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contact.php
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<!doctype html>
<html class="no-js" lang="en">
<!-- /contact.html /3.x [XR&CO'2014], Tue, 19:04:18 -->
<?php
include "./header.php";
?>
<style>
.form-container {
max-width: 600px;
margin: 0 auto;
font-family: Arial, sans-serif;
border-radius: 5px;
box-shadow: 0 0 10px rgba(0, 0, 0, 0.1);
padding: 2rem;
background-color: #fff;
margin-top: 50px;
}
.form-container label {
display: block;
margin-bottom: 0.5rem;
font-size: 1rem;
}
.form-container input,
.form-container select {
display: block;
width: 100%;
padding: 0.5rem;
margin-bottom: 1rem;
font-size: 1rem;
border-radius: 5px;
border: 1px solid #ccc;
}
.form-container select {
-webkit-appearance: none;
-moz-appearance: none;
appearance: none;
background-image: url("data:image/svg+xml;utf8,<svg xmlns='http://www.w3.org/2000/svg' width='20' height='20' viewBox='0 0 20 20'><polygon points='1 6, 9 15, 19 6'/></svg>");
background-repeat: no-repeat;
background-position: right 1rem center;
background-size: 1rem;
padding-right: 3rem;
}
.form-container textarea {
display: block;
width: 100%;
padding: 0.5rem;
margin-bottom: 1rem;
border-radius: 5px;
border: 1px solid #ccc;
resize: none;
height: 10rem;
font-size: 1rem;
}
.form-container button[type="submit"] {
display: block;
background: linear-gradient(to right, #4CAF50 0%, #5EBD8F 50%, #4CAF50 100%);
color: #fff;
font-size: 1rem;
padding: 0.5rem 1rem;
border: none;
border-radius: 5px;
cursor: pointer;
}
.form-container button[type="submit"]:hover {
background: linear-gradient(to right, #5EBD8F 0%, #4CAF50 50%, #5EBD8F 100%);
}
@media (max-width: 500px) {
.form-container input,
.form-container textarea {
padding-right: 0;
}
.form-container select {
background-image: none;
padding-right: 0;
}
}
</style>
<!--End of Header Area-->
<!--Breadcrumb Banner Area Start-->
<div class="breadcrumb-banner-area">
<div class="container">
<div class="row">
<div class="col-md-12">
<div class="breadcrumb-text">
<h1 class="text-center">Contact</h1>
<div class="breadcrumb-bar">
<ul class="breadcrumb text-center">
<li><a href="index.html">Home</a></li>
<li>Contact</li>
</ul>
</div>
</div>
</div>
</div>
</div>
</div>
<!--End of Breadcrumb Banner Area-->
<!--Contact Area Start-->
<div class="form-container"> <label for="firstName">First Name</label> <input type="text" id="firstName"
name="firstName" required>
<label for="lastName">Last Name</label> <input type="text" id="lastName" name="lastName" required>
<label for="emailAddress">Email Address</label> <input type="email" id="emailAddress" name="emailAddress" required>
<label for="zipCode">ZIP Code</label> <input type="text" id="zipCode" name="zipCode" required>
<label for="birthDate">What is your child's date of birth?</label> <input type="date" id="birthDate"
name="birthDate" required>
<label for="startIn">We'd like to start in...</label> <select id="startIn" name="startIn">
<option value="withinAMonth">Within a month</option>
</select>
<label for="visitDate">When would you like to visit?</label> <input type="date" id="birthDate" name="birthDate">
<option value="date1">Choose an available date</option> </select>
<label for="questions">Questions? Anything you'd like us to know about your family?</label>
<textarea id="questions" name="questions"></textarea>
<label for="phoneNumber">Phone Number</label> <input type="tel" id="phoneNumber" name="phoneNumber" required>
<label for="branch">Branch</label> <select id="branch" name="branch">
<option value="bhubaneswar">Bhubaneswar</option>
</select>
<input type="checkbox" id="privacy" name="privacy" value="privacyagreed" required> <label for="privacy"
style="margin-left:10px;"> By submitting this form, you agree to the Curious Cubs privacy notice.</label>
<button type="submit">Submit</button>
</div>
<!--Contact Area End-->
<?php
include "./footer.php";
?>
</div>
<!--End of Bg White-->
</div>
<!--End of Main Wrapper Area-->
<?php
include "./commonscript.php";
?>
</body>
<!-- /contact.html /3.x [XR&CO'2014], Tue, 19:04:18 -->
</html>