templates/childs/inscription.html.twig line 1

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  1. {% extends "./basenonav.html.twig" %}
  3. {% block body %}
  5. <main>
  6.     <div class="container-fluid">
  7.         <div class="text-center pb-4 mwb-4 d-xl-block d-none"><img src="{{ asset('images/logo.png') }}" alt="Suzie Loves Children"
  8.             class="img-fluid biglogo"></div>
  10.             {{ form_start(form) }}
  11.             <!--form box start-->
  12.             <div class="whitebx p-4">
  13.                 <div class="cftop">
  14.                     <div class="cfnamebx">
  15.                         <div class="cfimg">
  16.                             <img src="{{ asset('images/upload-thumb.png') }}" id="OpenImgUpload" alt="" class="uploadimg">
  17.                             {{ form_widget(form.image, {'attr': {'id': 'imgupload', 'style': 'display:none'}}) }}
  18.                         </div>
  19.                         <div class="cfname">
  20.                             <div class="mb-md-3 mb-4 row align-items-center">
  21.                                 {{ form_label(form.firstname, 'Nom :', {'label_attr': {'class': 'col-lg-3 col-sm-4 h4 mb-sm-0 mb-2'}}) }}
  22.                                 <div class="col-lg-7 col-sm-8">
  23.                                     {{ form_widget(form.firstname, {'attr': {'class': 'form-control input-sm'}}) }}
  24.                                 </div>
  25.                             </div>
  26.                             <div class="row align-items-center pb-md-0 pb-4">
  27.                                 {{ form_label(form.lastname, 'Prénom :', {'label_attr': {'class': 'col-lg-3 col-sm-4 h4 mb-sm-0 mb-2'}}) }}
  28.                                 <div class="col-lg-7 col-sm-8">
  29.                                     {{ form_widget(form.lastname, {'attr': {'class': 'form-control input-sm'}}) }}
  30.                                 </div>
  31.                             </div>
  32.                            
  33.                         </div>
  34.                     </div>
  35.                     <div class="ms-auto">
  36.                         {{ form_widget(form.save, { 'label': 'Enregistrer', 'attr': {'class': 'btn btn-primary btn-record'}}) }}
  37.                     </div>
  38.                 </div>
  39.                 <div class="row g-5 pb-5">
  40.                     <div class="col-lg-6">
  41.                         <div class="h3 fw-normal pb-4"><span class="border-bottom border-3">Coordonnées de l'enfant</span>
  42.                         </div>
  43.                         <div class="mb-4 row align-items-center">
  44.                             {{ form_label(form.dob, 'Date de naissance :', {'label_attr': {'class': 'col-sm-4 pb-sm-0 pb-2'}}) }}
  45.                             <div class="col-xxl-7 col-sm-8">
  46.                                 {{ form_widget(form.dob, {'attr': {'class': 'form-control input-sm'}}) }} 
  47.                             </div>
  48.                         </div>
  49.                         
  50.                           <div class="mb-4 row align-items-center">
  51.                                 {{ form_label(form.cityborn, 'Lieu de naissance :', {'label_attr': {'class': 'col-sm-4 pb-sm-0 pb-2'}}) }}
  52.                                 <div class="col-lg-7 col-sm-8">
  53.                                     {{ form_widget(form.cityborn, {'attr': {'class': 'form-control input-sm'}}) }}
  54.                                 </div>
  55.                             </div>
  56.                             
