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71 lines
3.0 KiB
PHP
71 lines
3.0 KiB
PHP
<?php
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/*
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* This Source Code Form is subject to the terms of the Mozilla Public
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* License, v. 2.0. If a copy of the MPL was not distributed with this
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* file, You can obtain one at http://mozilla.org/MPL/2.0/.
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*/
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// Use a random ID for each child, so we can tell 100% which inputs go together
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$randomid = mt_rand(0, 9999999999);
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?>
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<div class="list-group-item">
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<input type="hidden" name="child[ids][]" value="<?php echo $randomid; ?>" />
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<div class="row">
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<div class="col-12 col-sm-4">
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<div class="form-group">
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<label>Name:</label>
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<div class="input-group">
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<div class="input-group-prepend">
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<span class="input-group-text"><i class="fas fa-user-graduate"></i></span>
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</div>
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<input type="text" name="child[name][<?php echo $randomid; ?>]" class="form-control" />
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</div>
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</div>
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</div>
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<div class="col-12 col-sm-3">
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<div class="form-group">
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<label>Birth month:</label>
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<div class="input-group">
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<div class="input-group-prepend">
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<span class="input-group-text"><i class="fas fa-calendar"></i></span>
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</div>
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<select name="child[month][<?php echo $randomid; ?>]" class="form-control">
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<option value=1>January</option>
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<option value=2>February</option>
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<option value=3>March</option>
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<option value=4>April</option>
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<option value=5>May</option>
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<option value=6>June</option>
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<option value=7>July</option>
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<option value=8>August</option>
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<option value=9>September</option>
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<option value=10>October</option>
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<option value=11>November</option>
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<option value=12>December</option>
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</select>
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</div>
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</div>
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</div>
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<div class="col-12 col-sm-3">
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<div class="form-group">
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<label>Birth year:</label>
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<div class="input-group">
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<div class="input-group-prepend">
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<span class="input-group-text"><i class="fas fa-calendar-alt"></i></span>
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</div>
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<input type="number" name="child[year][<?php echo $randomid; ?>]" class="form-control" min="1980" max="<?php echo date('Y'); ?>" value="<?php echo date('Y', strtotime('now - 10 years')); ?>"/>
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</div>
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</div>
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</div>
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<div class="col-12 col-sm-2">
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<div class="form-check">
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<input class="form-check-input" type="checkbox" value="1" name="child[graduate][<?php echo $randomid; ?>]">
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<label class="form-check-label">Graduated</label>
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</div>
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</div>
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</div>
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</div>
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