@extends('layout.empty')

@section('title', 'Register')

@section('content')
    <!-- BEGIN register -->
    <div class="register">
        <!-- BEGIN register-content -->
        <div class="register-content">
            <form action="index.html" method="POST" name="register_form">
                <h1 class="text-center">Sign Up</h1>
                <p class="text-muted text-center">One Admin ID is all you need to access all the Admin services.</p>
                <div class="form-group">
                    <label>Name <span class="text-danger">*</span></label>
                    <input type="text" class="form-control form-control-lg fs-15px" placeholder="e.g John Smith" value="" />
                </div>
                <div class="form-group">
                    <label>Email Address <span class="text-danger">*</span></label>
                    <input type="text" class="form-control form-control-lg fs-15px" placeholder="username@address.com" value="" />
                </div>
                <div class="form-group">
                    <label>Password <span class="text-danger">*</span></label>
                    <input type="password" class="form-control form-control-lg fs-15px" value="" />
                </div>
                <div class="form-group">
                    <label>Confirm Password <span class="text-danger">*</span></label>
                    <input type="password" class="form-control form-control-lg fs-15px" value="" />
                </div>
                <div class="form-group">
                    <label>Country <span class="text-danger">*</span></label>
                    <select class="form-control form-control-lg fs-15px">
                        <option>United States</option>
                    </select>
                </div>
                <div class="form-group">
                    <label>Gender <span class="text-danger">*</span></label>
                    <select class="form-control form-control-lg fs-15px">
                        <option>Female</option>
                    </select>
                </div>
                <div class="form-group">
                    <label>Date of Birth <span class="text-danger">*</span></label>
                    <div class="row">
                        <div class="col-6">
                            <select class="form-control form-control-lg fs-15px">
                                <option>Month</option>
                            </select>
                        </div>
                        <div class="col-3">
                            <select class="form-control form-control-lg fs-15px">
                                <option>Day</option>
                            </select>
                        </div>
                        <div class="col-3">
                            <select class="form-control form-control-lg fs-15px">
                                <option>Year</option>
                            </select>
                        </div>
                    </div>
                </div>
                <div class="form-group">
                    <div class="custom-control custom-checkbox">
                        <input class="custom-control-input" type="checkbox" value="" id="customCheck1" />
                        <label class="custom-control-label fw-500" for="customCheck1">I have read and agree to the <a href="#">Terms of Use</a> and <a href="#">Privacy Policy</a>.</label>
                    </div>
                </div>
                <div class="form-group">
                    <button type="submit" class="btn btn-primary btn-lg fs-15px fw-500 btn-block">Sign Up</button>
                </div>
                <div class="text-muted text-center">
                    Already have an Admin ID? <a href="page_login.html">Sign In</a>
                </div>
            </form>
        </div>
        <!-- END register-content -->
    </div>
    <!-- END register -->
@endsection