{"id":11,"date":"2026-10-13T09:39:40","date_gmt":"2026-10-13T09:39:40","guid":{"rendered":"https:\/\/smartpay.flixvalet.com\/index.php\/smartpay-user-registration\/"},"modified":"2026-10-13T09:39:40","modified_gmt":"2026-10-13T09:39:40","slug":"smartpay-user-registration","status":"publish","type":"page","link":"https:\/\/smartpay.flixvalet.com\/index.php\/smartpay-user-registration\/","title":{"rendered":"Register"},"content":{"rendered":"\n<div class=\"smartpay-registration-page\">\n\t<div class=\"registration-container\">\n\t\t<div class=\"registration-form-wrapper\">\n\t\t\t<div class=\"registration-form-container\">\n\t\t\t\t<div class=\"form-header\">\n\t\t\t\t\t<h1 class=\"form-title\">Create Your Account<\/h1>\n\t\t\t\t\t<p class=\"form-subtitle\">Enter your details to get started<\/p>\n\t\t\t\t<\/div>\n\n\t\t\t\t<!-- Registration Form -->\n\t\t\t\t<form id=\"smartpay-registration-form\" class=\"registration-form\">\n\t\t\t\t\t<!-- Personal Information -->\n\t\t\t\t\t<div class=\"form-row\">\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<label for=\"first_name\">\n\t\t\t\t\t\t\t\tFirst Name <span class=\"required\">*<\/span>\n\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<input\n\t\t\t\t\t\t\t\ttype=\"text\"\n\t\t\t\t\t\t\t\tid=\"first_name\"\n\t\t\t\t\t\t\t\tname=\"first_name\"\n\t\t\t\t\t\t\t\tclass=\"form-control\"\n\t\t\t\t\t\t\t\tplaceholder=\"John\"\n\t\t\t\t\t\t\t\tautocomplete=\"given-name\"\n\t\t\t\t\t\t\t>\n\t\t\t\t\t\t\t<span class=\"error-message\"><\/span>\n\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<label for=\"last_name\">\n\t\t\t\t\t\t\t\tLast Name <span class=\"required\">*<\/span>\n\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<input\n\t\t\t\t\t\t\t\ttype=\"text\"\n\t\t\t\t\t\t\t\tid=\"last_name\"\n\t\t\t\t\t\t\t\tname=\"last_name\"\n\t\t\t\t\t\t\t\tclass=\"form-control\"\n\t\t\t\t\t\t\t\tplaceholder=\"Doe\"\n\t\t\t\t\t\t\t\tautocomplete=\"family-name\"\n\t\t\t\t\t\t\t>\n\t\t\t\t\t\t\t<span class=\"error-message\"><\/span>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t<label for=\"email\">\n\t\t\t\t\t\t\tEmail Address <span class=\"required\">*<\/span>\n\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"input-with-icon\">\n\t\t\t\t\t\t\t<svg class=\"input-icon\" width=\"20\" height=\"20\" viewBox=\"0 0 20 20\" fill=\"none\">\n\t\t\t\t\t\t\t\t<path d=\"M3 4H17C17.55 4 18 4.45 18 5V15C18 15.55 17.55 16 17 16H3C2.45 16 2 15.55 2 15V5C2 4.45 2.45 4 3 4Z\" stroke=\"currentColor\" stroke-width=\"1.5\"\/>\n\t\t\t\t\t\t\t\t<path d=\"M18 5L10 11L2 5\" stroke=\"currentColor\" stroke-width=\"1.5\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/>\n\t\t\t\t\t\t\t<\/svg>\n\t\t\t\t\t\t\t<input\n\t\t\t\t\t\t\t\ttype=\"email\"\n\t\t\t\t\t\t\t\tid=\"email\"\n\t\t\t\t\t\t\t\tname=\"email\"\n\t\t\t\t\t\t\t\tclass=\"form-control with-icon\"\n\t\t\t\t\t\t\t\tplaceholder=\"john.doe@example.com\"\n\t\t\t\t\t\t\t\tautocomplete=\"email\"\n\t\t\t\t\t\t\t>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<span class=\"error-message\"><\/span>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t<label for=\"phone\">\n\t\t\t\t\t\t\tPhone Number\n\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"input-with-icon\">\n\t\t\t\t\t\t\t<svg class=\"input-icon\" width=\"20\" height=\"20\" viewBox=\"0 0 20 20\" fill=\"none\">\n\t\t\t\t\t\t\t\t<path d=\"M18 14.5V17C18 17.2652 17.8946 17.5196 17.7071 17.7071C17.5196 17.8946 17.2652 18 17 18C13.5 17.5 10.5 15.5 8 13C5.5 10.5 3.5 7.5 3 4C3 3.73478 3.10536 