Fill in the form
to register

@if(Session::has('notification'))

@endif

{{ Form::open(['route' => ['post_registration'],'class' => 'form-registration']) }}

Firstname *

{{ Form::text('firstname',Input::old('firstname'),['id'=>'firstname','class'=>($errors->first('firstname')) ? 'error' : 'ok']) }}

Surname *

Please right down the surname that appears on your passport

{{ Form::text('surname',Input::old('surname'),['id'=>'surname','class'=>($errors->first('surname')) ? 'error' : 'ok']) }}

Email address *

{{ Form::text('email',Input::old('email'),['id'=>'email','class'=>($errors->first('email')) ? 'error' : 'ok']) }}

Date of Birth *

{{ Form::select('month_date_of_birth',$months,Input::old('month_date_of_birth'),['class'=>($errors->first('month_date_of_birth')) ? 'month error' : 'month ok']) }} {{ Form::select('day_date_of_birth',$days,Input::old('day_date_of_birth'),['class'=>($errors->first('day_date_of_birth')) ? 'day error' : 'day ok']) }} {{ Form::select('year_date_of_birth',$years,Input::old('year_date_of_birth'),['class'=>($errors->first('year_date_of_birth')) ? 'year error' : 'year ok']) }}

Nationality *

{{ Form::text('nationality',Input::old('nationality'),['id'=>'nationality','class'=>($errors->first('nationality')) ? 'error' : 'ok']) }}

Passport number *

{{ Form::text('passport_number',Input::old('passport_number'),['id'=>'passport_number','class'=>($errors->first('passport_number')) ? 'error' : 'ok']) }}

Passport date of expiry *

{{ Form::select('month_passport',$months,Input::old('month_passport'),['class'=>($errors->first('month_passport')) ? 'month error' : 'month ok']) }} {{ Form::select('day_passport',$days,Input::old('day_passport'),['class'=>($errors->first('day_passport')) ? 'day error' : 'day ok']) }} {{ Form::select('year_passport',$years_passport,Input::old('year_passport'),['class'=>($errors->first('year_passport')) ? 'year error' : 'year ok']) }}

Home address *

{{ Form::text('address',Input::old('address'),['id'=>'address','class'=>($errors->first('address')) ? 'error' : 'ok']) }} {{ Form::text('address_bis',Input::old('address_bis')) }}

City *

{{ Form::text('city',Input::old('city'),['id'=>'city','class'=>($errors->first('city')) ? 'error' : 'ok']) }}

ZIP code *

{{ Form::text('zip_code',Input::old('zip_code'),['id'=>'zip_code','class'=>($errors->first('zip_code')) ? 'error' : 'ok']) }}

Country *

{{ Form::text('country',Input::old('country'),['id'=>'country','class'=>($errors->first('country')) ? 'error' : 'ok']) }}

Indicate your airport of departure / arrival *

{{ Form::text('date_airport',Input::old('date_airport'),['id'=>'date_airport','class'=>($errors->first('date_airport')) ? 'error' : 'ok']) }}

We will book your flights according to the Convention agenda: outbound on February 3^rd / outward on February 5^th

Do you need an invitation letter to get your visa ? *

{{ Form::radio('invitation_letter','y',Input::old('invitation_letter'),['id'=>'invitation_letter_y']) }} Yes {{ Form::radio('invitation_letter','n',Input::old('invitation_letter'),['id'=>'invitation_letter_n']) }} No

{{ Form::textarea('comment',Input::old('comment'),['placeholder'=>'Leave a comment','class'=>'last-textarea']) }}

You will be in twin bedrooms. We offer you the possibility to chose the person you want to share the room with. Please indicate the firstname and surname of this person:

Fistname

{{ Form::text('firstname_second',Input::old('firstname_second'),['id'=>'firstname_second']) }}

Surname

{{ Form::text('surname_second',Input::old('surname_second'),['id'=>'surname_second']) }}

Dietary restrictions

{{ Form::radio('dietary_restrictions','Végétarien',Input::old('dietary_restrictions'),['id'=>'dietary_restrictions_vegetarian']) }} Vegetarian

{{ Form::radio('dietary_restrictions','Pas de porc',Input::old('dietary_restrictions'),['id'=>'dietary_restrictions_no_pork']) }} No pork

{{ Form::radio('dietary_restrictions','Kasher',Input::old('dietary_restrictions'),['id'=>'dietary_restrictions_kasher']) }} Kasher

{{ Form::radio('dietary_restrictions','Autre',Input::old('dietary_restrictions'),['id'=>'dietary_restrictions_other']) }} Other

{{ Form::radio('dietary_restrictions','Sans gluten',Input::old('dietary_restrictions'),['id'=>'dietary_restrictions_gluten_free']) }} Gluten free

{{ Form::radio('dietary_restrictions','Halal',Input::old('dietary_restrictions'),['id'=>'dietary_restrictions_halal']) }} Halal

{{ Form::radio('dietary_restrictions','Sans lactose',Input::old('dietary_restrictions'),['id'=>'dietary_restrictions_lactose_free']) }} Lactose free

{{ form::textarea('desc_dietary_restrictions',Input::old('desc_dietary_restrictions'),['placeholder'=>'Please right down any other dietary restriction or allergy you may have']) }}

I want to participate to the following activity on Wednesday 3rd (Please choose only one) *

{{ Form::radio('activity','Moroccan art and craft tour',Input::old('activity'),['id'=>'activity_1']) }}

Moroccan art and craft tour (14h30 – 18h00)
Visit of the souks with a focus on old and new craft

{{ Form::radio('activity','Marrakech history tour',Input::old('activity'),['id'=>'activity_2']) }}

Marrakech history tour (14h30 – 18h00)
Visit of the Medina with a focus on Palace and landmarks

{{ Form::radio('activity','Cooking class at a Medina\'s Palace',Input::old('activity'),['id'=>'activity_3']) }}

Cooking class at a Medina's Palace (14h30 – 17h30)
Introduction to Moroccan cuisine
Warning : limited number of participants allowed. Only the first 40 people registered will attend this activity.

{{ Form::radio('activity','9 hole golf game',Input::old('activity'),['id'=>'activity_4']) }}

9 hole golf game (equipment provided / 14h30 – 17h30)

{{ Form::radio('activity','Camel ride in the Marrakech Palm grove, 14H30 - 16H00 + free time',Input::old('activity'),['id'=>'activity_5']) }}

Camel ride in the Marrakech Palm grove + free time at the hotel (camel ride from 14h30 to 16h00 + free time)

{{ Form::radio('activity','Camel ride in the Marrakech Palm grove, free time + 16H00 - 17H30',Input::old('activity'),['id'=>'activity_6']) }}

Camel ride in the Marrakech Palm grove + free time at the hotel (free time + camel ride from 16h00 to 17h30)
Warning : if the slot you choose is not available anymore you will be automatically registered for the other one

{{ Form::radio('activity','Golf lesson',Input::old('activity'),['id'=>'activity_7']) }}

Golf lesson (introduction to golf) at the hotels' Golf Club + free time at the hotel (lesson from 14h30 to 17h30 + free time)

{{ Form::close() }} If you want to
extend your stay
in Marrakech,
please contact
diorconvention2016@spiceup.fr
within 48 hours after
your registration