  57.                         <div class="mb-4 row align-items-center">
  58.                             {{ form_label(form.gender, 'Genre :', {'label_attr': {'class': 'col-sm-4 pb-sm-0 pb-2'}}) }}
  59.                             <div class="col-xxl-7 col-sm-8">
  60.                                 {{ form_widget(form.gender, {'attr': {'class': 'form-control input-sm'}}) }} 
  61.                             </div>
  62.                         </div>
  63.                         <div class="mb-4 row align-items-center">
  64.                             {{ form_label(form.phone, 'Tel:', {'label_attr': {'class': 'col-sm-4 pb-sm-0 pb-2'}}) }}
  65.                             <div class="col-xxl-7 col-sm-8">
  66.                                 {{ form_widget(form.phone, {'attr': {'class': 'form-control input-sm', 'onkeypress' : 'return restrictAlphabets(event)', 'maxlength': 10}}) }}
  67.                             </div>
  68.                         </div>
  69.                         <div class="mb-4 row align-items-center">
  70.                             {{ form_label(form.email, 'Email:', {'label_attr': {'class': 'col-sm-4 pb-sm-0 pb-2'}}) }}
  71.                             <div class="col-xxl-7 col-sm-8">
  72.                                 {{ form_widget(form.email, {'attr': {'class': 'form-control input-sm'}}) }}
  73.                             </div>
  74.                         </div>
  75.                         <div class="mb-4 row align-items-center">
  76.                             {{ form_label(form.childaddress, 'Adresse :', {'label_attr': {'class': 'col-sm-4 pb-sm-0 pb-2'}}) }}
  77.                             <div class="col-xxl-7 col-sm-8">
  78.                                 {{ form_widget(form.childaddress, {'attr': {'class': 'form-control input-sm', 'autocomplete': 'address-line1'}}) }}
  79.                             </div>
  80.                         </div>
  82.                         <div class="mb-4 row align-items-center">
  83.                             {{ form_label(form.childcity, 'Ville :', {'label_attr': {'class': 'col-sm-4 pb-sm-0 pb-2'}}) }}
  84.                             <div class="col-xxl-7 col-sm-8">
  85.                                 {{ form_widget(form.childcity, {'attr': {'class': 'form-control input-sm', 'autocomplete': 'address-level2'}}) }}
  86.                             </div>
  87.                         </div> 
  89.                         <div class="mb-4 row align-items-center">
  90.                             {{ form_label(form.childzipcode, 'Code Postal :', {'label_attr': {'class': 'col-sm-4 pb-sm-0 pb-2'}}) }}
  91.                             <div class="col-xxl-7 col-sm-8">
  92.                                 {{ form_widget(form.childzipcode, {'attr': {'class': 'form-control input-sm', 'autocomplete': 'postal-code'}}) }}
  93.                             </div>
  94.                         </div>
  95.                            <div class="mb-4 row align-items-center">
  96.                             {{ form_label(form.school, 'École :', {'label_attr': {'class': 'col-sm-4 pb-sm-0 pb-2'}}) }}
  97.                             <div class="col-xxl-7 col-sm-8">
  98.                                 {{ form_widget(form.school, {'attr': {'class': 'form-control input-sm search-select'}}) }} 
  99.                             </div>
  100.                         </div>
  101.                         <div class="mb-4 row align-items-center">
  102.                             {{ form_label(form.commentaire, 'Commentaire:', {'label_attr': {'class': 'col-sm-4 pb-sm-0 pb-2'}}) }}
  103.                             <div class="col-xxl-7 col-sm-8">
  104.                                 {{ form_widget(form.commentaire, {'attr': {'class': 'form-control input-sm'}}) }}
  105.                             </div>
  106.                         </div>
  107.                     </div>
  108.                     <div class="col-lg-6">
  109.                         <div class="h3 fw-normal pb-4"><span class="border-bottom border-3">Coordonnées du père</span>
  110.                         </div>
  111.                         <div class="mb-4 row align-items-center">
  112.                             {{ form_label(form.fathername, 'Nom :', {'label_attr': {'class': 'col-sm-4 pb-sm-0 pb-2'}}) }}
  113.                             <div class="col-xxl-7 col-sm-8">
  114.                                 {{ form_widget(form.fathername, {'attr': {'class': 'form-control input-sm'}}) }}
  115.                             </div>
  116.                         </div>
  117.                         <div class="mb-4 row align-items-center">
  118.                             {{ form_label(form.fatheremail, 'Email:', {'label_attr': {'class': 'col-sm-4 pb-sm-0 pb-2'}}) }}
  119.                             <div class="col-xxl-7 col-sm-8">
  120.                                 {{ form_widget(form.fatheremail, {'attr': {'class': 'form-control input-sm'}}) }}
  121.                             </div>
  122.                         </div>
  123.                         <div class="mb-4 row align-items-center">
  124.                             {{ form_label(form.fatherhebrewname, 'Prénom hébraïque :', {'label_attr': {'class': 'col-sm-4 pb-sm-0 pb-2'}}) }}
  125.                             <div class="col-xxl-7 col-sm-8">
  126.                                 {{ form_widget(form.fatherhebrewname, {'attr': {'class': 'form-control input-sm'}}) }}
  127.                             </div>
  128.                         </div>
  129.                        
