51 lines
2.7 KiB
Smarty
51 lines
2.7 KiB
Smarty
<!DOCTYPE html>
|
|
<html>
|
|
<head>
|
|
<title>Corona-Kontaktformular - {{ get("event", "Heizhaus") }}</title>
|
|
<meta name="viewport" content="width=device-width, initial-scale=1">
|
|
<link rel="stylesheet" href="https://maxcdn.bootstrapcdn.com/bootstrap/3.4.1/css/bootstrap.min.css">
|
|
</head>
|
|
<body>
|
|
<div class="container">
|
|
<h1>Corona-Kontaktformular</h1>
|
|
% if get("success", False):
|
|
<p>Erfolgreich registriert.</p>
|
|
<form method="get">
|
|
<input type="hidden" name="event" value="{{ get("event", "Heizhaus") }}">
|
|
<button type="submit" class="btn btn-primary">Weitere Person registrieren</button>
|
|
</form>
|
|
% else:
|
|
<p>Die Daten werden nach 1 Monat gelöscht und ausschließlich zur Corona-Kontaktverfolgung verwendet.</p>
|
|
<form method="post" autocomplete="on">
|
|
<div class="form-group">
|
|
<label for="event">Veranstaltung:</label>
|
|
<input id="event" class="form-control" name="event" value="{{ get("event", "Heizhaus") }}" readonly>
|
|
</div>
|
|
<div class="form-group {{ ("has-success" if get("name", False) else "has-error") + " has-feedback" if get("feedback", False) else "" }}">
|
|
<label for="name">Name, Vorname:</label>
|
|
<input id="name" class="form-control" placeholder="Söder, Markus" name="name" value="{{ get("name", "") }}" required>
|
|
% if get("feedback", False):
|
|
<span class="glyphicon {{ "glyphicon-ok" if get("name", False) else "glyphicon-remove" }} form-control-feedback"></span>
|
|
% end
|
|
</div>
|
|
<div class="form-group {{ ("has-success" if get("address", False) else "has-error") + " has-feedback" if get("feedback", False) else "" }}">
|
|
<label for="address">Adresse:</label>
|
|
<input id="address" class="form-control" placeholder="Jakobstraße 46, 90402 Nürnberg" name="address" value="{{ get("address", "") }}" required>
|
|
% if get("feedback", False):
|
|
<span class="glyphicon {{ "glyphicon-ok" if get("address", False) else "glyphicon-remove" }} form-control-feedback"></span>
|
|
% end
|
|
</div>
|
|
<div class="form-group {{ ("has-success" if get("contact", False) else "has-error") + " has-feedback" if get("feedback", False) else "" }}">
|
|
<label for="contact">Email/Telefon:</label>
|
|
<input id="contact" class="form-control" placeholder="markus.soeder@soeder.de" name="contact" value="{{ get("contact", "") }}" required>
|
|
% if get("feedback", False):
|
|
<span class="glyphicon {{ "glyphicon-ok" if get("contact", False) else "glyphicon-remove" }} form-control-feedback"></span>
|
|
% end
|
|
</div>
|
|
<button type="submit" class="btn btn-success">Registrieren</button>
|
|
</form>
|
|
% end
|
|
</div>
|
|
</body>
|
|
</html>
|