3.48043 3.29289 3.29289C3.48043 3.10536 3.73478 3 4 3H6.5C6.63261 3 6.75979 3.05268 6.85355 3.14645C6.94732 3.24021 7 3.36739 7 3.5C7 4.5 7.19 5.39 7.5 6.17C7.54 6.28 7.52 6.41 7.44 6.5L6 8C7 10 10 13 12 14L13.5 12.56C13.59 12.48 13.72 12.46 13.83 12.5C14.61 12.81 15.5 13 16.5 13C16.6326 13 16.7598 13.0527 16.8536 13.1464C16.9473 13.2402 17 13.3674 17 13.5V14.5Z\" stroke=\"currentColor\" stroke-width=\"1.5\"\/>\n\t\t\t\t\t\t\t<\/svg>\n\t\t\t\t\t\t\t<input\n\t\t\t\t\t\t\t\ttype=\"tel\"\n\t\t\t\t\t\t\t\tid=\"phone\"\n\t\t\t\t\t\t\t\tname=\"phone\"\n\t\t\t\t\t\t\t\tclass=\"form-control with-icon\"\n\t\t\t\t\t\t\t\tplaceholder=\"+1 (555) 000-0000\"\n\t\t\t\t\t\t\t\tautocomplete=\"tel\"\n\t\t\t\t\t\t\t>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<span class=\"error-message\"><\/span>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<!-- Address Information -->\n\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t<label for=\"address_line_1\">\n\t\t\t\t\t\t\tStreet Address <span class=\"required\">*<\/span>\n\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"text\"\n\t\t\t\t\t\t\tid=\"address_line_1\"\n\t\t\t\t\t\t\tname=\"address_line_1\"\n\t\t\t\t\t\t\tclass=\"form-control\"\n\t\t\t\t\t\t\tplaceholder=\"123 Main Street\"\n\t\t\t\t\t\t\tautocomplete=\"address-line1\"\n\t\t\t\t\t\t>\n\t\t\t\t\t\t<span class=\"error-message\"><\/span>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t<label for=\"address_line_2\">\n\t\t\t\t\t\t\tApartment, suite, etc.\n\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"text\"\n\t\t\t\t\t\t\tid=\"address_line_2\"\n\t\t\t\t\t\t\tname=\"address_line_2\"\n\t\t\t\t\t\t\tclass=\"form-control\"\n\t\t\t\t\t\t\tplaceholder=\"Apt 4B\"\n\t\t\t\t\t\t\tautocomplete=\"address-line2\"\n\t\t\t\t\t\t>\n\t\t\t\t\t\t<span class=\"error-message\"><\/span>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"form-row\">\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<label for=\"city\">\n\t\t\t\t\t\t\t\tCity <span class=\"required\">*<\/span>\n\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<input\n\t\t\t\t\t\t\t\ttype=\"text\"\n\t\t\t\t\t\t\t\tid=\"city\"\n\t\t\t\t\t\t\t\tname=\"city\"\n\t\t\t\t\t\t\t\tclass=\"form-control\"\n\t\t\t\t\t\t\t\tplaceholder=\"New York\"\n\t\t\t\t\t\t\t\tautocomplete=\"address-level2\"\n\t\t\t\t\t\t\t>\n\t\t\t\t\t\t\t<span class=\"error-message\"><\/span>\n\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<label for=\"state\">\n\t\t\t\t\t\t\t\tState \/ Province <span class=\"required\">*<\/span>\n\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<input\n\t\t\t\t\t\t\t\ttype=\"text\"\n\t\t\t\t\t\t\t\tid=\"state\"\n\t\t\t\t\t\t\t\tname=\"state\"\n\t\t\t\t\t\t\t\tclass=\"form-control\"\n\t\t\t\t\t\t\t\tplaceholder=\"NY\"\n\t\t\t\t\t\t\t\tautocomplete=\"address-level1\"\n\t\t\t\t\t\t\t>\n\t\t\t\t\t\t\t<span class=\"error-message\"><\/span>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"form-row\">\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<label for=\"postal_code\">\n\t\t\t\t\t\t\t\tPostal Code <span class=\"required\">*<\/span>\n\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<input\n\t\t\t\t\t\t\t\ttype=\"text\"\n\t\t\t\t\t\t\t\tid=\"postal_code\"\n\t\t\t\t\t\t\t\tname=\"postal_code\"\n\t\t\t\t\t\t\t\tclass=\"form-control\"\n\t\t\t\t\t\t\t\tplaceholder=\"10001\"\n\t\t\t\t\t\t\t\tautocomplete=\"postal-code\"\n\t\t\t\t\t\t\t>\n\t\t\t\t\t\t\t<span class=\"error-message\"><\/span>\n\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<label