@extends('layouts.main')

@push('styles')
    <link href="{{ asset('css/step-progress.css') }}" rel="stylesheet">
@endpush

@push('scripts')
    <script type="text/javascript" src="{{ asset('js/subscription.js') }}"></script>
@endpush

@section('content')



    <div class="row">
        <div class="steps">
            <ul class="steps-container">
                <li style="width:33%;" class="activated">
                    <div class="step">
                        <div class="step-image"><span></span></div>
                        <div class="step-current">Etapa 1</div>
                        <div class="step-description">Contexto</div>
                    </div>
                </li>
                <li style="width:33%;">
                    <div class="step">
                        <div class="step-image"><span></span></div>
                        <div class="step-current">Etapa 2</div>
                        <div class="step-description">Selecionar</div>
                    </div>
                </li>
                <li style="width:33%;">
                    <div class="step">
                        <div class="step-image"><span></span></div>
                        <div class="step-current">Etapa 3</div>
                        <div class="step-description">Finalizar</div>
                    </div>
                </li>
            </ul>
            <div class="step-bar" style="width: 33%;"></div>
        </div>
    </div>

    <div class="page-header">
        <h1>Iscrizione Dolomitica 2019</h1>
    </div>


    @include('errors')

    @if ($subscription->id > 0)
        <form id="subscription" method="POST" action="/subscription/{{ $subscription->id }}">
        @method('PATCH')
    @else
        <form id="subscription" method="POST" action="/subscription">
    @endif

    <div id="subscription" method="POST" action="/subscription">
        {{ csrf_field() }}

        <fieldset class="subscriber">
            <legend>Partecipante</legend>

            <div class="form-row">
                <div class="col form-group">
                    <label for="name">Nome</label>
                    <input type="text" class="form-control" name="name" placeholder="Nome" required value="{{ old('name', $subscription->name)  }}">
                </div>
                <div class="col form-group">
                    <label for="last_name">Cognome</label>
                    <input type="text" class="form-control"  name="last_name" placeholder="Cognome"  required value="{{ old('last_name', $subscription->last_name) }}">
                </div>
            </div>
            <div class="form-row">
                <div class="col form-group">
                    <label for="birthdate">Data di nascita</label>
                    <input type="date" class="form-control" name="birthdate" id="birthdate"  required value="{{ old('birthdate', $subscription->birthdate) }}">
                </div>
                <div class="col form-group">
                    <label for="birthplace">Luogo di Nascita</label>
                    <input type="text" class="form-control"  name="birthplace" placeholder="Luogo di Nascita" required value="{{ old('birthplace', $subscription->birthplace) }}">
                </div>
            </div>
            <div class="form-row">
                <div class="col-10 form-group">
                    <label for="street">Via</label>
                    <input type="text" class="form-control" name="street" placeholder="Via" required value="{{ old('street', $subscription->street) }}">
                </div>
                <div class="col form-group">
                    <label for="street_number">N. Civico</label>
                    <input type="text" class="form-control" name="street_number" placeholder="N. Civico" required value="{{ old('street_number', $subscription->street_number) }}">
                </div>
            </div>
            <div class="form-row">
                <div class="col-7 form-group">
                    <label for="city">Citt&agrave;</label>
                    <input type="text" class="form-control" name="city" placeholder="Citt&agrave;" required value="{{ old('city', $subscription->city) }}">
                </div>
                <div class="col form-group">
                    <label for="zip">CAP</label>
                    <input type="text" class="form-control" name="zip" placeholder="CAP" required value="{{ old('zip', $subscription->zip) }}">
                </div>
                <div class="col form-group">
                    <label for="state">Provincia</label>
                    <input type="text" class="form-control" name="state" placeholder="Provincia" required value="{{ old('state', $subscription->state) }}">
                </div>
                <div class="col form-group">
                    <label for="country">Stato</label>
                    <select name="country"  class="form-control"  required>
                        <option value="IT">Italia</option>
                        <option value="EU">Europe</option>
                        <option value="X">Others</option>
                    </select>
                </div>
            </div>
            <div class="form-row">
                <div class="col-4 form-group">
                    <label for="document_type">Documento</label>
                    <select name="document_type"  class="form-control" required>
                        <option value="PAT" {{ old('document_type', $subscription->document_type) == "PAT" ? 'selected' : '' }} >Patente</option>
                        <option value="CI" {{ old('document_type', $subscription->document_type) == "CI" ? 'selected' : '' }}>Carta di identit&agrave;</option>
                        <option value="PAS" {{ old('document_type', $subscription->document_type) == "PAS" ? 'selected' : '' }}>Passaporto</option>
                    </select>
                </div>
                <div class="col form-group">
                    <label for="document_number">Documento numero</label>
                    <input type="text" class="form-control" name="document_number" placeholder="Documento numero" required value="{{ old('document_number', $subscription->document_number) }}">
                </div>
            </div>



