@extends('mobile.template-login')

@section('css')
{!! RecaptchaV3::initJs() !!}

@endsection

@section('content')

<div class="content-wrap page-login">
  <div class="subsite-banner">
      <img src="{{app('App\Helpers\Images')->urlImage($imagePage->image, 'Image Page Mobile')}}">
  </div>
  <div class="subsite subsite-with-banner">
    <div class="row">
      <div class="col-md-12">
        <div class="subsite-heading">
          Register
        </div>
      </div>
    </div>
    <form class="form-group" action="{{route('mobile.daftar.store')}}" enctype="multipart/form-data " method="post"> @csrf
      {!! RecaptchaV3::field('registerUser') !!}
      @if ($errors->has('g-recaptcha-response'))
          <span class="text-danger">
            Gunakan Browser Lain
          </span>
      @endif

      <div class="row field-row">
        <div class="col">
          <label>Username</label>
          <div class="field-group">
            <i class="fas fa-user-circle"></i>
            <input type="text" name="username" placeholder="Username" required value="{{env('APP_ENV') != 'production' ? 'user1' : ''}}" class="form-control with-icon"   >

            @if ($errors->has('username'))
              <label class="error mt-2 text-danger" for="username">{{ $errors->first('username') }}</label>
            @endif
          </div>
        </div>
      </div>
      <div class="row field-row">
        <div class="col">
          <label>Nama</label>
          <div class="field-group">
            <i class="fas fa-user"></i>
            <input type="text" name="nama" placeholder="Nama" required value="{{env('APP_ENV') != 'production' ? 'nama1' : ''}}" class="form-control with-icon"   >
          </div>
        </div>
      </div>
      <div class="row field-row">
        <div class="col">
          <label>Phone</label>
          <div class="field-group">
            <i class="fas fa-phone"></i>
            <input type="text" name="hp" placeholder="Phone" required value="{{env('APP_ENV') != 'production' ? '0987654321' : ''}}" class="form-control with-icon"   >
          </div>
        </div>
      </div>
      <div class="row field-row">
        <div class="col">
          <label>Domisili</label>
          <div class="field-group">
            <i class="fas fa-home"></i>
            <input type="text" name="domisili" placeholder="Domisili" required value="{{env('APP_ENV') != 'production' ? 'Karanggeneng Lamongan' : ''}}" class="form-control with-icon"   >
          </div>
        </div>
      </div>
      <div class="row field-row">
        <div class="col">
          <label>Tempat lahir</label>
          <div class="field-group">
            <i class="fas fa-map-marker-alt"></i>
            <input type="text" name="tempat_lahir" placeholder="Tempat Lahir" required value="{{env('APP_ENV') != 'production' ? 'Lamongan' : ''}}" class="form-control with-icon"   >
          </div>
        </div>
      </div>
      <div class="row field-row">
        <div class="col">
          <label>Tanggal Lahir</label>
          <div class="field-group">
            <i class="far fa-calendar-alt"></i>
            <input type="date" name="tanggal_lahir" required value="{{env('APP_ENV') != 'production' ? '1999-09-09' : ''}}" class="form-control with-icon"   >
          </div>
        </div>
      </div>
      <div class="row field-row">
        <div class="col">
          <label>Email</label>
          <div class="field-group">
            <i class="far fa-envelope-open"></i>
            <input type="email" name="email" placeholder="email" required value="{{env('APP_ENV') != 'production' ? 'email1@gmail.com' : ''}}" class="form-control with-icon"   >
            @if ($errors->has('email'))
              <label class="error mt-2 text-danger" for="username">{{ $errors->first('email') }}</label>
            @endif
          </div>
        </div>
      </div>
      <div class="row field-row">
        <div class="col">
          <label>NIK</label>
          <div class="field-group">
            <i class="far fa-id-card"></i>
            <input type="number" name="nik" placeholder="NIK" required value="{{env('APP_ENV') != 'production' ? '352401010100001' : ''}}" class="form-control with-icon"   >
          </div>
        </div>
      </div>
      <div class="row field-row">
        <div class="col">
          <label>Gender</label>
          <div class="field-group">
            <i class="fas fa-venus-mars"></i>
            <select name="gender" id="" class="form-control with-icon">
              <option value="">Pilih Gender</option>
              <option value="Laki-laki" {{env('APP_ENV') != 'production' ? 'selected' : ''}} >Laki Laki</option>
              <option value="Perempuan">Perempuan</option>
            </select>
          </div>
        </div>
      </div>
      <div class="row field-row">
        <div class="col">
          <label>Disabilitas</label>
          <div class="field-group">
            <i class="fas fa-wheelchair"></i>
            <select name="disabilitas" id="" class="form-control with-icon">
              <option value="0" {{env('APP_ENV') != 'production' ? 'selected' : ''}} >Tidak</option>
              <option value="1">Iya</option>
            </select>
          </div>
        </div>
      </div>

      
      <div class="row field-row">
        <div class="col">
          <label>Pekerjaan</label>
          <div class="field-group">
            <i class="fas fa-briefcase"></i>
            <input type="text" name="pekerjaan" placeholder="Pekerjaan Saat Ini" required value="{{env('APP_ENV') != 'production' ? 'Wiraswasta' : ''}}" class="form-control with-icon"   >
          </div>
        </div>
      </div>
      
      <div class="row field-row">
        <div class="col">
          <label>Password</label>
          <div class="field-group">
            <i class="fas fa-lock"></i>
            <input type="password" name="password" placeholder="Password" value="{{env('APP_ENV') != 'production' ? 'sandi1234' : ''}}" class="form-control with-icon" >
          </div>
        </div>
      </div>

      <div class="row field-row">
        <div class="col">
          <label>Confirm Password</label>
          <div class="field-group">
            <i class="fas fa-lock"></i>
            <input type="password" name="cpassword" placeholder="Ulangi Masukkan Password" value="{{env('APP_ENV') != 'production' ? 'sandi1234' : ''}}" class="form-control with-icon" >
            @if ($errors->has('password'))
              <label class="error mt-2 text-danger" for="cpassword">{{ $errors->first('password') }}</label>
            @endif
          </div>
        </div>
      </div>

      <div class="row field-row">
        <div class="col">
          <label>NIP ( Bila ASN )</label>
          <div class="field-group">
            <i class="far fa-id-badge"></i>
            <input type="text" name="nip" placeholder="NIP" value="{{env('APP_ENV') != 'production' ? '081291299' : ''}}" class="form-control with-icon"   >
          </div>
        </div>
      </div>
      <div class=" form-check form-check-inline">
        <input class="form-check-input" name="syarat" type="checkbox"  id="syarat" value="1" required>
        <label class="form-check-label" for="syarat">Saya telah membaca dan menyetujui <a href="{{route('home.termsOfUse')}}" target="_blank">Syarat dan Ketentuan Layanan</a></label>
      </div> 
      
      <div class="row field-row login-submit">
        <div class="col">
          <div class="button">
            <button type="submit" class="theme-button">Daftar</button>
          </div>
        </div>
      </div>
      
      
    </form>
    <div class="row field-row text-with-link">
      <div class="col">
        <div class="field-group">
          
          Sudah Punya Account ? <a href="{{route('mobile.login')}}">Login</a>
        </div>
      </div>
    </div>
    
  </div> 
</div>

@endsection