2024-02-17 14:28:59 +01:00
< div id = "anfrageform" >
< form data-request = "anfrage::onSubmit" data-request-flash class = "grid sm:grid-cols-2 md:grid-cols-1 lg:grid-cols-2 gap-3" >
2024-02-13 02:18:27 +01:00
2024-02-17 14:28:59 +01:00
< div >
< label for = "reason" class = "block text-sm font-medium text-gray-900 dark:text-white" > Grund für die Feier< / label >
< input id = "reason" name = "reason" class = "shadow-sm bg-gray-50 border border-gray-300 text-gray-900 text-sm rounded-lg focus:ring-blue-500 focus:border-blue-500 block w-full p-2.5 dark:bg-gray-700 dark:border-gray-600 dark:placeholder-gray-400 dark:text-white dark:focus:ring-blue-500 dark:focus:border-blue-500 dark:shadow-sm-light" placeholder = "z.B. 18. Geburtstag" >
< / div >
2024-02-13 02:18:27 +01:00
2024-02-17 14:28:59 +01:00
< div >
< label for = "date" class = "block text-sm font-medium text-gray-900 dark:text-white" > Gewünschtes Datum< / label >
< input id = "date" name = "date" datepicker datepicker-autohide datepicker-format = "dd.mm.yyyy" class = "shadow-sm bg-gray-50 border border-gray-300 text-gray-900 text-sm rounded-lg focus:ring-blue-500 focus:border-blue-500 block w-full p-2.5 dark:bg-gray-700 dark:border-gray-600 dark:placeholder-gray-400 dark:text-white dark:focus:ring-blue-500 dark:focus:border-blue-500 dark:shadow-sm-light" placeholder = "" >
< / div >
2024-02-13 02:18:27 +01:00
2024-03-05 10:08:03 +01:00
< div >
< label for = "guests" class = "block text-sm font-medium text-gray-900 dark:text-white" > Anzahl Gäste (ca)< / label >
< input id = "guests" name = "guests" class = "shadow-sm bg-gray-50 border border-gray-300 text-gray-900 text-sm rounded-lg focus:ring-blue-500 focus:border-blue-500 block w-full p-2.5 dark:bg-gray-700 dark:border-gray-600 dark:placeholder-gray-400 dark:text-white dark:focus:ring-blue-500 dark:focus:border-blue-500 dark:shadow-sm-light" placeholder = "" >
< / div >
< div >
< label for = "birthday" class = "block text-sm font-medium text-gray-900 dark:text-white" > Geburtsdatum< / label >
< input id = "birthday" name = "birthday" datepicker datepicker-autohide datepicker-format = "dd.mm.yyyy" class = "shadow-sm bg-gray-50 border border-gray-300 text-gray-900 text-sm rounded-lg focus:ring-blue-500 focus:border-blue-500 block w-full p-2.5 dark:bg-gray-700 dark:border-gray-600 dark:placeholder-gray-400 dark:text-white dark:focus:ring-blue-500 dark:focus:border-blue-500 dark:shadow-sm-light" placeholder = "" >
< / div >
2024-02-17 14:28:59 +01:00
< div >
< label for = "firstname" class = "block text-sm font-medium text-gray-900 dark:text-white" > Vorname< / label >
< input id = "firstname" name = "firstname" class = "shadow-sm bg-gray-50 border border-gray-300 text-gray-900 text-sm rounded-lg focus:ring-blue-500 focus:border-blue-500 block w-full p-2.5 dark:bg-gray-700 dark:border-gray-600 dark:placeholder-gray-400 dark:text-white dark:focus:ring-blue-500 dark:focus:border-blue-500 dark:shadow-sm-light" placeholder = "" >
< / div >
2024-02-13 02:18:27 +01:00
2024-02-17 14:28:59 +01:00
< div >
< label for = "lastname" class = "block text-sm font-medium text-gray-900 dark:text-white" > Nachname< / label >
< input id = "lastname" name = "lastname" class = "shadow-sm bg-gray-50 border border-gray-300 text-gray-900 text-sm rounded-lg focus:ring-blue-500 focus:border-blue-500 block w-full p-2.5 dark:bg-gray-700 dark:border-gray-600 dark:placeholder-gray-400 dark:text-white dark:focus:ring-blue-500 dark:focus:border-blue-500 dark:shadow-sm-light" placeholder = "" >
< / div >
2024-02-13 02:18:27 +01:00
2024-02-17 14:28:59 +01:00
< div >
2024-03-05 10:08:03 +01:00
< label for = "address" class = "block text-sm font-medium text-gray-900 dark:text-white" > Adresse< / label >
< input id = "address" name = "address" class = "shadow-sm bg-gray-50 border border-gray-300 text-gray-900 text-sm rounded-lg focus:ring-blue-500 focus:border-blue-500 block w-full p-2.5 dark:bg-gray-700 dark:border-gray-600 dark:placeholder-gray-400 dark:text-white dark:focus:ring-blue-500 dark:focus:border-blue-500 dark:shadow-sm-light" placeholder = "" >
2024-02-17 14:28:59 +01:00