for=\"country\">\n\t\t\t\t\t\t\t\tCountry <span class=\"required\">*<\/span>\n\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<select\n\t\t\t\t\t\t\t\tid=\"country\"\n\t\t\t\t\t\t\t\tname=\"country\"\n\t\t\t\t\t\t\t\tclass=\"form-control\"\n\t\t\t\t\t\t\t\tautocomplete=\"country\"\n\t\t\t\t\t\t\t>\n\t\t\t\t\t\t\t\t<option value=\"\">Select Country<\/option>\n\t\t\t\t\t\t\t\t<option value=\"AF\">Afghanistan<\/option><option value=\"AX\">Aland Islands<\/option><option value=\"AL\">Albania<\/option><option value=\"DZ\">Algeria<\/option><option value=\"AS\">American Samoa<\/option><option value=\"AD\">Andorra<\/option><option value=\"AO\">Angola<\/option><option value=\"AI\">Anguilla<\/option><option value=\"AQ\">Antarctica<\/option><option value=\"AG\">Antigua and Barbuda<\/option><option value=\"AR\">Argentina<\/option><option value=\"AM\">Armenia<\/option><option value=\"AW\">Aruba<\/option><option value=\"AU\">Australia<\/option><option value=\"AT\">Austria<\/option><option value=\"AZ\">Azerbaijan<\/option><option value=\"BH\">Bahrain<\/option><option value=\"BD\">Bangladesh<\/option><option value=\"BB\">Barbados<\/option><option value=\"BY\">Belarus<\/option><option value=\"BE\">Belgium<\/option><option value=\"BZ\">Belize<\/option><option value=\"BJ\">Benin<\/option><option value=\"BM\">Bermuda<\/option><option value=\"BT\">Bhutan<\/option><option value=\"BO\">Bolivia<\/option><option value=\"BQ\">Bonaire, Sint Eustatius and Saba<\/option><option value=\"BA\">Bosnia and Herzegovina<\/option><option value=\"BW\">Botswana<\/option><option value=\"BV\">Bouvet Island<\/option><option value=\"BR\">Brazil<\/option><option value=\"IO\">British Indian Ocean Territory<\/option><option value=\"BN\">Brunei<\/option><option value=\"BG\">Bulgaria<\/option><option value=\"BF\">Burkina Faso<\/option><option value=\"BI\">Burundi<\/option><option value=\"KH\">Cambodia<\/option><option value=\"CM\">Cameroon<\/option><option value=\"CA\">Canada<\/option><option value=\"CV\">Cape Verde<\/option><option value=\"KY\">Cayman Islands<\/option><option value=\"CF\">Central African Republic<\/option><option value=\"TD\">Chad<\/option><option value=\"CL\">Chile<\/option><option value=\"CN\">China<\/option><option value=\"CX\">Christmas Island<\/option><option value=\"CC\">Cocos (Keeling) Islands<\/option><option value=\"CO\">Colombia<\/option><option value=\"KM\">Comoros<\/option><option value=\"CG\">Congo<\/option><option value=\"CK\">Cook Islands<\/option><option value=\"CR\">Costa Rica<\/option><option value=\"HR\">Croatia<\/option><option value=\"CU\">Cuba<\/option><option value=\"CW\">Cura\u00e7ao<\/option><option value=\"CY\">Cyprus<\/option><option value=\"CZ\">Czech Republic<\/option><option value=\"CD\">Democratic Republic of the Congo<\/option><option value=\"DK\">Denmark<\/option><option value=\"DJ\">Djibouti<\/option><option value=\"DM\">Dominica<\/option><option value=\"DO\">Dominican Republic<\/option><option value=\"EC\">Ecuador<\/option><option value=\"EG\">Egypt<\/option><option value=\"SV\">El Salvador<\/option><option value=\"GQ\">Equatorial Guinea<\/option><option value=\"ER\">Eritrea<\/option><option value=\"EE\">Estonia<\/option><option value=\"SZ\">Eswatini<\/option><option value=\"ET\">Ethiopia<\/option><option value=\"FK\">Falkland Islands<\/option><option value=\"FO\">Faroe Islands<\/option><option value=\"FJ\">Fiji Islands<\/option><option value=\"FI\">Finland<\/option><option value=\"FR\">France<\/option><option value=\"GF\">French