@extends('Layouts/simplified')
@section('content')
{!! Form::open(['data-toggle' => 'validator']) !!}
@if (isset($product))
Selected product
{{ $product->name }}
1 ×
@if ($product->price)
{{ $currency->symbol}}{{ $product->price }}
@else
free
@endif
@endif
Customer details
@if (isset($product_id) && $product_id)
{!! Form::label('data[User][birthday]', t('Date of Birth')) !!}
{!! Form::text(
'data[User][birthday]',
(isset($data->birthday) ? $data->birthday : null),
[
'class' => 'form-control birthdaypicker select-huge'
]
) !!}
@endif
@include('Elements/User/toc_promotions', ['data' => []])
{!! Form::submit(
t('Submit'),
['class' => 'btn btn-huge btn-pink btn-block']
) !!}
{!! Form::close() !!}
{{--
This is to comply with Goverment Track & Trace and will be held for 21 days after your visit
--}}
@endsection