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<div class="form-checkout" id="form-checkout"> <input type="hidden" name="code" value="{{$booking->code}}"> <div class="mb-5 shadow-soft bg-white rounded-sm"> <div class="pt-4 pb-5 px-5"> <h5 id="scroll-description" class="font-size-21 font-weight-bold text-dark mb-4"> {{ __("Let us know who you are") }} </h5> <div class="row"> <div class="col-sm-6 mb-4"> <label class="form-label"> {{ __("First Name") }} </label> <input type="text" placeholder="{{__("First Name")}}" class="form-control" value="{{$user->first_name ?? ''}}" name="first_name"> </div> <div class="col-sm-6 mb-4"> <label class="form-label"> {{ __("Last name") }} </label> <input type="text" placeholder="{{__("Last Name")}}" class="form-control" value="{{$user->last_name ?? ''}}" name="last_name"> </div> <div class="col-sm-6 mb-4"> <label class="form-label"> {{ __("Email") }} </label> <input type="email" placeholder="{{__("email@domain.com")}}" class="form-control" value="{{$user->email ?? ''}}" name="email"> </div> <div class="col-sm-6 mb-4"> <label class="form-label"> {{ __("Phone") }} </label> <input type="email" placeholder="{{__("Your Phone")}}" class="form-control" value="{{$user->phone ?? ''}}" name="phone"> </div> <div class="w-100"></div> <div class="col-sm-6 mb-4"> <label class="form-label"> {{ __("Address line 1") }} </label> <input type="text" placeholder="{{__("Address line 1")}}" class="form-control" value="{{$user->address ?? ''}}" name="address_line_1"> </div> <div class="col-sm-6 mb-4"> <label class="form-label"> {{ __("Address line 2") }} </label> <input type="text" placeholder="{{__("Address line 2")}}" class="form-control" value="{{$user->address2 ?? ''}}" name="address_line_2"> </div> <div class="col-sm-6 mb-4"> <label class="form-label"> {{ __("State/Province/Region") }} </label> <input type="text" class="form-control" value="{{$user->state ?? ''}}" name="state" placeholder="{{__("State/Province/Region")}}"> </div> <div class="col-sm-6 mb-4"> <label class="form-label"> {{ __("ZIP code/Postal code") }} </label> <input type="text" class="form-control" value="{{$user->zip_code ?? ''}}" name="zip_code" placeholder="{{__("ZIP code/Postal code")}}"> </div> <div class="col-sm-6 mb-4"> <label class="form-label"> {{ __("Country") }} </label> <select name="country" class="form-control"> <option value="">{{__('-- Select --')}}</option> @foreach(get_country_lists() as $id=>$name) <option @if(($user->country ?? '') == $id) selected @endif value="{{$id}}">{{$name}}</option> @endforeach </select> </div> <div class="col-sm-6 mb-4"> <label class="form-label"> {{ __("City") }} </label> <input type="text" class="form-control" value="{{$user->city ?? ''}}" name="city" placeholder="{{__("Your City")}}"> </div> <div class="w-100"></div> <div class="col"> <div class="mb-6"> <label class="form-label"> {{ __("Special Requirements") }} </label> <div class="input-group"> <textarea name="customer_notes" cols="30" rows="6" class="form-control" placeholder="{{__('Special Requirements')}}"></textarea> </div> </div> </div> <div class="w-100"></div> <div class="col-sm-12 mb-4"> @include ('Booking::frontend/booking/checkout-deposit') @include ($service->checkout_form_payment_file ?? 'Booking::frontend/booking/checkout-payment') </div> <div class="col-sm-12 mb-4"> @php $term_conditions = setting_item('booking_term_conditions'); @endphp <div class="mb-3"> <div class="custom-control custom-checkbox d-flex align-items-center text-muted"> <input type="checkbox" class="custom-control-input" id="termsCheckbox" name="term_conditions"> <label class="custom-control-label" for="termsCheckbox"> <small> {{__('By continuing, you agree to the')}} <a target="_blank" class="link-muted" href="{{get_page_url($term_conditions)}}">{{__('Terms and Conditions')}}</a> </small> </label> </div> @if(setting_item("booking_enable_recaptcha")) <div class="form-group"> {{recaptcha_field('booking')}} </div> @endif </div> <div class="html_before_actions"></div> <p class="alert-text mt10" v-show=" message.content" v-html="message.content" :class="{'danger':!message.type,'success':message.type}"></p> <button class="btn btn-primary w-100 rounded-sm transition-3d-hover font-size-16 font-weight-bold py-3" @click="doCheckout">{{__('CONFIRM BOOKING')}} <i class="fa fa-spin fa-spinner" v-show="onSubmit"></i> </button> </div> </div> </div> </div> </div>