Guiana<\/option><option value=\"PF\">French Polynesia<\/option><option value=\"TF\">French Southern Territories<\/option><option value=\"GA\">Gabon<\/option><option value=\"GE\">Georgia<\/option><option value=\"DE\">Germany<\/option><option value=\"GH\">Ghana<\/option><option value=\"GI\">Gibraltar<\/option><option value=\"GR\">Greece<\/option><option value=\"GL\">Greenland<\/option><option value=\"GD\">Grenada<\/option><option value=\"GP\">Guadeloupe<\/option><option value=\"GU\">Guam<\/option><option value=\"GT\">Guatemala<\/option><option value=\"GG\">Guernsey<\/option><option value=\"GN\">Guinea<\/option><option value=\"GW\">Guinea-Bissau<\/option><option value=\"GY\">Guyana<\/option><option value=\"HT\">Haiti<\/option><option value=\"HM\">Heard Island and McDonald Islands<\/option><option value=\"HN\">Honduras<\/option><option value=\"HK\">Hong Kong S.A.R.<\/option><option value=\"HU\">Hungary<\/option><option value=\"IS\">Iceland<\/option><option value=\"IN\">India<\/option><option value=\"ID\">Indonesia<\/option><option value=\"IR\">Iran<\/option><option value=\"IQ\">Iraq<\/option><option value=\"IE\">Ireland<\/option><option value=\"IL\">Israel<\/option><option value=\"IT\">Italy<\/option><option value=\"CI\">Ivory Coast<\/option><option value=\"JM\">Jamaica<\/option><option value=\"JP\">Japan<\/option><option value=\"JE\">Jersey<\/option><option value=\"JO\">Jordan<\/option><option value=\"KZ\">Kazakhstan<\/option><option value=\"KE\">Kenya<\/option><option value=\"KI\">Kiribati<\/option><option value=\"XK\">Kosovo<\/option><option value=\"KW\">Kuwait<\/option><option value=\"KG\">Kyrgyzstan<\/option><option value=\"LA\">Laos<\/option><option value=\"LV\">Latvia<\/option><option value=\"LB\">Lebanon<\/option><option value=\"LS\">Lesotho<\/option><option value=\"LR\">Liberia<\/option><option value=\"LY\">Libya<\/option><option value=\"LI\">Liechtenstein<\/option><option value=\"LT\">Lithuania<\/option><option value=\"LU\">Luxembourg<\/option><option value=\"MO\">Macau S.A.R.<\/option><option value=\"MG\">Madagascar<\/option><option value=\"MW\">Malawi<\/option><option value=\"MY\">Malaysia<\/option><option value=\"MV\">Maldives<\/option><option value=\"ML\">Mali<\/option><option value=\"MT\">Malta<\/option><option value=\"IM\">Man (Isle of)<\/option><option value=\"MH\">Marshall Islands<\/option><option value=\"MQ\">Martinique<\/option><option value=\"MR\">Mauritania<\/option><option value=\"MU\">Mauritius<\/option><option value=\"YT\">Mayotte<\/option><option value=\"MX\">Mexico<\/option><option value=\"FM\">Micronesia<\/option><option value=\"MD\">Moldova<\/option><option value=\"MC\">Monaco<\/option><option value=\"MN\">Mongolia<\/option><option value=\"ME\">Montenegro<\/option><option value=\"MS\">Montserrat<\/option><option value=\"MA\">Morocco<\/option><option value=\"MZ\">Mozambique<\/option><option value=\"MM\">Myanmar<\/option><option value=\"NA\">Namibia<\/option><option value=\"NR\">Nauru<\/option><option value=\"NP\">Nepal<\/option><option value=\"NL\">Netherlands<\/option><option value=\"NC\">New Caledonia<\/option><option value=\"NZ\">New Zealand<\/option><option value=\"NI\">Nicaragua<\/option><option value=\"NE\">Niger<\/option><option value=\"NG\">Nigeria<\/option><option value=\"NU\">Niue<\/option><option value=\"NF\">Norfolk Island<\/option><option value=\"KP\">North Korea<\/option><option value=\"MK\">North Macedonia<\/option><option value=\"MP\">Northern Mariana Islands<\/option><option value=\"NO\">Norway<\/option><option