_name'))
                                <span class="text-danger"> City name is required! </span>
                                @endif -->



                                <div class="col-md-6 mb-3">
                                    <label for="pincode" class="form-label">Pincode</label>
                                    <input type="number" class="form-control shadow-none fs-14" id="pincode" placeholder="Your Pincode" name="pincode">
                                    @if ($errors->has('pincode'))
                                    <span class="text-danger">  {{ $errors->first('pincode') }}  </span>
                                    @endif
                                </div>

                                <div class="col-md-6 mb-3">
                                    <label for="gst_number" class="form-label">GSTin</label>
                                    <input type="text" class="form-control shadow-none fs-14" id="gst_number" placeholder="Your GST Number (optional)" name="gst_number" value="{{ old('gst_number') }}">

                                </div>

                            </div>
                            <!-- <div class="mt-4">
                            <a href="{{url('registration-summary')}}">
                                <button class="btn bg-orange btn-padding mb-0 text-white fs-16">Submit</button>
                            </a>
                        </div> -->

                            <input type="hidden" name="event_session_id" value="{{ $event_session_id }}">
                            <input type="hidden" name="event_id" value="{{ $event_id }}">
                            <input type="hidden" name="event_users_id" value="{{ $event_users_id }}">
                            <input type="hidden" name="display_price_id" value="{{ $display_price_id }}">

                            <div class="mt-4">
                                <!-- <a href="{{url('registration-summary')}}"> -->
                                <button type="submit" class="btn bg-orange btn-padding mb-0 text-white fs-16">Submit</button>
                                <a href="{{url('https://www.iesaonline.org/event-details/ai-summit-2023')}}" class="btn bg-orange btn-padding mb-0 text-white fs-16">Back</a>

                                <!-- </a> -->
                            </div>

                        </form>

                        <!-- </div> -->
                        <!-- <div class="col-md-4 mb-3"> -->
                        <!-- <div class="card shadow-sm border-0">
                                    <div class="card-header border-0  bg-orange">
                                        <h3 class="fs-20 text-white fw-bold text-center">October 23 2023</h3>
                                    </div>
                                    <div class="card-body bg-events-agenda pb-1 p-3 text-center">
                                        <h3 class="fs-34 text_black mb-4">Rs 5000.00</h3>
                                        <p class="fs-14 text_black mb-2">Inclusive GST Amount</p>
                                    </div>
                                </div> -->
                        <!-- <div class="mt-4">
                                    <div class="form-check mb-3">
                                        <input class="form-check-input" type="radio" name="member" id="member" checked>
                                        <label class="form-check-label" for="">
                                            Member
                                        </label>
                                    </div> -->
                        <!-- <h3 class="fs-18">Payment Details</h3>
                                    <div class="fs-14 d-flex justify-content-between">
                                        <div>
                                            <p class="text-grey mb-0">Delegates Fee</p>
                                            <span class="text-grey">(Incl of all taxes)</span>
                                        </div>
                                        <p class="text-grey">Rs 5000.00</p>
                                    </div> -->
                    </div>
                    <!-- </div> -->
                    <!-- </div> -->

                </div>
            </div>
        </div>

        <div class="col-md-1">

        </div>
    </div>
    </div>
</section>
@endsection