<!DOCTYPE html>
<html>
<head>
<title>Hotel Reservation Form</title>
<link href="https://fonts.googleapis.com/css?family=Roboto:300,400,500,700" rel="stylesheet">
<link rel="stylesheet" href="https://use.fontawesome.com/releases/v5.5.0/css/all.css" integrity="sha384-B4dIYHKNBt8Bc12p+WXckhzcICo0wtJAoU8YZTY5qE0Id1GSseTk6S+L3BlXeVIU" crossorigin="anonymous">
<style>
html, body {
min-height: 100%;
}
body, div, form, input, select, textarea, label {
padding: 0;
margin: 0;
outline: none;
font-family: Roboto, Arial, sans-serif;
font-size: 14px;
color: #666;
line-height: 22px;
}
h1 {
position: absolute;
margin: 0;
font-size: 50px;
color: #fff;
z-index: 2;
line-height: 83px;
}
legend {
padding: 10px;
font-family: Roboto, Arial, sans-serif;
font-size: 18px;
color: #fff;
background-color: #006622;
}
textarea {
width: calc(100% - 12px);
padding: 5px;
}
.testbox {
display: flex;
justify-content: center;
align-items: center;
height: inherit;
padding: 20px;
}
form {
width: 100%;
padding: 20px;
border-radius: 6px;
background: #fff;
box-shadow: 0 0 8px #006622;
}
.banner {
position: relative;
height: 250px;
background-image: url("/uploads/media/default/0001/02/b23a2c8c49b8e43249487140e4c2e22a63bd7cb8.jpeg");
background-size: cover;
display: flex;
justify-content: center;
align-items: center;
text-align: center;
}
.banner::after {
content: "";
background-color: rgba(0, 0, 0, 0.4);
position: absolute;
width: 100%;
height: 100%;
}
input, select, textarea {
margin-bottom: 10px;
border: 1px solid #ccc;
border-radius: 3px;
}
input {
width: calc(100% - 10px);
padding: 5px;
}
input[type="date"] {
padding: 4px 5px;
}
textarea {
width: calc(100% - 12px);
padding: 5px;
}
.item:hover p, .item:hover i, .question:hover p, .question label:hover, input:hover::placeholder {
color: #006622;
}
.item input:hover, .item select:hover, .item textarea:hover {
border: 1px solid transparent;
box-shadow: 0 0 3px 0 #006622;
color: #006622;
}
.item {
position: relative;
margin: 10px 0;
}
.item span {
color: red;
}
input[type="date"]::-webkit-inner-spin-button {
display: none;
}
.item i, input[type="date"]::-webkit-calendar-picker-indicator {
position: absolute;
font-size: 20px;
color: #00b33c;
}
.item i {
right: 1%;
top: 30px;
z-index: 1;
}
.week {
display:flex;
justify-content:space-between;
}
.columns {
display:flex;
justify-content:space-between;
flex-direction:row;
flex-wrap:wrap;
}
.columns div {
width:48%;
}
[type="date"]::-webkit-calendar-picker-indicator {
right: 1%;
z-index: 2;
opacity: 0;
cursor: pointer;
}
input[type=radio], input[type=checkbox] {
display: none;
}
label.radio {
position: relative;
display: inline-block;
margin: 5px 20px 15px 0;
cursor: pointer;
}
.question span {
margin-left: 30px;
}
.question-answer label {
display: block;
}
label.radio:before {
content: "";
position: absolute;
left: 0;
width: 17px;
height: 17px;
border-radius: 50%;
border: 2px solid #ccc;
}
input[type=radio]:checked + label:before, label.radio:hover:before {
border: 2px solid #006622;
}
label.radio:after {
content: "";
position: absolute;
top: 6px;
left: 5px;
width: 8px;
height: 4px;
border: 3px solid #006622;
border-top: none;
border-right: none;
transform: rotate(-45deg);
opacity: 0;
}
input[type=radio]:checked + label:after {
opacity: 1;
}
.flax {
display:flex;
justify-content:space-around;
}
.btn-block {
margin-top: 10px;
text-align: center;
}
button {
width: 150px;
padding: 10px;
border: none;
border-radius: 5px;
background: #006622;
font-size: 16px;
color: #fff;
cursor: pointer;
}
button:hover {
background: #00b33c;
}
@media (min-width: 568px) {
.name-item, .city-item {
display: flex;
flex-wrap: wrap;
justify-content: space-between;
}