value=\"OM\">Oman<\/option><option value=\"PK\">Pakistan<\/option><option value=\"PW\">Palau<\/option><option value=\"PS\">Palestinian Territory Occupied<\/option><option value=\"PA\">Panama<\/option><option value=\"PG\">Papua New Guinea<\/option><option value=\"PY\">Paraguay<\/option><option value=\"PE\">Peru<\/option><option value=\"PH\">Philippines<\/option><option value=\"PN\">Pitcairn Island<\/option><option value=\"PL\">Poland<\/option><option value=\"PT\">Portugal<\/option><option value=\"PR\">Puerto Rico<\/option><option value=\"QA\">Qatar<\/option><option value=\"RE\">Reunion<\/option><option value=\"RO\">Romania<\/option><option value=\"RU\">Russia<\/option><option value=\"RW\">Rwanda<\/option><option value=\"SH\">Saint Helena<\/option><option value=\"KN\">Saint Kitts and Nevis<\/option><option value=\"LC\">Saint Lucia<\/option><option value=\"PM\">Saint Pierre and Miquelon<\/option><option value=\"VC\">Saint Vincent and the Grenadines<\/option><option value=\"BL\">Saint-Barthelemy<\/option><option value=\"MF\">Saint-Martin (French part)<\/option><option value=\"WS\">Samoa<\/option><option value=\"SM\">San Marino<\/option><option value=\"ST\">Sao Tome and Principe<\/option><option value=\"SA\">Saudi Arabia<\/option><option value=\"SN\">Senegal<\/option><option value=\"RS\">Serbia<\/option><option value=\"SC\">Seychelles<\/option><option value=\"SL\">Sierra Leone<\/option><option value=\"SG\">Singapore<\/option><option value=\"SX\">Sint Maarten (Dutch part)<\/option><option value=\"SK\">Slovakia<\/option><option value=\"SI\">Slovenia<\/option><option value=\"SB\">Solomon Islands<\/option><option value=\"SO\">Somalia<\/option><option value=\"ZA\">South Africa<\/option><option value=\"GS\">South Georgia<\/option><option value=\"KR\">South Korea<\/option><option value=\"SS\">South Sudan<\/option><option value=\"ES\">Spain<\/option><option value=\"LK\">Sri Lanka<\/option><option value=\"SD\">Sudan<\/option><option value=\"SR\">Suriname<\/option><option value=\"SJ\">Svalbard and Jan Mayen Islands<\/option><option value=\"SE\">Sweden<\/option><option value=\"CH\">Switzerland<\/option><option value=\"SY\">Syria<\/option><option value=\"TW\">Taiwan<\/option><option value=\"TJ\">Tajikistan<\/option><option value=\"TZ\">Tanzania<\/option><option value=\"TH\">Thailand<\/option><option value=\"BS\">The Bahamas<\/option><option value=\"GM\">The Gambia<\/option><option value=\"TL\">Timor-Leste<\/option><option value=\"TG\">Togo<\/option><option value=\"TK\">Tokelau<\/option><option value=\"TO\">Tonga<\/option><option value=\"TT\">Trinidad and Tobago<\/option><option value=\"TN\">Tunsia<\/option><option value=\"TR\">Turkey<\/option><option value=\"TM\">Turkmenistan<\/option><option value=\"TC\">Turks and Caicos Islands<\/option><option value=\"TV\">Tuvalu<\/option><option value=\"UG\">Uganda<\/option><option value=\"UA\">Ukraine<\/option><option value=\"AE\">United Arab Emirates<\/option><option value=\"GB\">United Kingdom<\/option><option value=\"US\">United States<\/option><option value=\"UM\">United States Minor Outlying Islands<\/option><option value=\"UY\">Uruguay<\/option><option value=\"UZ\">Uzbekistan<\/option><option value=\"VU\">Vanuatu<\/option><option value=\"VA\">Vatican City State (Holy See)<\/option><option value=\"VE\">Venezuela<\/option><option value=\"VN\">Vietnam<\/option><option value=\"VG\">Virgin Islands (British)<\/option><option value=\"VI\">Virgin Islands (US)<\/option><option value=\"WF\">Wallis and Futuna Islands<\/option><option value=\"EH\">Western Sahara<\/option><option value=\"YE\">Yemen<\/option><option value=\"ZM\">Zambia<\/option><option value=\"ZW\">Zimbabwe<\/option>\t\t\t\t\t\t\t<\/select>\n\t\t\t\t\t\t\t<span class=\"error-message\"><\/span>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<!