<div class="subscribe-form grid-row" id="scroll-form">

        <h1>{{KommaLang::get('subscribeForm')}}</h1>


        {{ Form::open(['url' => URL::to(route('subscribe.process'), [], true), 'id' => 'subscribeForm', 'class' => 'form']) }}

        <div class="initials form-element ">
            {{Form::label('initials',trans('translations.initials'))}}
            <span class="error-message {{($errors->has('initials')? 'active' :'')}}">{{$errors->first('initials')}}</span>
            {{ Form::text('initials', Input::old('initials'), ['id' => 'initials']) }}
        </div>

        <div class="name form-element multiple-elements">
            <span class="error-message {{($errors->has('firstName')? 'active' :'')}}">{{$errors->first('firstName')}}</span>
            <span class="error-message {{($errors->has('lastName')? 'active' :'')}}">{{$errors->first('lastName')}}</span>

            <div class="first-name">
                {{Form::label('first-name',trans('translations.first-name'))}}
                {{ Form::text('firstName', Input::old('first-name'), ['id' => 'first-name']) }}
            </div>

            <div class="last-name">
                {{Form::label('last-name',trans('translations.last-name'))}}
                {{ Form::text('lastName', Input::old('last-name'), ['id' => 'last-name']) }}
            </div>
        </div>

        <div class="street form-element multiple-elements">
            <span class="error-message {{($errors->has('street')? 'active' :'')}}">{{$errors->first('street')}}</span>
            <span class="error-message {{($errors->has('houseNumber')? 'active' :'')}}">{{$errors->first('houseNumber')}}</span>

            <div class="street-name">
                {{Form::label('street',trans('translations.street'))}}
                {{ Form::text('street', Input::old('street'), ['id' => 'street']) }}
            </div>

            <div class="house-number">
                {{Form::label('house-number',trans('translations.house-number'))}}
                {{ Form::text('houseNumber', Input::old('house-number'), ['id' => 'house-number']) }}
            </div>
        </div>

        <div class="location form-element multiple-elements">
            <span class="error-message {{($errors->has('city')? 'active' :'')}}">{{$errors->first('city')}}</span>
            <span class="error-message {{($errors->has('zip')? 'active' :'')}}">{{$errors->first('zip')}}</span>

            <div class="city">
                {{Form::label('city',trans('translations.city'))}}
                {{ Form::text('city', Input::old('city'), ['id' => 'city']) }}
            </div>

            <div class="zip">
                {{Form::label('zip',trans('translations.zip'))}}
                {{ Form::text('zip', Input::old('zip'), ['id' => 'zip']) }}
            </div>
        </div>

        <div class="country form-element ">
            {{Form::label('country',trans('translations.country'))}}
            <span class="error-message {{($errors->has('country')? 'active' :'')}}">{{$errors->first('country')}}</span>
            {{ Form::text('country', Input::old('country'), ['id' => 'country']) }}
        </div>

        <div class="mail-number form-element multiple-elements">
            <span class="error-message {{($errors->has('email')? 'active' :'')}}">{{$errors->first('email')}}</span>
            <span class="error-message {{($errors->has('phone')? 'active' :'')}}">{{$errors->first('phone')}}</span>

            <div class="email">
                {{Form::label('email',trans('translations.email'))}}
                {{ Form::email('email', Input::old('email'), ['id' => 'email']) }}
            </div>

            <div class="phone">
                {{Form::label('phone',trans('translations.phone'))}}
                {{ Form::text('phone', Input::old('phone'), ['id' => 'phone']) }}
            </div>
        </div>

        <div class="account-number form-element">
            {{Form::label('account-number',trans('translations.account-number'))}}
            <span class="error-message {{($errors->has('accountNumber')? 'active' :'')}}">{{$errors->first('accountNumber')}}</span>
            {{ Form::text('accountNumber', Input::old('accountNumber'), ['id' => 'account-number']) }}

        </div>

        <div class="form-element">
            <div class="g-recaptcha" data-sitekey="6LfQlkQrAAAAADd8iixJpdoaa3oLC2-MixV1ID-p"></div>
            <span class="error-message {{($errors->has('recaptcha')? 'active' :'')}}">{{$errors->first('recaptcha')}}</span>
        </div>

        <div class="submit">
            @lang('translations.send')
            {{ Form::submit(trans('translations.send')) }}
        </div>

        {{ Form::close() }}

</div>