{% set formClasses = "bg-gray-500 text-gray-50 placeholder-gray-300 focus:ring-2 focus:ring-blue-500 focus:ring-offset-2 focus:ring-offset-transparent m-2 p-3 rounded-lg hover:bg-gray-600 checked:text-gray-500" -%} {% set requiredField = "<span class='inline-block text-[#f39] text-sm align-super'>* required</span>" -%} <div id="mt-form" class="form text-lg w-full"> <form id='form' hx-post="/api/camp-form" hx-encoding="multipart/form-data" autocomplete="on" method="post" target="_parent" class="w-full items-center flex flex-wrap"> <h3 class="basis-full">Camp Form</h3> <div class="basis-full flex flex-wrap my-4"> <label for="first-name" class="basis-full">What is your first and last name? <span class='inline-block text-[#f39] text-sm align-sub'>* required</span></label> <br/> <input type="text" id="first-name" name="first-name" placeholder="First Name" class="peer flex-1 form-input {{ formClasses }}" required> <input type="text" id="last-name" name="last-name" placeholder="Last Name" class="peer flex-1 form-input {{ formClasses }}" required> <label for="parent-first-name" class="basis-full mt-2">What is your guardian's first and last name? <span class='inline-block text-[#f39] text-sm align-sub'>* required</span></label> <input type="text" id="parent-first-name" name="parent-first-name" class="peer flex-1 form-input {{ formClasses }}" placeholder="First Name" required> <input type="text" id="parent-last-name" name="parent-last-name" class="peer flex-1 form-input {{ formClasses }}" placeholder="Last Name" required> </div> <label for="birth-date" class="basis-full">When were you born? <span class='inline-block text-[#f39] text-sm align-sub'>* required</span></label> <input type="date" id="birth-date" name="birth-date" class="basis-full form-date {{ formClasses }}" required> <label for="gender" class="basis-full">Gender <span class='inline-block text-[#f39] text-sm align-sub'>* required</span></label> <select id="gender" name="gender" class="basis-full form-select {{ formClasses }}" required> <option value="Male">Male</option> <option value="Female">Female</option> </select> <div class="basis-full flex flex-wrap my-4"> <label for="street" class="basis-full">What is your address? <span class='inline-block text-[#f39] text-sm align-sub'>* required</span></label> <input type="text" id="street" name="street" class="basis-full form-input {{ formClasses }}" placeholder="Street Address" required> <input type="text" id="city" name="city" class="flex-auto form-input {{ formClasses }}" placeholder="City" required> <input type="text" id="state" name="state" class="flex-auto form-input {{ formClasses }}" placeholder="State" required> <input type="text" id="zip" name="zip" class="flex-auto form-input {{ formClasses }}" placeholder="Zip Code" required> </div> <div class="basis-full my-4"> <label for="grade" class="">Grade this Fall <span class='inline-block text-[#f39] text-sm align-sub'>* required</span></label> <br/> <input type="radio" id="grade" name="grade" value="6" class="form-input {{ formClasses }}" checked> <label for="grade" class="">6th</label> <br/> <input type="radio" id="grade" name="grade" value="7" class="form-input {{ formClasses }}" checked> <label for="grade" class="">7th</label> <br/> <input type="radio" id="grade" name="grade" value="8" class="form-input {{ formClasses }}" checked> <label for="grade" class="">8th</label> <br/> <input type="radio" id="grade" name="grade" value="freshman" class="form-input {{ formClasses }}"> <label for="grade" class="">Freshman</label> <br/> <input type="radio" id="grade" name="grade" value="sophomore" class="form-input {{ formClasses }}"> <label for="grade" class="">Sophomore</label> <br/> <input type="radio" id="grade" name="grade" value="junior" class="form-input {{ formClasses }}"> <label for="grade" class="">Junior</label> <br/> <input type="radio" id="grade" name="grade" value="senior" class="form-input {{ formClasses }}"> <label for="grade" class="">Senior</label> <br/> <input type="radio" id="grade" name="grade" value="college-freshman" class="form-input {{ formClasses }}"> <label for="grade" class="">College Freshman</label> </div> <label for="parent-phone" class="basis-full">Guardian's phone <span class='inline-block text-[#f39] text-sm align-sub'>* required</span></label> <input type="tel" id="parent-phone" name="parent-phone" class="basis-full peer form-input {{ formClasses }} invalid:text-[#f39] invalid:ring-[#f39] focus:invalid:ring-[#f39] focus:invalid:border-[#f39]" required pattern="\(?\d{3}\)? ?-?\d{3} ?-?\d{4}"/> <!