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Direktori : /home/importfo/public_html/physiocarephysiotherapy.co.in/ajax-load/ |
Current File : /home/importfo/public_html/physiocarephysiotherapy.co.in/ajax-load/booking-form-spa.html |
<div class="modal-header bg-theme-colored"> <button type="button" class="close" data-dismiss="modal" aria-label="Close"><span aria-hidden="true">×</span></button> <h4 class="modal-title text-white" id="myModalLabel">Members’ Booking Form</h4> </div> <div class="p-40"> <!-- Booking Form Starts --> <form id="booking_form" name="booking_form" class="" action="https://kodesolution.com/html/2016/health-zone-html/demo/ajax-load/includes/booking-spa.php" method="post"> <div class="row"> <div class="col-sm-12"> <div class="form-group"> <label><strong>Treatment:</strong></label> <select name="booking_treatment" class="form-control" required> <option value="">-- select --</option> <option>Hydration Strategy - Brilliance (60 min)</option> <option>Reverse – Ageing Ritual – Lift (1h30) </option> <option>Instant Glow Green Tea Facial (30 min)</option> <option>Ensuring better life</option> </select> </div> <div class="row"> <div class="col-sm-6"> <div class="form-group"> <label><strong>Arrival Date:</strong></label> <input type="text" placeholder="Arrival Date" class="form-control date-picker" name="booking_arrival_date" required> </div> </div> <div class="col-sm-6"> <div class="form-group"> <label><strong>Departure Date:</strong></label> <input type="text" placeholder="Departure Date" class="form-control date-picker" name="booking_departure_date" required> </div> </div> </div> <div class="form-group"> <label><strong>Time:</strong></label> <input type="text" placeholder="Time" class="form-control time-picker" name="booking_time" required> </div> <div class="form-group"> <label><strong>Guest:</strong></label> <input type="text" placeholder="Enter Your Guest Name" id="guest_name" name="booking_guest_name" class="form-control" required> </div> </div> <div class="col-sm-12"> <div class="form-group mb-20"> <label><strong>Your Stay:</strong></label> <div class="radio mt-5"> <label class="radio-inline"> <input type="radio" value="Beach Resort and Spa" name="booking_stay_at" checked=""> Beach Resort and Spa </label> <label class="radio-inline"> <input type="radio" value="Staying at Other Hotels" name="booking_stay_at"> Staying at Other Hotels </label> </div> </div> </div> <div class="col-sm-12"> <div class="form-group"> <label><strong>Title:</strong></label> <select name="booking_title" class="form-control" required> <option value="">-- select one --</option> <option value="Mr">Mr.</option> <option value="Mrs">Mrs.</option> <option value="Ms">Ms.</option> <option value="Mr & Mrs">Mr & Mrs.</option> <option value="Dr">Dr.</option> </select> </div> </div> <div class="col-sm-6"> <div class="form-group"> <label><strong>Name:</strong></label> <input type="text" placeholder="Enter Name" name="booking_name" class="form-control" required> </div> </div> <div class="col-sm-6"> <div class="form-group"> <label><strong>Membership Number:</strong></label> <input type="text" placeholder="Enter Membership Number" name="booking_membership_number" class="form-control" required> </div> </div> <div class="col-sm-6"> <div class="form-group"> <label><strong>Email:</strong></label> <input type="text" placeholder="Enter Email" name="booking_email" class="form-control" required> </div> </div> <div class="col-sm-6"> <div class="form-group"> <label><strong>Phone:</strong></label> <input type="text" placeholder="Enter Phone" name="booking_phone" class="form-control" required> </div> </div> <div class="col-sm-12"> <div class="form-group"> <label><strong>Comments:</strong></label> <textarea name="booking_comments" class="form-control"></textarea> </div> </div> </div> <div class="form-group"> <input name="form_botcheck" class="form-control" type="hidden" value="" /> <button type="submit" class="btn btn-dark btn-theme-colored btn-flat mr-5" data-loading-text="Please wait...">Book Now</button> <button type="reset" class="btn btn-default btn-flat btn-theme-colored">Reset</button> </div> </form> <!-- Booking Form Validation--> <script type="text/javascript"> $("#booking_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> <!-- Booking Form Ends --> </div> <div class="modal-footer"> </div> <!-- Footer Scripts --> <script> //reload date and time picker THEMEMASCOT.initialize.TM_datePicker(); </script>