-- Account Security -->\n\t\t\t\t\t<div class=\"form-row\">\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<label for=\"password\">\n\t\t\t\t\t\t\t\tPassword <span class=\"required\">*<\/span>\n\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<div class=\"password-input-wrapper\">\n\t\t\t\t\t\t\t\t<input\n\t\t\t\t\t\t\t\t\ttype=\"password\"\n\t\t\t\t\t\t\t\t\tid=\"password\"\n\t\t\t\t\t\t\t\t\tname=\"password\"\n\t\t\t\t\t\t\t\t\tminlength=\"8\"\n\t\t\t\t\t\t\t\t\tclass=\"form-control\"\n\t\t\t\t\t\t\t\t\tplaceholder=\"\u2022\u2022\u2022\u2022\u2022\u2022\u2022\u2022\"\n\t\t\t\t\t\t\t\t\tautocomplete=\"new-password\"\n\t\t\t\t\t\t\t\t>\n\t\t\t\t\t\t\t\t<button type=\"button\" class=\"password-toggle\" data-target=\"password\">\n\t\t\t\t\t\t\t\t\t<svg class=\"eye-icon\" width=\"20\" height=\"20\" viewBox=\"0 0 20 20\" fill=\"none\">\n\t\t\t\t\t\t\t\t\t\t<path d=\"M10 4C4.5 4 2 10 2 10C2 10 4.5 16 10 16C15.5 16 18 10 18 10C18 10 15.5 4 10 4Z\" stroke=\"currentColor\" stroke-width=\"1.5\"\/>\n\t\t\t\t\t\t\t\t\t\t<circle cx=\"10\" cy=\"10\" r=\"3\" stroke=\"currentColor\" stroke-width=\"1.5\"\/>\n\t\t\t\t\t\t\t\t\t<\/svg>\n\t\t\t\t\t\t\t\t<\/button>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"password-strength\"><\/div>\n\t\t\t\t\t\t\t<span class=\"help-text\">Minimum 8 characters with letters and numbers<\/span>\n\t\t\t\t\t\t\t<span class=\"error-message\"><\/span>\n\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<label for=\"confirm_password\">\n\t\t\t\t\t\t\t\tConfirm Password <span class=\"required\">*<\/span>\n\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t<div class=\"password-input-wrapper\">\n\t\t\t\t\t\t\t\t<input\n\t\t\t\t\t\t\t\t\ttype=\"password\"\n\t\t\t\t\t\t\t\t\tid=\"confirm_password\"\n\t\t\t\t\t\t\t\t\tname=\"confirm_password\"\n\t\t\t\t\t\t\t\t\tclass=\"form-control\"\n\t\t\t\t\t\t\t\t\tplaceholder=\"\u2022\u2022\u2022\u2022\u2022\u2022\u2022\u2022\"\n\t\t\t\t\t\t\t\t\tautocomplete=\"new-password\"\n\t\t\t\t\t\t\t\t>\n\t\t\t\t\t\t\t\t<button type=\"button\" class=\"password-toggle\" data-target=\"confirm_password\">\n\t\t\t\t\t\t\t\t\t<svg class=\"eye-icon\" width=\"20\" height=\"20\" viewBox=\"0 0 20 20\" fill=\"none\">\n\t\t\t\t\t\t\t\t\t\t<path d=\"M10 4C4.5 4 2 10 2 10C2 10 4.5 16 10 16C15.5 16 18 10 18 10C18 10 15.5 4 10 4Z\" stroke=\"currentColor\" stroke-width=\"1.5\"\/>\n\t\t\t\t\t\t\t\t\t\t<circle cx=\"10\" cy=\"10\" r=\"3\" stroke=\"currentColor\" stroke-width=\"1.5\"\/>\n\t\t\t\t\t\t\t\t\t<\/svg>\n\t\t\t\t\t\t\t\t<\/button>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<span class=\"error-message\"><\/span>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"checkbox-group\">\n\t\t\t\t\t\t<label class=\"checkbox-label\">\n\t\t\t\t\t\t\t<input type=\"checkbox\" name=\"agree_terms\" id=\"agree_terms\" required>\n\t\t\t\t\t\t\t<span class=\"checkbox-custom\"><\/span>\n\t\t\t\t\t\t\t<span class=\"checkbox-text\">\n\t\t\t\t\t\t\t\tI agree to the <a href=\"#\" target=\"_blank\">Terms of Service<\/a> and <a href=\"#\" target=\"_blank\">Privacy Policy<\/a> <span class=\"required\">*<\/span>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<span 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