Linux SRV-16 6.18.44-paas #1 SMP PREEMPT_DYNAMIC Thu Aug 13 10:08:12 UTC 2026 x86_64
/srv/data/web/vhosts/www.volley92.asso.fr/htdocs/modules/
/srv/data/web/vhosts/www.volley92.asso.fr/htdocs/modules/pre-devis.php
 <?php include "functions/devis-home.php" ?>
<div class="pre-reservation">
    <h2 class="tit"><span >Je réserve en ligne</span></h2>
    <?=form_open("#carousel-header",array('class'=>'p20'))?>

           <div class="row" >
                 <div class="col-xs-6 col-sm-6 col-md-6 col-lg-6 clabel">
                    <div class="form-group has-feedback <?=$data['lastname']['status']?>">
                        <?=form_label($data['lastname']['label'],'lastname')?><br/>
                        <?=form_text('lastname',$data['lastname']['value'],array('class'=>'form-control','placeholder'=>'Nom'))?>
                        <?=form_feedback($form_is_submitted,$data['lastname']['status'])?>
                    </div>
                </div>

                <div class="col-xs-6 col-sm-6 col-md-6 col-lg-6  clabel">
                    <div class="form-group has-feedback <?=$data['phone']['status']?>">
                        <?=form_label($data['phone']['label'],'phone')?>
                        <?=form_text('phone',$data['phone']['value'],array('class'=>'form-control','placeholder'=>'Tél'))?>
                        <?=form_feedback($form_is_submitted,$data['phone']['status'])?>
                    </div>
                </div>
             </div>
            <div class="row" >
                <div class="col-xs-12 clabel ">
                    <div class=" padl form-group has-feedback <?=$data['email']['status']?>">
                        <?=form_label($data['email']['label'],'email')?><br/>
                        <?=form_text('email',$data['email']['value'],array('class'=>'form-control ','placeholder'=>'text@exemple.fr'))?>
                        <?=form_feedback($form_is_submitted,$data['email']['status'])?>
                    </div>
                </div>
            </div>
            <div class="row" >
                 <div class="col-xs-6  clabel">
                    <div class="form-group has-feedback <?=$data['adressdep']['status']?>">
                        <?=form_label($data['adressdep']['label'],'adressdep')?><br/>
                        <?=form_text('adressdep',$data['adressdep']['value'],array('class'=>'form-control','placeholder'=>'Adresse de départ'))?>
                        <?=form_feedback($form_is_submitted,$data['adressdep']['status'])?>
                    </div>
                </div>

                <div class="col-xs-6  clabel">
                    <div class="form-group has-feedback <?=$data['adressarr']['status']?>">
                        <?=form_label($data['adressarr']['label'],'adressarr')?><br/>
                        <?=form_text('adressarr',$data['adressarr']['value'],array('class'=>'form-control','placeholder'=>'Adresse d’arrivée:'))?>
                        <?=form_feedback($form_is_submitted,$data['adressarr']['status'])?>
                    </div>
                </div>
            </div>

            <div class="row" >
                <div class="col-xs-6">
                    <div class="form-group has-feedback <?=$data['date1']['status']?>">
                        <?=form_label($data['date1']['label'],'date1')?>
                        <div class="input-group bootstrap-datepicker">
                            <?=form_text('date1',$data['date1']['value'],array('class'=>'form-control','placeholder'=>date("d/m/Y")))?>
                            <span class="input-group-addon"><span class="fa fa-calendar fa-fw"></span></span>
                        </div>
                    </div>
                </div>
                <div class="col-xs-6">
                    <div class="form-group has-feedback <?=$data['hour1']['status']?>">
                        <?=form_label($data['hour1']['label'],'date1')?>
                        <div class="input-group clockpicker">
                            <?=form_text('hour1',$data['hour1']['value'],array('class'=>'form-control','placeholder'=>date("H:i")))?>
                            <span class="input-group-addon"><span class="fa fa-clock-o fa-fw"></span></span>
                        </div>
                    </div>
                </div>
            </div>
            <div class="text-center">
                <input id="btSubmit" class="button" name="devis" type="submit" value="Envoyer">
            </div> 
        <br>
    <?=form_close()?>
</div>