<link href="//netdna.bootstrapcdn.com/bootstrap/3.1.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css">
<script src="//netdna.bootstrapcdn.com/bootstrap/3.1.0/js/bootstrap.min.js"></script>
<script src="//code.jquery.com/jquery-1.11.1.min.js"></script>
<!------ Include the above in your HEAD tag ---------->
<div class="container">
<div class="row">
<h3 class="col-sm-offset-3 col-sm-6">Signup</h3>
</div
<div class="row">
<div class="col-sm-offset-1 col-sm-2">
xxx
</div>
<div class="col-sm-6">
<form action="r" method="post" accept-charset="utf-8" class="form" role="form">
<div class="row">
<div class="col-xs-6 col-md-6">
<input type="text" name="firstname" value="" class="form-control input-lg" placeholder="First Name" /> </div>
<div class="col-xs-6 col-md-6">
<input type="text" name="lastname" value="" class="form-control input-lg" placeholder="Last Name" /> </div>
</div>
<input type="text" name="email" value="" class="form-control input-lg" placeholder="Your Email" /><input type="password" name="password" value="" class="form-control input-lg" placeholder="Password" /><input type="password" name="confirm_password" value="" class="form-control input-lg" placeholder="Confirm Password" />
<label>Birth Date</label>
<div class="row">
<div class="col-xs-4 col-md-4">
<select name="month" class = "form-control input-lg">
<option value="01">Jan</option><option value="02">Feb</option><option value="03">Mar</option>
<option value="04">Apr</option><option value="05">May</option><option value="06">Jun</option>
<option value="07">Jul</option><option value="08">Aug</option><option value="09">Sep</option>
<option value="10">Oct</option><option value="11">Nov</option><option value="12">Dec</option>
</select>
</div>
<div class="col-xs-4 col-md-4">
<select name="day" class = "form-control input-lg">
<option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option>
<option value="5">5</option><option value="6">6</option><option value="7">7</option><option value="8">8</option>
<option value="9">9</option><option value="10">10</option><option value="11">11</option><option value="12">12</option>
<option value="13">13</option><option value="14">14</option><option value="15">15</option><option value="16">16</option>
<option value="17">17</option><option value="18">18</option><option value="19">19</option><option value="21">21</option>
<option value="22">22</option><option value="23">23</option><option value="24">24</option><option value="25">25</option>
<option value="26">26</option><option value="27">27</option><option value="28">28</option><option value="29">29</option>
<option value="30">30</option><option value="31">31</option>
</select>
</div>
<div class="col-xs-4 col-md-4">
<select name="year" class = "form-control input-lg">
<option value="2001">2001</option><option value="2002">2002</option><option value="2003">2003</option><option value="2004">2004</option>
<option value="2005">2005</option><option value="2006">2006</option><option value="2007">2007</option><option value="2008">2008</option>
<option value="2009">2009</option><option value="2010">2010</option><option value="2011">2011</option><option value="2012">2012</option>
<option value="2013">2013</option>
</select>
</div>
</div>
<label>Gender : </label>
<label class="radio-inline">
<input type="radio" name="gender" value="M" id=male />Male
</label>
<label class="radio-inline">
<input type="radio" name="gender" value="F" id=female />Female
</label>
<br />
<span class="help-block">By clicking Create my account, you agree to our Terms and that you have read our Data Use Policy, including our Cookie Use.</span>
<button class="btn btn-lg btn-primary btn-block signup-btn" type="submit">Create my account</button>
</form>
</div>
</div>
</div>
</div>
legend{
color:#141823;
font-size:25px;
font-weight:bold;
}
.signup-btn {
background: #79bc64;
background-image: -webkit-linear-gradient(top, #79bc64, #578843);
background-image: -moz-linear-gradient(top, #79bc64, #578843);
background-image: -ms-linear-gradient(top, #79bc64, #578843);
background-image: -o-linear-gradient(top, #79bc64, #578843);
background-image: linear-gradient(to bottom, #79bc64, #578843);
-webkit-border-radius: 4;
-moz-border-radius: 4;
border-radius: 4px;
text-shadow: 0px 1px 0px #898a88;
-webkit-box-shadow: 0px 0px 0px #a4e388;
-moz-box-shadow: 0px 0px 0px #a4e388;
box-shadow: 0px 0px 0px #a4e388;
font-family: Arial;
color: #ffffff;
font-size: 20px;
padding: 10px 20px 10px 20px;
border: solid #3b6e22 1px;
text-decoration: none;
}
.signup-btn:hover {
background: #79bc64;
background-image: -webkit-linear-gradient(top, #79bc64, #5e7056);
background-image: -moz-linear-gradient(top, #79bc64, #5e7056);
background-image: -ms-linear-gradient(top, #79bc64, #5e7056);
background-image: -o-linear-gradient(top, #79bc64, #5e7056);
background-image: linear-gradient(to bottom, #79bc64, #5e7056);
text-decoration: none;
}
.navbar-default .navbar-brand{
color:#fff;
font-size:30px;
font-weight:bold;
}
.form .form-control { margin-bottom: 10px; }
@media (min-width:768px) {
#home{
margin-top:50px;
}
#home .slogan{
color: #0e385f;
line-height: 29px;
font-weight:bold;
}
}