1import{b as p,j as e}from"./app-DCmRnz1M.js";import{P as n,c as d,L as c}from"./base-Ck7RNkmN.js";import{R as u}from"./RegisterController-DHIb3a0F.js";import{B as f}from"./Button-X00moFao.js";import{B as g,R as h}from"./login-hero-Dsnfj_6h.js";import{P as w}from"./page-CFPOzVun.js";import{C as x}from"./checkbox-CqWJA5B_.js";import{I as s}from"./input-Dh_hg154.js";import{s as b}from"./utils-DRFJABgr.js";/* empty css */import"./index-_JifkXZ6.js";import"./Combination-BbvaEwml.js";import"./index--bH0ejcI.js";import"./FlashMessages-N4kk4jNE.js";import"./alert-onOjm6B_.js";import"./IconChevronLeft-C8_Fvxnr.js";import"./GlobalNoticeBox-Deu1ezlH.js";function D(){const{data:a,setData:o,post:l,processing:i,errors:t}=p({first_name:"",last_name:"",email:"",password:"",password_confirmation:"",newsletter:!1,accept_rules:""}),m=r=>{r.preventDefault(),l(u.register().url,{onError:()=>{b()}})};return e.jsx(w,{children:e.jsx(g,{image:h,imageAlt:"Mother using breast pump with baby",title:"Create a new account",description:"Please fill in the form below to create a new account.",back:{href:c.showLoginForm().url,label:"Back to login"},children:e.jsxs("form",{onSubmit:m,className:"space-y-6",children:[e.jsxs("div",{className:"grid gap-4 md:grid-cols-2",children:[e.jsx(s,{label:"First Name",name:"first_name",autoComplete:"given-name",required:!0,value:a.first_name,onChange:r=>o("first_name",r.target.value),placeholder:"First Name",error:t.first_name}),e.jsx(s,{label:"Last Name",name:"last_name",autoComplete:"family-name",required:!0,value:a.last_name,onChange:r=>o("last_name",r.target.value),placeholder:"Last Name",error:t.last_name})]}),e.jsx(s,{label:"E-mail address",type:"email",name:"email",autoComplete:"email",required:!0,value:a.email,onChange:r=>o("email",r.target.value),placeholder:"E-mail address",error:t.email}),e.jsx(s,{label:"Password",type:"password",name:"password",autoComplete:"new-password",required:!0,value:a.password,onChange:r=>o("password",r.target.value),placeholder:"Password",error:t.password}),e.jsx(s,{label:"Confirm Password",type:"password",name:"password_confirmation",autoComplete:"new-password",required:!0,value:a.password_confirmation,onChange:r=>o("password_confirmation",r.target.value),placeholder:"Confirm Password",error:t.password_confirmation}),e.jsx(x,{label:"I want to receive offers and further information on breastfeeding from Medela.",checked:a.newsletter,onChange:r=>o("newsletter",r.target.checked)}),e.jsx("input",{type:"text",name:"accept_rules",value:a.accept_rules,onChange:r=>o("accept_rules",r.target.value),tabIndex:-1,autoComplete:"off",style:{position:"absolute",left:"-9999px"}}),e.jsxs("p",{className:"text-sm leading-5 font-light text-black",children:["By registering for a Medela Account, I agree to Medela's"," ",e.jsx("a",{href:n.index["/{page}/{subs?}"].url({page:"privacy-policy"}),target:"_blank",rel:"noopener noreferrer",className:"font-normal underline decoration-solid underline-offset-2 hover:text-primary",children:"Privacy Policy"})," ","and"," ",e.jsx("a",{href:n.index["/{page}/{subs?}"].url({page:"terms-and-conditions"}),target:"_blank",rel:"noopener noreferrer",className:"font-normal underline decoration-solid underline-offset-2 hover:text-primary",children:"Terms and Conditions of use"}),"."]}),e.jsxs(f,{type:"submit",variant:"primary",loading:i,className:"w-full",children:[e.jsx(d,{className:"size-5"}),"Create an Account"]})]})})})}export{D as default};
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