            <div class="form-row">
                <div class="col form-group">
                    <label for="motorbike_plate">Targa motoveicolo</label>
                    <input type="text" class="form-control" name="motorbike_plate" placeholder="Targa motoveicolo" required value="{{ old('motorbike_plate', $subscription->motorbike_plate) }}">
                </div>
                <div class="col form-group">
                    <label for="motorbike_brand">Marca motoveicolo</label>
                    <input type="text" class="form-control"  name="motorbike_brand" placeholder="Marca motoveicolo" required value="{{ old('motorbike_brand', $subscription->motorbike_brand) }}">
                </div>
            </div>


            <div class="form-group row">
                <div class="col-sm-2">Titolare di:</div>
                <div class="col-sm-10">
                    <div class="form-check">
                        <input class="form-check-input" type="checkbox" name="fmi_card" value="1" @if(old('fmi_card', $subscription->fmi_card)=="1") checked @endif >
                        <label class="form-check-label" for="fmi_card">
                            Tessera FMI 2019
                        </label>
                    </div>
                    <div class="form-check">
                        <input class="form-check-input" type="checkbox" name="competitive_card" value="1" @if(old('competitive_card', $subscription->competitive_card)=="1") checked @endif >
                        <label class="form-check-label" for="competitive_card">
                            Licenza agonistica 2019{{old('competitive_card', $subscription->competitive_card)=="1"}}
                        </label>
                    </div>
                </div>
            </div>
        </fieldset>


        <fieldset class="parent underage">
            <legend>Genitore</legend>

            <div class="form-row">
                <div class="col form-group">
                    <label for="parent_name">Nome</label>
                    <input type="text" class="form-control" name="parent_name" placeholder="Nome" value="{{ old('parent_name', $subscription->parent_name) }}">
                </div>
                <div class="col form-group">
                    <label for="parent_last_name">Cognome</label>
                    <input type="text" class="form-control"  name="parent_last_name" placeholder="Cognome" value="{{ old('parent_last_name', $subscription->parent_last_name) }}">
                </div>
            </div>
            <div class="form-row">
                <div class="col form-group">
                    <label for="parent_birthdate">Data di nascita</label>
                    <input type="date" class="form-control" name="parent_birthdate" value="{{ old('parent_birthdate', $subscription->parent_birthdate) }}">
                </div>
                <div class="col form-group">
                    <label for="parent_birthplace">Luogo di Nascita</label>
                    <input type="text" class="form-control"  name="parent_birthplace" placeholder="Luogo di Nascita" value="{{ old('parent_birthplace', $subscription->parent_birthplace) }}">
                </div>
            </div>
            <div class="form-row">
                <div class="col-10 form-group">
                    <label for="parent_street">Via</label>
                    <input type="text" class="form-control" name="parent_street" placeholder="Via" value="{{ old('parent_street', $subscription->parent_street) }}">
                </div>
                <div class="col form-group">
                    <label for="parent_street_number">N. Civico</label>
                    <input type="text" class="form-control" name="parent_street_number" placeholder="N. Civico" value="{{ old('parent_street_number', $subscription->parent_street_number) }}">
                </div>
            </div>
            <div class="form-row">
                <div class="col-7 form-group">
                    <label for="parent_city">Citt&agrave;</label>
                    <input type="text" class="form-control" name="parent_city" placeholder="Citt&agrave;" value="{{ old('parent_city', $subscription->parent_city) }}">
                </div>
                <div class="col form-group">
                    <label for="parent_zip">CAP</label>
                    <input type="text" class="form-control" name="parent_zip" placeholder="CAP" value="{{ old('parent_zip', $subscription->parent_zip) }}">
                </div>
                <div class="col form-group">
                    <label for="parent_state">Provincia</label>
                    <input type="text" class="form-control" name="parent_state" placeholder="Provincia" value="{{ old('parent_state', $subscription->parent_state) }}">
                </div>
                <div class="col form-group">
                    <label for="parent_country">Stato</label>
                    <select name="parent_country"  class="form-control">
                        <option value="IT">Italia</option>
                        <option value="EU">Europe</option>
                        <option value="X">Others</option>
                    </select>
                </div>
            </div>
            <div class="form-row">
                <div class="col-4 form-group">
                    <label for="parent_document_type">Documento</label>
                    <select name="parent_document_type"  class="form-control">
                        <option value="PAT" {{ old('parent_document_type', $subscription->parent_document_type) == "PAT" ? 'selected' : '' }} >Patente</option>
                        <option value="CI" {{ old('parent_document_type', $subscription->parent_document_type) == "CI" ? 'selected' : '' }}>Carta di identit&agrave;</option>
                        <option value="PAS" {{ old('parent_document_type', $subscription->parent_document_type) == "PAS" ? 'selected' : '' }}>Passaporto</option>
                    </select>
                </div>
                <div class="col form-group">
                    <label for="parent_document_number">Documento numero</label>
                    <input type="text" class="form-control" name="parent_document_number" placeholder="Documento numero" value="{{ old('parent_document_number', $subscription->parent_document_number) }}">
                </div>
            </div>