-- <div id="warning-phone" class="invisible flex rounded-lg h-0 peer-invalid:p-2 peer-invalid:visible peer-empty:invisible peer-empty:h-0 peer-empty:mb-0 peer-invalid:basis-full peer-invalid:mb-32"> <span class="text-[#f39] ltr:pr-3 rtl:pl-3 content-right float-right"> Make sure you have included a valid phone number for your guardian so we can contact them. Numbers are in the format "999-999-9999 or 0123456789". Make sure to include an area code. </span> </div> --> <div class="basis-full flex flex-wrap"> <label for="parent-email" class="basis-full">Guardian's Email <span class='inline-block text-[#f39] text-sm align-sub'>* required</span> </label> <input type="email" id="parent-email" name="parent-email" pattern="^[a-zA-Z0-9]+(?:\.[a-zA-Z0-9]+)*@[a-zA-Z0-9]+(?:\.[a-zA-Z0-9]+)*$" class="basis-full peer form-input {{ formClasses }} invalid:text-[#F39] invalid:ring-[#f39] focus:invalid:ring-[#f39] focus:invalid:border-[#f39]"> <div id="warning-email" class="invisible flex rounded-lg h-0 peer-invalid:p-2 peer-invalid:visible peer-invalid:basis-full peer-invalid:mb-24"> <span class="text-[#f39] ltr:pr-3 rtl:pl-3 content-right float-right"> Make sure you have included an email for your guardian so we can contact them. Emails are in the format "name@website.end". </span> </div> </div> <label for="allergies" class="basis-full">Do you have any food allergies?</label> <input type="text" id="allergies" name="allergies" class="basis-full form-input {{ formClasses }}"> <label for="week" class="basis-full">My Camp Plan (The first week is filled, so if you'd like to be on a waiting list, you'll have to check the second option.)<span class='inline-block text-[#f39] text-sm align-sub'>* required</span></label> <select id="week" name="week" class="flex-auto form-select {{ formClasses }}"> <option value="week1">Week 1: July 21-25</option> <option value="week2">Week 2: July 28-Aug 1</option> <!-- <option value="waiting-list">Week 2: July 29-Aug 2, but on a waiting list for week 1</option> --> </select> <label for="shirt" class="basis-full">T-Shirt Size <span class='inline-block text-[#f39] text-sm'>all t-shirts are in adult sizes only</span></label> <select id="shirt" name="shirt" class="mb-8 flex-auto form-select {{ formClasses }}"> <option value="small">Small</option> <option value="medium">Medium</option> <option value="large">Large</option> <option value="xl">XL</option> <option value="xxl">2XL</option> <option value="xxxl">3XL</option> </select> <div class="basis-full my-2"> <label for="final-agreement"> I understand that in order to go to camp I need to have this form, a health form, and the total cost paid. </label> <div class="my-4"> <input type="radio" value="yes" id="final-agreement" name="final-agreement" class="form-input {{ formClasses }}" required> <label for="final-agreement" class="mt-4"> I understand <span class='inline-block text-[#f39] text-sm align-sub'>* required</span> </label> </div> </div> <label for="health-form" class="basis-full my-2"> Would you like to fill out the health form now or later? Your health form is not required right now, but you cannot go to camp without one. </label> <div class="basis-full mt-4"> <input type="radio" value="now" id="health-form" name="health-form" class="form-input {{ formClasses }}" checked> <label for="health-form" class=""> Now </label> </div> <div class="basis-full mb-4"> <input type="radio" value="later" id="health-form" name="health-form" class="form-input {{ formClasses }}"> <label for="health-form" class=""> Later </label> </div> <label for="registration" class="basis-full my-2"> Would you like to pay the registration fee or the full cost now or later? </label> <!-- For early bird prices --> <div class="basis-full mt-4"> <input type="radio" value="now" id="registration" name="registration" class="form-input {{ formClasses }}" checked> <label for="registration" class=""> Now - $85 </label> </div> <div class="basis-full"> <input type="radio" value="full" id="registration" name="registration" class="form-input {{ formClasses }}"> <label for="registration" class=""> Full Cost - $185 </label> </div> <div class="basis-full mb-4"> <input type="radio" value="later" id="registration" name="registration" class="form-input {{ formClasses }}"> <label for="registration" class=""> Later - Send $85 or $185 to the TFC Office </label> </div> <!-- For after early bird prices --> <!-- <div class="basis-full mt-4"> <input type="radio" value="now" id="registration" name="registration" class="form-input {{ formClasses }}" checked> <label for="registration" class=""> Now - $100 </label> </div> <div class="basis-full"> <input type="radio" value="full" id="registration" name="registration" class="form-input {{ formClasses }}"> <label for="registration" class=""> Full Cost - $200 </label> </div> <div class="basis-full mb-4"> <input type="radio" value="later" id="registration" name="registration" class="form-input {{ formClasses }}"> <label for="registration" class=""> Later - Send $100 or $200 to the TFC Office </label> </div> --> <div class="basis-full mt-8"> <button type="submit" class="content-right rounded-lg bg-gray-700 h-12 w-24 focus:bg-gray-900 focus:ring focus:ring-primary-700 hover:bg-gray-900 float-right">Submit</button> </div> </form> </div>