<?php require view('theme/header'); ?>

<div class="container">
	<div class="row">
		<div class="col-md-8 col-md-offset-2">
			<div class="well mt">
				<form id="register" onsubmit="return false;">
					<div class="form-loader">
						<span class="intro-banner-vdo-play-btn pinkBg">
							<span class="ripple pinkBg"></span>
							<span class="ripple pinkBg"></span>
							<span class="ripple pinkBg"></span>
						</span>
					</div>
					<div class="form-group">
						<label>{REGISTER_EMAIL_TITLE}:</label>
						<input type="text" name="email" class="form-control" />
					</div>
					<div class="form-group">
						<label>{REGISTER_USERNAME_TITLE}:</label>
						<input type="text" name="username" class="form-control" />
					</div>
					<div class="form-group">
						<label>{REGISTER_PASSWORD_TITLE}:</label>
						<input type="password" name="password" class="form-control" />
					</div>
					<div class="form-group">
						<label>{REGISTER_RE_PASSWORD_TITLE}:</label>
						<input type="password" name="re_password" class="form-control" />
					</div>
					<div class="form-group">
						<label>{REGISTER_FIRST_NAME_TITLE}:</label>
						<input type="text" name="first_name" class="form-control" />
					</div>
					<div class="form-group">
						<label>{REGISTER_LAST_NAME_TITLE}:</label>
						<input type="text" name="last_name" class="form-control" />
					</div>
					<div class="form-group">
						<label>{REGISTER_SKYPE_TITLE}:</label>
						<input type="text" name="skype" class="form-control" id="phone" />
					</div>
					{reCAPTCHA}
					<div class="form-group">
						<button class="btn btn-success">{REGISTER_SUBMIT}</button>
						<small class="form-text text-muted">{REGISTER_SUBMIT_MESSAGE_TITLE}</small>
					</div>
				</form>
			</div>
		</div>
	</div>
</div>
<?php require view('theme/footer'); ?>