Registration 2

    [md-form]
    [md-text label="Your name"]

    [/md-text]
    [md-text label="Contact No."]

    [/md-text]
    [md-text label="Email" help="Must be a valid email address" outlined="yes"]

    [/md-text]

    Address where appliances are held
    Billing Address

    [md-select label="Select the Packaged Purchased"]

    [/md-select]

    [group group-658]
    [md-checkbox label="Select Kitchen Appliances which are included in cover by customer"]
    Coffee MachineExtractor FanFreezerFridgeFridge/FreezerHOBMicrowaveOvenTumble DryerWasher/DryerWashing MachineWine cooler
    Remind the Client to Buy a package , Which Cover Minimum 5 Appliances
    [/md-checkbox]
    [/group]

    [group group-94]
    [md-checkbox label="Select Living Room Appliances which are included in cover by customer"]
    DVD/Blue Ray PlayerHi Fi SystemSatelite TV BoxSurround Sound SpeakerTelevision
    Remind the Client to Buy a package , Which Cover Minimum 5 Appliances
    [/md-checkbox]
    [/group]

    [md-select label="Remind them to add Computer or Game Console cover only for 9GBP extra a month" help="If yes then Select the add on Purchased below"]

    [/md-select]

    [group group-95]
    [md-checkbox label="Select Computer Appliances which are included in cover by customer"]
    Desktop ComputerDesktop MonitorIPADLaptopPrinter/Scanner
    [/md-checkbox]
    [/group]

    [group group-96]
    [md-checkbox label="Select Game Console which are included in cover by customer"]
    Nintendo SwitchSony Play StationXBOX Console
    [/md-checkbox]
    [/group]

    Debit Details

    Card Details

    [md-checkbox label="Check if following questions have been asked and answered by Customer"]
    Single Payment will activate the cover after 30 DaysDouble Payment will activate the cover instantlyCustomer give consent to store their card and account DetailsAsk Customer if they want to convert it to a yearly package which save 2 months an yearConfirm, All the products are in good Condition
    [/md-checkbox]

    [md-textarea label="Your message"]

    [/md-textarea]

    [md-submit]

    [/md-submit]
    [/md-form]