175 lines
4.9 KiB
Plaintext
175 lines
4.9 KiB
Plaintext
<%- include('partials/header') %>
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<% if (typeof error !== 'undefined') { %>
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<div class="alert alert-danger">
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⚠️ <%= error %>
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</div>
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<% } %>
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<h2 class="text-center mb-4">Mitglied werden</h2>
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<form method="POST" action="/register/create" class="row g-3">
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<!-- ================= -->
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<!-- PERSÖNLICHE DATEN -->
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<!-- ================= -->
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<h4>Persönliche Daten</h4>
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<div class="col-md-6">
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<input name="vorname" class="form-control" placeholder="Vorname" required>
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</div>
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<div class="col-md-6">
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<input name="nachname" class="form-control" placeholder="Nachname" required>
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</div>
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<!-- ================= -->
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<!-- ADRESSE -->
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<!-- ================= -->
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<h4 class="mt-4">Adresse</h4>
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<div class="col-md-6">
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<input name="strasse" class="form-control" placeholder="Straße" required>
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</div>
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<div class="col-md-2">
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<input name="hausnummer" class="form-control" placeholder="Nr." required>
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</div>
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<div class="col-md-2">
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<input name="plz" class="form-control" placeholder="PLZ" required>
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</div>
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<div class="col-md-4">
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<input name="ort" class="form-control" placeholder="Ort" required>
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</div>
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<div class="col-md-4">
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<input name="land" class="form-control" placeholder="Land" value="Deutschland">
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</div>
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<!-- ================= -->
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<!-- KONTAKT -->
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<!-- ================= -->
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<h4 class="mt-4">Kontakt</h4>
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<div class="col-md-4">
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<input name="mobil" class="form-control" placeholder="Mobilnummer" required>
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</div>
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<div class="col-md-4">
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<input name="telefon" class="form-control" placeholder="Telefon">
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</div>
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<div class="col-md-4">
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<input type="email" name="email" class="form-control" placeholder="E-Mail" required>
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</div>
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<!-- ================= -->
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<!-- VERTRAG -->
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<!-- ================= -->
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<h4 class="mt-4">Vertrag</h4>
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<div class="col-md-12">
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<select name="vertragsvariante" class="form-select" required>
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<option value="">Bitte Vertrag auswählen</option>
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<% vertragsarten.forEach(v => { %>
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<option value="<%= v.id %>"
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<%= selectedVertrag == v.id ? 'selected' : '' %>>
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<%= v.name %> – <%= v.betrag.toFixed(2) %> € / Monat
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</option>
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<% }) %>
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</select>
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</div>
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<div class="col-md-12">
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<input class="form-control bg-light" disabled
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placeholder="Vertragsnummer wird automatisch vergeben">
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</div>
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<!-- ================= -->
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<!-- SEPA -->
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<!-- ================= -->
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<h4 class="mt-4">SEPA-Lastschrift</h4>
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<div class="col-md-6">
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<input name="kontoinhaber" class="form-control"
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placeholder="Kontoinhaber" required>
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</div>
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<div class="col-md-6">
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<input name="mandatsreferenz" class="form-control"
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placeholder="Mandatsreferenz" required>
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</div>
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<div class="col-md-6">
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<input name="iban" class="form-control"
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placeholder="IBAN" required>
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</div>
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<div class="col-md-6">
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<input name="bic" class="form-control"
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placeholder="BIC" required>
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</div>
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<!-- ✅ EINZIGE SEPA-ZUSTIMMUNG -->
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<div class="col-md-12 form-check mt-2">
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<input
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type="checkbox"
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class="form-check-input"
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id="agreeSepa"
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name="agreeSepa"
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required>
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<label class="form-check-label" for="agreeSepa">
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Ich erteile ein SEPA-Lastschriftmandat und stimme der Abbuchung zu.
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</label>
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</div>
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<!-- ================= -->
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<!-- RECHTLICHES -->
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<!-- ================= -->
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<hr class="my-4">
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<h5>Rechtliches</h5>
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<div class="form-check mb-2">
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<input class="form-check-input"
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type="checkbox"
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id="agreeConsent"
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name="agreeConsent"
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required>
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<label class="form-check-label" for="agreeConsent">
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Ich habe die
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<a href="/documents/Einverstaendniserklaerung.pdf" target="_blank">
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Einverständniserklärung
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</a>
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gelesen.
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</label>
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</div>
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<div class="form-check mb-3">
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<input class="form-check-input"
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type="checkbox"
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id="agreeAgb"
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name="agreeAgb"
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required>
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<label class="form-check-label" for="agreeAgb">
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Ich akzeptiere die
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<a href="https://plusfit24.de/wp-content/uploads/2022/11/AG_PlusFit24.pdf" target="_blank">
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AGB
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</a>.
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</label>
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</div>
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<!-- ================= -->
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<!-- ABSCHICKEN -->
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<!-- ================= -->
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<div class="col-12 mt-4">
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<button type="submit" class="btn btn-success btn-lg w-100">
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💳 Kostenpflichtig verbindlich abschließen
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</button>
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</div>
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</form>
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<%- include('partials/footer') %>
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