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Mini Shell

Direktori : /home/importfo/www/drvidhisphysiotherapy.com/ajax-load/
Upload File :
Current File : /home/importfo/www/drvidhisphysiotherapy.com/ajax-load/booking-form-yoga.html

<div class="modal-header bg-theme-colored">
  <button type="button" class="close" data-dismiss="modal" aria-label="Close"><span aria-hidden="true">&times;</span></button>
  <h4 class="modal-title text-white" id="myModalLabel">Members’ Booking Form</h4>
</div>
<div class="p-40">
  <!-- Reservation Form Start-->
  <form id="reservation_form" name="reservation_form" class="reservation-form p-50 pt-60 pb-60 mb-0 bg-light" method="post" action="https://html.kodesolution.com/2016/health-zone-html/demo/ajax-load/includes/reservation.php">
    <h3 class="font-raleway text-theme-colored mt-0 mb-20">Reservation Here</h3>
    <div class="row">
      <div class="col-sm-12">
        <div class="form-group mb-30">
          <input placeholder="Enter Name" type="text" id="reservation_name" name="reservation_name" required="" class="form-control">
        </div>
      </div>
      <div class="col-sm-6">
        <div class="form-group mb-30">
          <input placeholder="Email" type="text" id="reservation_email" name="reservation_email" class="form-control" required="">
        </div>
      </div>
      <div class="col-sm-6">
        <div class="form-group mb-30">
          <input placeholder="Phone" type="text" id="reservation_phone" name="reservation_phone" class="form-control" required="">
        </div>
      </div>
      <div class="col-sm-6">
        <div class="form-group mb-30">
          <div class="styled-select">
            <select id="person_select" name="person_select" class="form-control" required="">
              <option value="">Sex</option>
              <option value="1 Person">Male</option>
              <option value="2 Person">Female</option>
            </select>
          </div>
        </div>
      </div>
      <div class="col-sm-6">
        <div class="form-group mb-30">
          <input name="reservation_date" class="form-control required date-picker" type="text" placeholder="Reservation Date">
        </div>
      </div>
      <div class="col-sm-12">
        <div class="form-group mb-0 mt-0">
          <input name="form_botcheck" class="form-control" type="hidden" value="">
          <button type="submit" class="btn btn-colored btn-theme-colored btn-lg btn-flat btn-submit" data-loading-text="Please wait...">Submit Now</button>
        </div>
      </div>
    </div>
  </form>
  <!-- Reservation Form End-->

  <!-- Reservation Form Validation Start-->
  <script type="text/javascript">
    $("#reservation_form").validate({
      submitHandler: function(form) {
        var form_btn = $(form).find('button[type="submit"]');
        var form_result_div = '#form-result';
        $(form_result_div).remove();
        form_btn.before('<div id="form-result" class="alert alert-success" role="alert" style="display: none;"></div>');
        var form_btn_old_msg = form_btn.html();
        form_btn.html(form_btn.prop('disabled', true).data("loading-text"));
        $(form).ajaxSubmit({
          dataType:  'json',
          success: function(data) {
            if( data.status == 'true' ) {
              $(form).find('.form-control').val('');
            }
            form_btn.prop('disabled', false).html(form_btn_old_msg);
            $(form_result_div).html(data.message).fadeIn('slow');
            setTimeout(function(){ $(form_result_div).fadeOut('slow') }, 6000);
          }
        });
      }
    });
  </script>
  <!-- Reservation Form Validation Start -->
</div>
<div class="modal-footer">
</div>
<!-- Footer Scripts -->
<script>
  //reload date and time picker
  THEMEMASCOT.initialize.TM_datePicker();
</script>

Zerion Mini Shell 1.0