  132.                         <div class="mb-4 row align-items-center">
  133.                             {{ form_label(form.fatherphone, 'Tel:', {'label_attr': {'class': 'col-sm-4 pb-sm-0 pb-2'}}) }}
  134.                             <div class="col-xxl-7 col-sm-8">
  135.                                 {{ form_widget(form.fatherphone, {'attr': {'class': 'form-control input-sm', 'onkeypress' : 'return restrictAlphabets(event)', 'maxlength': 10}}) }} 
  136.                             </div>
  137.                         </div>
  138.                     </div>
  139.                     <div class="col-lg-6">
  140.                         <div class="h3 fw-normal pb-4"><span class="border-bottom border-3">Coordonnées de la mere</span>
  141.                     </div>
  142.                     <div class="mb-4 row align-items-center">
  143.                         {{ form_label(form.mothername, 'Nom complet:', {'label_attr': {'class': 'col-sm-4 pb-sm-0 pb-2'}}) }}
  144.                         <div class="col-xxl-7 col-sm-8">
  145.                             {{ form_widget(form.mothername, {'attr': {'class': 'form-control input-sm'}}) }} 
  146.                         </div>
  147.                     </div>
  148.                      <div class="mb-4 row align-items-center">
  149.                             {{ form_label(form.motheremail, 'Email:', {'label_attr': {'class': 'col-sm-4 pb-sm-0 pb-2'}}) }}
  150.                             <div class="col-xxl-7 col-sm-8">
  151.                                 {{ form_widget(form.motheremail, {'attr': {'class': 'form-control input-sm'}}) }}
  152.                             </div>
  153.                         </div>
  154.                         <div class="mb-4 row align-items-center">
  155.                             {{ form_label(form.motherhebrewname, 'Prénom hébraïque :', {'label_attr': {'class': 'col-sm-4 pb-sm-0 pb-2'}}) }}
  156.                             <div class="col-xxl-7 col-sm-8">
  157.                                 {{ form_widget(form.motherhebrewname, {'attr': {'class': 'form-control input-sm'}}) }} 
  158.                             </div>
  159.                         </div>
  160.                         
  161.                         <div class="mb-4 row align-items-center"> 
  162.                             {{ form_label(form.motherphone, 'Tel:', {'label_attr': {'class': 'col-sm-4 pb-sm-0 pb-2'}}) }}
  163.                             <div class="col-xxl-7 col-sm-8"> 
  164.                                 {{ form_widget(form.motherphone, {'attr': {'class': 'form-control input-sm', 'onkeypress' : 'return restrictAlphabets(event)', 'maxlength': 10}}) }} 
  165.                             </div>
  166.                         </div>
  167.                      
  168.                     </div>
  169.                     <div class="col-lg-6">
  170.                         <div class="h3 fw-normal pb-4"><span class="border-bottom border-3">Coordonnées du médecin </span>
  171.                         </div>
  172.                         <div class="mb-4 row align-items-center">
  173.                             {{ form_label(form.doctorname, 'Nom:', {'label_attr': {'class': 'col-sm-4 pb-sm-0 pb-2'}}) }}
  174.                             <div class="col-xxl-7 col-sm-8">
  175.                                 {{ form_widget(form.doctorname, {'attr': {'class': 'form-control input-sm'}}) }} 
  176.                             </div>
  177.                         </div>
  178.                         <div class="mb-4 row align-items-center">
  179.                             {{ form_label(form.doctoraddress, 'Adresse:', {'label_attr': {'class': 'col-sm-4 pb-sm-0 pb-2'}}) }}
  180.                             <div class="col-xxl-7 col-sm-8">
  181.                                 {{ form_widget(form.doctoraddress, {'attr': {'class': 'form-control input-sm', 'autocomplete': 'address-line1'}}) }} 
  182.                             </div>
  183.                         </div>
  184.                         <div class="mb-4 row align-items-center">
  185.                             {{ form_label(form.doctorcity, 'Ville:', {'label_attr': {'class': 'col-sm-4 pb-sm-0 pb-2'}}) }}
  186.                             <div class="col-xxl-7 col-sm-8">
  187.                                 {{ form_widget(form.doctorcity, {'attr': {'class': 'form-control input-sm', 'autocomplete': 'address-level2'}}) }} 
  188.                             </div>
  189.                         </div>
  190.                         <div class="mb-4 row align-items-center">
  191.                             {{ form_label(form.doctorzipcode, 'Postal Code:', {'label_attr': {'class': 'col-sm-4 pb-sm-0 pb-2'}}) }}
  192.                             <div class="col-xxl-7 col-sm-8">
  193.                                 {{ form_widget(form.doctorzipcode, {'attr': {'class': 'form-control input-sm', 'autocomplete': 'postal-code'}}) }} 
  194.                             </div>
  195.                         </div>
  196.                         <div class="mb-4 row align-items-center">
  197.                             {{ form_label(form.doctorphone, 'Tel:', {'label_attr': {'class': 'col-sm-4 pb-sm-0 pb-2'}}) }}
  198.                             <div class="col-xxl-7 col-sm-8">
