Register

<div class=”lb-wrap“>
<a href=”javascript:void(0);class=”close register_lightbox toggle_lightbox“>x</a>
<div class=”lb-content“>
<form action=”http://development.perfecthideaways.co.za/register/method=”post“>
<h2>Register</h2>
<div class=”row“>
<div class=”f-item full-width“>
<label for=”user_login“>Username</label>
<input tabindex=”27type=”textid=”user_loginname=”user_login” />
</div>
<div class=”f-item full-width“>
<label for=”user_email“>Email</label>
<input tabindex=”28type=”emailid=”user_emailname=”user_email” />
<input type=”hiddenname=”emailid=”emailvalue=”” />
<input type=”hiddenname=”passwordid=”passwordvalue=”” />
</div>
<div class=”f-item captcha full-width“>
<label>How much is 15 + 15?</label>
<input tabindex=”29type=”textrequired=”requiredid=”c_val_s_regname=”c_val_s_reg” />
<input type=”hiddenname=”c_val_1_regid=”c_val_1_regvalue=”F57tlqjinCJklLmoVvK12HIsuZuBalZ6ehSZznWqnAQ=” />
<input type=”hiddenname=”c_val_2_regid=”c_val_2_regvalue=”F57tlqjinCJklLmoVvK12HIsuZuBalZ6ehSZznWqnAQ=” />
</div>
<div class=”f-item one-half“>
<label for=”password“>Password</label>
<input id=”passwordclass=”inputtype=”passwordtabindex=”30size=”25value=”” name=”password” />
</div>
<div class=”f-item one-half“>
<label for=”repeat_password“>Repeat password</label>
<input id=”repeat_passwordclass=”inputtype=”passwordtabindex=”40size=”25value=”” name=”repeat_password” />
</div>
<div class=”f-item checkbox full-width“>
<div class=”checkerid=”uniform-check“><span><input tabindex=”32type=”checkboxvalue=”ch1id=”checkboxagreename=”checkboxagreestyle=”opacity: 0;“></span></div>
<label>I agree to the <a href=””>terms &amp; conditions</a>.</label>
</div>
</div>
<input type=”hiddenid=”_wpnoncename=”_wpnoncevalue=”8ec071f220” /><input type=”hiddenname=”_wp_http_referervalue=”/register/” /> <input type=”hiddenid=”_wpnoncename=”_wpnoncevalue=”6da1b74108” /><input type=”hiddenname=”_wp_http_referervalue=”/register/” /> <input type=”submitid=”registername=”registervalue=”Create accountclass=”gradient-button“/>
</form>
</div>
</div>