"Engage - Check-in"
Bootstrap 3.0.0 Snippet by drhetesi

<link href="//netdna.bootstrapcdn.com/bootstrap/3.0.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css"> <script src="//netdna.bootstrapcdn.com/bootstrap/3.0.0/js/bootstrap.min.js"></script> <script src="//code.jquery.com/jquery-1.11.1.min.js"></script> <!------ Include the above in your HEAD tag ----------> <form class="form-horizontal"> <fieldset> <!-- Form Name --> <legend>Check-in</legend> <!-- Multiple Checkboxes --> <div class="form-group"> <label class="col-md-4 control-label" for="checkboxes">Authorized Pick Up</label> <div class="col-md-4"> <div class="checkbox"> <label for="checkboxes-0"> <input type="checkbox" name="checkboxes" id="checkboxes-0" value="1"> Joe Smith </label> </div> <div class="checkbox"> <label for="checkboxes-1"> <input type="checkbox" name="checkboxes" id="checkboxes-1" value="2"> Jane Smith </label> </div> <div class="checkbox"> <label for="checkboxes-2"> <input type="checkbox" name="checkboxes" id="checkboxes-2" value=""> Other </label> </div> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="otherPickUp"></label> <div class="col-md-4"> <input id="otherPickUp" name="otherPickUp" type="text" placeholder="Full Name" class="form-control input-md" required=""> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="otherPhone"></label> <div class="col-md-4"> <input id="otherPhone" name="otherPhone" type="text" placeholder="###-###-####" class="form-control input-md" required=""> </div> </div> </fieldset> </form>

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