@extends('template.homepage')

@section('content')

@if ( $errors->count() > 0 )
      <div class="alert alert-danger fade in"><button type="button" class="close" data-dismiss="alert">&times;</button>
      <h4>Attenzione</h4>
      <p>
      <ul>
        @foreach( $errors->all() as $message )
          <li>{{ $message }}</li>
        @endforeach
      </ul>
      </p>
      </div>
@endif

@if (!empty($error))
<div class="alert alert-danger fade in"> <button type="button" data-dismiss="alert" class="close" aria-hidden="true" id="msg_close">×</button><h4>Attenzione</h4><p> {{ $error }} </p></div>
@elseif (!empty($success))
<div class="alert alert-success fade in"> <button type="button" data-dismiss="alert" class="close" aria-hidden="true" id="msg_close">×</button><h4><span class="glyphicon glyphicon-thumbs-up"></span></h4><p> {{ $success }} </p></div>
@endif


<div class="container">
<blockquote>Per iscriverti alla newsletter e all'SMS news compila il modulo sottostante</blockquote>
{{ Form::open(array('url' => URL::to('/check', [], true), 'method' => 'post', 'role' => 'form'))}}
{{ Form::hidden('id', $hash)}}
@if(Cookie::get('laravel_session') == null) 
	<script>
		window.top.location.href = "{{  secure_url('/carica', ['hash' => $hash]) }}";
	</script>
@endif
<div class="col-lg-6">
    <div class="col-lg-12">
	<div class="form-group required col-lg-10 @if ($errors->has('nome')) has-error @endif">
		<i class="fa fa-circle"></i>{{ Form::label('nome', 'Nome:', array('class' => 'control-label')) }}
		{{ Form::text('nome', '', array('class' => 'form-control', 'max-length' => '30', 'autocomplete' => 'off', 'placeholder' => 'Il tuo nome'))}}
		@if ($errors->has('nome')) <p class="help-block">{{ $errors->first('nome') }}</p> @endif
	</div>
        <div class="col-lg-2">&nbsp;</div>
    </div>
    <div class="col-lg-12">
	<div class="form-group required col-lg-10 @if ($errors->has('cognome')) has-error @endif">
		<i class="fa fa-circle"></i>{{ Form::label('cognome', 'Cognome:', array('class' => 'control-label')) }}
		{{ Form::text('cognome', '', array('class' => 'form-control', 'max-length' => '30', 'autocomplete' => 'off', 'placeholder' => 'Il tuo cognome'))}}
		@if ($errors->has('cognome')) <p class="help-block">{{ $errors->first('cognome') }}</p> @endif
	</div>
        <div class="col-lg-2">&nbsp;</div>
    </div>
    <div class="col-lg-12">
        <div class="form-group required col-lg-10">
            <i class="fa fa-circle"></i>{{ Form::label('sesso', 'Sesso:', array('class' => 'control-label'))}}
            <div class="radio">
              <label class="radio-inline">
                {{ Form::radio('sesso', 'M', false, ['id' => 'maschio']) }}
                Maschio
              </label>
              <label class="radio-inline">
                {{ Form::radio('sesso', 'F', false, ['id' => 'femmina']) }}
                Femmina
              </label>
            </div>
        </div>
        <div class="col-lg-2">&nbsp;</div>
    </div>
    <div class="col-lg-12">
        <div class="form-group required col-lg-10">
		<i class="fa fa-circle"></i>{{ Form::label('citta', 'Città:', array('class' => 'control-label'))}}
		{{ Form::text('citta', '', array('class' => 'form-control', 'max-length' => '50', 'autocomplete' => 'off', 'placeholder' => 'Il tuo comune'))}}
	</div>
        <div class="col-lg-2">&nbsp;</div>
    </div>
</div>
<div class="col-lg-6">
    <div class="col-lg-12">
	<div class="form-group col-lg-10 @if ($errors->has('email')) has-error @endif">
		<i class="fa fa-adjust"></i>{{ Form::label('email', 'E-mail:', array('class' => 'control-label'))}}
		{{ Form::text('email', '', array('class' => 'form-control', 'max-length' => '50', 'autocomplete' => 'off', 'placeholder' => 'La tua e-mail'))}}
		@if ($errors->has('email')) <p class="help-block">{{ $errors->first('email') }}</p> @endif
	</div>
        <div class="col-lg-2">&nbsp;</div>
        <div class="form-group col-lg-10">
                <i class="fa fa-adjust"></i>{{ Form::label('sms', 'Cellulare:', array('class' => 'control-label'))}}
                {{ Form::text('sms', '', array('class' => 'form-control', 'max-length' => '16', 'autocomplete' => 'off', 'placeholder' => 'Il tuo numero di cellulare'))}}
                <label id="titolo-consenso">
                    CONSENSO ex art. 23 D. Lgs. 196/2003 (Codice in materia di protezione dei dati personali)     
                </label>
                {{ Form::textarea('privacysms', $privacySMS, array('readonly', 'class'=> "form-control privacy", 'rows' => '5', 'style' => 'width: 100%;') ) }}
                @if ($errors->has('sms')) <p class="help-block">{{ $errors->first('sms') }}</p> @endif
                <i class="fa fa-circle"></i>{{ Form::checkbox('acconsentoSMS', '1', false) }} Acconsento
        </div>
        <div class="col-lg-2">&nbsp;</div>
    </div>
</div>
<div class="col-lg-12">
    <div class="col-lg-12">
        <div class="form-group col-lg-11">
            <label id="titolo-consenso">
                INFORMATIVA ex art. 13 D. Lgs. 196/2003 (Codice in materia di protezione dei dati personali)     
            </label>           
            {{ Form::textarea('privacy', $privacy, array('id' => 'privacy', 'readonly', 'class'=> "form-control privacy", 'rows' => '5') ) }}
        </div>
        <div class="col-lg-1">&nbsp;</div>
    </div>
    <div class="col-lg-12">
	<div class="form-group col-lg-11 @if ($errors->has('privacyChk')) has-error @endif">
		<i class="fa fa-circle"></i>{{ Form::checkbox('privacyChk', '1', false)}} Ho preso atto dell'informativa
		@if ($errors->has('privacyChk')) <p class="help-block">{{ $errors->first('privacyChk') }}</p> @endif
	</div>
        <div class="col-lg-1">&nbsp;</div>
    </div>
    <div class="col-lg-12">
	<div class="form-group col-lg-11 required @if ($errors->has('captcha')) has-error @endif">
            {{ Form::captcha() }}
	</div>
	@if ($errors->has('captcha')) <p class="help-block">{{ $errors->first('captcha') }}</p> @endif
        <div class="col-lg-1">&nbsp;</div>
    </div>
    <div class="col-lg-12">
        <div class="col-lg-10">
        {{ Form::submit('Iscrivimi', array('class' => 'btn btn-sm btn-primary'))}}
        </div>
    </div>
    <div class="col-lg-6">
        <div class="col-lg-12">
            &nbsp;
        </div>
    </div>
    <div class="col-lg-6">
        <div class="col-lg-12">
            <i class="fa fa-circle"></i> <b class="small"><i>Dato indispensabile</i></b>
        </div>
        <div class="col-lg-12">
            <i class="fa fa-adjust"></i> <b class="small"><i>Almeno un dato indispensabile</i></b>
        </div>
    </div>
</div>
{{ Form::close() }}
</div>
<hr>
<a href="{{ URL::to($hash . '/unsubscribe', [], true) }}">Clicca qui per disiscriverti</a>
@stop