  199.                                 {{ form_widget(form.doctorphone, {'attr': {'class': 'form-control input-sm', 'onkeypress' : 'return restrictAlphabets(event)', 'maxlength': 10}}) }} 
  200.                             </div>
  201.                         </div>
  202.                     </div>
  203.                 </div>
  204.                 <div class="pb-3">
  205.                     <div class="h3 fw-normal pb-4"><span class="border-bottom border-3">Séances</span></div>
  206.                     <div class="mb-4 row align-items-center">
  207.                         {{ form_label(form.referrals, 'Nombres de séances max', {'label_attr': {'class': 'col-lg-3 col-sm-4 pb-sm-0 pb-2'}}) }}
  208.                         <div class="col-lg-4 col-sm-8">
  209.                             {{ form_widget(form.referrals, {'attr': {'class': 'form-control input-sm'}}) }}
  210.                         </div>
  211.                     </div>
  212.                     <div class="mb-4 row align-items-center"> 
  213.                         {{ form_label(form.sessionseta, 'Date estimée de fin des sessions :', {'label_attr': {'class': 'col-lg-3 col-sm-4 pb-sm-0 pb-2'}}) }}
  214.                         <div class="col-lg-4 col-sm-8">
  215.                             {{ form_widget(form.sessionseta, {'attr': {'class': 'form-control input-sm'}}) }} 
  216.                         </div>
  217.                     </div>
  218.                 </div>
  220.                 <div class="pb-3">
  221.                     <div class="h3 fw-normal pb-4"><span class="border-bottom border-3">Fichiers</span></div>
  222.                     <div class="mb-4 row align-items-center">
  223.                         {{ form_label(form.fileone, 'Fichiers 1', {'label_attr': {'class': 'col-lg-3 col-sm-4 pb-sm-0 pb-2'}}) }}
  224.                         <div class="col-lg-4 col-sm-8">
  225.                             {{ form_widget(form.fileone, {'attr': {'class': 'form-control input-sm'}}) }}
  226.                         </div>
  227.                     </div>
  228.                     <div class="mb-4 row align-items-center">
  229.                         {{ form_label(form.filetwo, 'Fichiers 2', {'label_attr': {'class': 'col-lg-3 col-sm-4 pb-sm-0 pb-2'}}) }}
  230.                         <div class="col-lg-4 col-sm-8">
  231.                             {{ form_widget(form.filetwo, {'attr': {'class': 'form-control input-sm'}}) }}
  232.                         </div>
  233.                     </div>
  234.                     <div class="mb-4 row align-items-center">
  235.                         {{ form_label(form.filethree, 'Fichiers 3', {'label_attr': {'class': 'col-lg-3 col-sm-4 pb-sm-0 pb-2'}}) }}
  236.                         <div class="col-lg-4 col-sm-8">
  237.                             {{ form_widget(form.filethree, {'attr': {'class': 'form-control input-sm'}}) }}
  238.                         </div>
  239.                     </div>
  240.                 </div>
  241.             </div>
  242.             <!--form box end-->
  243.             {{ form_widget(form.status, {'attr': {'value': 'not_check', 'style': 'display:none'}}) }}
  244.             <div class="form-rest" style="display: none;">
  245.                 {{ form_end(form, {render_rest: true}) }}
  246.             </div>
  247.         </div>
  248.     </main>
  250.     <script>
  251.         $('#OpenImgUpload').click(function () {
  252.             $('#childs_form_image').trigger('click');
  253.         });
  254.         $("#childs_form_image").change(function(event){
  255.             RecurFadeIn(); readURL(this); 
  256.         });
  257.         $("#childs_form_image").on('click',function(event){
  258.          RecurFadeIn();
  259.      });
  260.         function readURL(input){
  261.             if (input.files && input.files[0]) {
  262.                 var reader = new FileReader();
  263.                 var filename = $("#childs_form_image").val();
  264.                 filename = filename.substring(filename.lastIndexOf()+1);
  265.                 reader.onload = function(e) {
  266.                     debugger; $('#OpenImgUpload').attr('src', e.target.result);
  267.                     $('#OpenImgUpload').hide(); $('#OpenImgUpload').fadeIn(500);
  268.                     $('.custom-file-label').text(filename); 
  269.                 }
  270.                 reader.readAsDataURL(input.files[0]); 
  271.             }
  272.             $(".alert").removeClass("loading").hide();
  273.         }
  274.         function RecurFadeIn(){
  275.             console.log('ran');
  276.             FadeInAlert("Wait for it…");
  277.         }
  278.         function FadeInAlert(text){
  279.             $(".alert").show();
  280.             $(".alert").text(text).addClass("loading");
  281.         }
  282.         function restrictAlphabets(e) {
  283.            var x = e.which || e.keycode;
  284.            console.log(x);
  285.            if ((x >= 48 && x <= 57) || x == 43)
  286.                return true;
  287.            else
  288.                return false;
  289.        }
  291.        jQuery(document).ready(function(){
  292.             mapboxsearch.autofill({
  293.                 accessToken: 'pk.eyJ1IjoicGFua2FqNTU1NSIsImEiOiJjbDhzbm5iaG8wMHZuM25zMXQ0M3psNWpzIn0.bvFhD2p0GAYk827qg6vaJA',
  294.             });
  295.         });
  296.     </script>
  298.     {% endblock %}