< / div >
2024-02-13 02:18:27 +01:00
2024-02-17 14:28:59 +01:00
< div >
2024-03-05 10:08:03 +01:00
< label for = "zip" class = "block text-sm font-medium text-gray-900 dark:text-white" > PLZ< / label >
< input id = "zip" name = "zip" class = "shadow-sm bg-gray-50 border border-gray-300 text-gray-900 text-sm rounded-lg focus:ring-blue-500 focus:border-blue-500 block w-full p-2.5 dark:bg-gray-700 dark:border-gray-600 dark:placeholder-gray-400 dark:text-white dark:focus:ring-blue-500 dark:focus:border-blue-500 dark:shadow-sm-light" placeholder = "" >
2024-02-17 14:28:59 +01:00
< / div >
2024-02-13 02:18:27 +01:00
2024-02-17 14:28:59 +01:00
< div >
2024-03-05 10:08:03 +01:00
< label for = "location" class = "block text-sm font-medium text-gray-900 dark:text-white" > Ort< / label >
< input id = "location" name = "location" class = "shadow-sm bg-gray-50 border border-gray-300 text-gray-900 text-sm rounded-lg focus:ring-blue-500 focus:border-blue-500 block w-full p-2.5 dark:bg-gray-700 dark:border-gray-600 dark:placeholder-gray-400 dark:text-white dark:focus:ring-blue-500 dark:focus:border-blue-500 dark:shadow-sm-light" placeholder = "" >
2024-02-17 14:28:59 +01:00
< / div >
2024-02-13 02:18:27 +01:00
2024-02-17 14:28:59 +01:00
< div >
2024-03-05 10:08:03 +01:00
< label for = "phone" class = "block text-sm font-medium text-gray-900 dark:text-white" > Telefonnummer< / label >
< input id = "phone" name = "phone" class = "shadow-sm bg-gray-50 border border-gray-300 text-gray-900 text-sm rounded-lg focus:ring-blue-500 focus:border-blue-500 block w-full p-2.5 dark:bg-gray-700 dark:border-gray-600 dark:placeholder-gray-400 dark:text-white dark:focus:ring-blue-500 dark:focus:border-blue-500 dark:shadow-sm-light" placeholder = "" >
< / div >
< div class = "col-span-full" >
< label for = "email" class = "block text-sm font-medium text-gray-900 dark:text-white" > E-Mail-Adresse< / label >
< input id = "email" name = "email" class = "shadow-sm bg-gray-50 border border-gray-300 text-gray-900 text-sm rounded-lg focus:ring-blue-500 focus:border-blue-500 block w-full p-2.5 dark:bg-gray-700 dark:border-gray-600 dark:placeholder-gray-400 dark:text-white dark:focus:ring-blue-500 dark:focus:border-blue-500 dark:shadow-sm-light" placeholder = "" >
2024-02-17 12:08:17 +01:00
< / div >
2024-02-13 02:18:27 +01:00
2024-02-17 14:28:59 +01:00
< div class = "col-span-full" >
< label for = "misc" class = "block text-sm font-medium text-gray-900 dark:text-white" > Was du sonst noch loswerden willst …< / label >
< textarea id = "misc" name = "misc" rows = "5" class = "shadow-sm bg-gray-50 border border-gray-300 text-gray-900 text-sm rounded-lg focus:ring-blue-500 focus:border-blue-500 block w-full p-2.5 dark:bg-gray-700 dark:border-gray-600 dark:placeholder-gray-400 dark:text-white dark:focus:ring-blue-500 dark:focus:border-blue-500 dark:shadow-sm-light" > < / textarea >
< / div >
2024-02-13 02:18:27 +01:00
2024-02-17 14:28:59 +01:00
< div class = "relative col-span-full" >
< div class = "grid grid-cols-1 gap-2" >
< label for = "datenschutz" class = "p-0 block leading-none relative flex items-start" >
< input id = "datenschutz" type = "checkbox" name = "datenschutz" class = "peer absolute invisible" / >
< span class = "border-neutral-400 border-4 border-solid peer-checked:border-neutral-800 absolute left-0 w-6 h-6 rounded block top-0" > < / span >
< span class = "peer-checked:bg-neutral-800 left-[0.5rem] top-[0.5rem] w-2 h-2 absolute rounded block top-0" > < / span >
< span class = "pl-8 pt-1 @sm:pt-0 text-gray-600 text-sm @sm:text-base" >
< span > Ich habe die < a href = "/datenschutzerklaerung" class = "font-semibold" target = "_BLANK" > Datenschutzerklärung< / a > zur Kenntnis genommen und akzeptiere diese.< / span >
< span class = "text-red-800" > *< / span >
< / span >
< / label >
< / div >
< / div >
2024-02-13 02:18:27 +01:00
2024-02-17 14:28:59 +01:00
< div class = "flex justify-center col-span-full mt-5" >
< button class = "py-2 px-6 rounded bg-blue-900 hover:bg-blue-800 text-lg font-bold text-gray-300" type = "submit" > Absenden< / button >
< / div >
< / form >
< / div >