.name-item input, .name-item div {
width: calc(50% - 20px);
}
.name-item div input {
width:97%;}
.name-item div label {
display:block;
padding-bottom:5px;
}
}
</style>
</head>
<body>
<div class="testbox">
<form>
<div class="banner">
<h1>Hotel Reservation Form</h1>
</div>
<br/>
<fieldset>
<legend>Reservation Details</legend>
<div class="columns">
<div class="item">
<label for="fname">First Name<span>*</span></label>
<input id="fname" type="text" name="fname" />
</div>
<div class="item">
<label for="lname"> Last Name<span>*</span></label>
<input id="lname" type="text" name="lname" />
</div>
<div class="item">
<label for="address">Address<span>*</span></label>
<input id="address" type="text" name="address" />
</div>
<div class="item">
<label for="zip">Zip Code<span>*</span></label>
<input id="zip" type="text" name="zip" required/>
</div>
<div class="item">
<label for="city">City<span>*</span></label>
<input id="city" type="text" name="city" />
</div>
<div class="item">
<label for="state">State<span>*</span></label>
<input id="state" type="text" name="state" />
</div>
<div class="item">
<label for="eaddress">Email Address<span>*</span></label>
<input id="eaddress" type="text" name="eaddress" />
</div>
<div class="item">
<label for="phone">Phone<span>*</span></label>
<input id="phone" type="tel" name="phone" />
</div>
</fieldset>
<br/>
<fieldset>
<legend>Dates</legend>
<div class="columns">
<div class="item">
<label for="checkindate">Check-in Date <span>*</span></label>
<input id="checkindate" type="date" name="checkindate" />
<i class="fas fa-calendar-alt"></i>
</div>
<div class="item">
<label for="checkoutdate">Check-out Date <span>*</span></label>
<input id="checkoutdate" type="date" name="checkoutdate" />
<i class="fas fa-calendar-alt"></i>
</div>
<div class="item">
<p>Check-in Time </p>
<select>
<option value="" disabled selected>Select time</option>
<option value="1" >Morning</option>
<option value="2">Afternoon</option>
<option value="3">Evening</option>
</select>
</div>
<div class="item">
<p>Check-out Time </p>
<select>
<option value="4" disabled selected>Select time</option>
<option value="5" >Morning</option>
<option value="6">Afternoon</option>
<option value="7">Evening</option>
</select>
</div>
<div class="item">
<p>How many adults are coming?</p>
<select>
<option value="8" disabled selected>Number of adults</option>
<option value="9" >1</option>
<option value="10">2</option>
<option value="11">3</option>
<option value="12">4</option>
<option value="13">5</option>
</select>
</div>
<div class="item">
<p>How many children are coming?</p>
<select>
<option value="14" disabled selected>Number of children</option>
<option value="15" >0</option>
<option value="16">1</option>
<option value="17">2</option>
<option value="18">3</option>
<option value="19">4</option>
<option value="19">5</option>
</select>
</div>
<div class="item" style=width:100%>
<label for="room">Number of rooms</label>
<input id="room" type="number" name="room" />
</div>
<div class="item">
<p>Room 1 type</p>
<select>
<option value="20" selected></option>
<option value="21">Standard</option>
<option value="22">Deluxe</option>
<option value="23">Suite</option>
</select>
</div>
<div class="item">
<p>Room 2 type</p>
<select>
<option value="24" selected></option>
<option value="25">Standard</option>
<option value="26">Deluxe</option>
<option value="27">Suite</option>
</select>
</div>
</div>
<div class="item">
<label for="instruction">Special Instructions</label>
<textarea id="instruction" rows="3"></textarea>
</div>
</fieldset>
<div class="btn-block">
<button type="submit" href="/">Submit</button>
</div>
</form>
</div>
</body>
</html>