        </fieldset>

        <fieldset class="rules">
            <div class="form-row underage">
                <div class="col form-group">
                    <div class="form-check">
                        <input class="form-check-input" type="checkbox" name="parent_confirmation" value="1"  @if(old('parent_confirmation', $subscription->parent_confirmation)=="1") checked @endif >
                        <label class="form-check-label" for="parent_confirmation">
                            @include('subscription.text.parent_condifirmation')
                        </label>
                    </div>
                </div>
            </div>
            <div class="form-row">
                <div class="col form-group">
                    <div class="form-check">
                        <input class="form-check-input" type="checkbox" name="exemption_from_liability" value="1" @if(old('exemption_from_liability', $subscription->exemption_from_liability)=="1")checked @endif required>
                        <label class="form-check-label" for="exemption_from_liability">
                            <span class="non-underage">@include('subscription.text.exemption_from_liability')</span>
                            <span class="underage">@include('subscription.text.parent_exemption_from_liability')</span>
                        </label>
                    </div>
                </div>
            </div>
            <div class="form-row">
                <div class="col form-group">
                    <div class="form-check">
                        <input class="form-check-input" type="checkbox" name="exemption_from_liability_confirmation" value="1" @if(old('exemption_from_liability_confirmation', $subscription->exemption_from_liability_confirmation)=="1")checked @endif required>

                        <label class="form-check-label" for="exemption_from_liability_confirmation">
                            @include('subscription.text.exemption_from_liability_confirmation')
                        </label>
                    </div>
                </div>
            </div>
            <div class="form-row">
                <div class="col form-group">
                    <div class="form-check">
                        <input class="form-check-input" type="checkbox" name="disclosure_2016_679" value="1"  @if(old('disclosure_2016_679', $subscription->disclosure_2016_679)=="1")checked @endif required>
                        <label class="form-check-label" for="disclosure_2016_679">
                            @include('subscription.text.disclosure_2016_679')
                        </label>
                    </div>
                </div>
            </div>
            <div class="form-row">
                <div class="col form-group">
                    <div class="form-check">
                        <input class="form-check-input" type="checkbox" name="consent_2016_679" value="1"  @if(old('consent_2016_679', $subscription->consent_2016_679)=="1")checked @endif required>
                        <label class="form-check-label" for="consent_2016_679">
                            <span class="non-underage">@include('subscription.text.consent_2016_679')</span>
                            <span class="underage">@include('subscription.text.parent_consent_2016_679')</span>
                        </label>
                    </div>
                </div>
            </div>
        </fieldset>



        <div class="row">
            <a href="/home/" class="btn btn-secondary">Annulla</a>
            <div class="ml-auto">
                <button type="submit" class="btn btn-primary">Riepilogo</button>
            </div>
        </div>
    </form>




@endsection