@section('title', 'Enter')
@extends('layouts.main')


@section('extra-css')
    <link rel="stylesheet" href="{{ asset('/assets/plugins/light-pick/lightpick.css') }}"/>
    <style>
        html {
            background-image: url({{ asset('/assets/images/bg.jpg') }});
            background-size: cover;
            background-repeat: no-repeat;
            background-color: #362768;
            background-position: top center;
        }
        .fContent { background: rgba(174,208,236, 0.4); }

        @media screen and (max-width: 991px) {
            html {
                background-image: url({{ asset('/assets/images/bg-991.jpg') }});
            }
        }

        @media screen and (max-width: 600px) {
            html {
                background-image: url({{ asset('/assets/images/bg-600.jpg') }});
                background-color: #94c0e8;
                background-position: 100% 30%;
                background-repeat: no-repeat;
                background-size: cover;
            }
            .fContent { background: rgba(174,208,236, 0.9); }
        }

    </style>
@endsection

@section('content')

        <!--begin:: Check error or success -->
    @include('layouts.partials.success')
    @include('layouts.partials.errors')
    <!--end:: Check error or success -->
        <div class="row">
            <div class="col-xs-12">
                <div class="fContent animated slideInRight">

                <form action="{{ route('entries.create') }}" enctype="multipart/form-data" method="post">
                    @csrf
                    <div class="col-xs-12">
                        <p class="text-center"><strong>Welcome to The Spring Clean with Bravecto<sup>®</sup>. Please complete below fields.</strong></p>
                    </div>
                    <div class="form-group col-md-6">
                            <input class="form-control" type="text" name="name" placeholder="First Name" value="{{ !empty(session('currentPlayerName')) ? session('currentPlayerName') : old('name') }}"/>
                        </div>
                    <div class="form-group col-md-6">
                            <input class="form-control" type="text" name="surname" placeholder="Surname" value="{{ !empty(session('currentPlayerSurname')) ? session('currentPlayerSurname') : old('surname') }}"/>
                        </div>
                    <div class="form-group col-md-12">
                            <input class="form-control" type="text" name="email" id="email" value="{{ !empty(session('currentPlayerEmail')) ? session('currentPlayerEmail') : old('email') }}" placeholder="Email Address"/>
                        </div>
                    <div class="form-group col-md-12">
                            <input class="form-control" type="text" name="cell" value="{{ !empty(session('currentPlayerCell')) ? session('currentPlayerCell') : old('cell') }}" placeholder="Mobile Number"/>
                        </div>
                    <div class="form-group col-md-6">
                        <input class="form-control" type="number" name="quantity" value="{{ !empty(session('currentPlayerQuantity')) ? session('currentPlayerQuantity') : old('quantity') }}" placeholder="Quantity of Products Bought" {{ session('currentPlayerQuantity') > 1 ? 'readonly' : '' }}/>
                    </div>
                    <div class="form-group col-md-6">
                        <input class="form-control" type="text" name="store" value="{{ !empty(session('currentPlayerStore')) ? session('currentPlayerStore') : old('store') }}" placeholder="Name of Vet Practice or Vetshop"/>
                    </div>
                    <div class="form-group col-md-12">
                        <input class="form-control" type="text" name="city" value="{{ !empty(session('currentPlayerCity')) ? session('currentPlayerCity') : old('city') }}" placeholder="City"/>
                    </div>
                    <div class="form-group col-md-12">
                        {{--<input class="form-control" type="file" name="file" placeholder="Upload till slip"/>--}}
                        <label for="slip" style="font-size: 14px; font-weight: bold;">Upload Proof of Purchase.</label>
                        <input type="file" name="file"  class="form-control" id="slip"/>
                    </div>
                    <div class="col-md-12 form-group">
                            <p><span><strong>One entry into main draw will be permitted per Bravecto<sup>®</sup> Product bought.</strong></span></p>
                            <hr style="border-top:1px solid #000; border-bottom: 0px solid #fff;">
                            <p>Opt-in for future communication from MSD Animal Health (makers of Bravecto<sup>®</sup>)</p>
                        </div>
                    <div class="col-md-2 form-group ">
                            <label class="custom-input-container">Yes
                                <input type="radio" checked="checked" name="communicate" value="Yes"
                                       checked="checked">
                                <span class="checkmark-radio"></span>
                            </label>
                        </div>
                    <div class="col-md-2 form-group ">
                            <label class="custom-input-container">No
                                <input type="radio" name="communicate" value="No">
                                <span class="checkmark-radio"></span>
                            </label>
                        </div>
                    <div class="col-md-8">&nbsp;</div>
                    <div class="col-md-12 form-group">
                            <p>Do you have the Bravecto® Rewards and Reminders app? (Yes = Additional entry into the main draw.)<br><strong><a href="https://blog.bravecto.co.za/rewards-and-reminders-app/" target="_blank" style="text-decoration: underline;">Click here to download now</a></strong></p>
                        </div>
                    <div class="col-md-2 form-group ">
                        <label class="custom-input-container">Yes
                            <input type="radio"  name="app_downloaded" value="Yes" checked="checked">
                            <span class="checkmark-radio"></span>
                        </label>
                    </div>
                    <div class="col-md-2 form-group ">
                        <label class="custom-input-container">No
                            <input type="radio" name="app_downloaded" value="No">
                            <span class="checkmark-radio"></span>
                        </label>
                    </div>
                        <div class="col-md-8">&nbsp;</div>
                    <br>

                        <div class="col-md-12">
                            <label class="custom-input-container"> Accept Terms and Conditions
                                    <br><a href="https://blog.bravecto.co.za/terms-and-conditions/"
                                    target="_blank" style="color:#000; text-decoration: underline;">See T&C's</a>
                                <input type="checkbox" name="read_terms" value="Yes">
                                <span class="checkmark"></span>
                            </label>
                            <p></p>
                        </div>

                         <div class="col-md-12 text-center">
                             <p>Click below to win with Bravecto®</p>
                            <button type="submit" class="btn btn-primary">SUBMIT & SPRING CLEAN</button>
                            <br>
                            <br>
                        </div>
                     </form>
                 </div>
            </div>
        </div>
        <div class="clearfix"></div>
@endsection



@section('extra-js')

@endsection()