<div class="add-form bootstrap-wrapper">
    <form class="add-form-section container" id="add_child_form">
        <div class="form-group-c row">
            <div class="col-md-3">
                <input type="radio" id="regular" name="sign-up-type" value="regular" checked>
                <label for="regular">Regular</label>
            </div>
            <div class="col-md-3">
                <input type="radio" id="drop-in" name="sign-up-type" value="drop-in">
                <label for="drop-in">Drop In</label>
            </div>
        </div>
        <div class="form-group-c row">
            <div class="col-md-6">
                <label for="child-name">Child's Name</label>
                <input type="text" class="form-control" id="child-name" name="child-name" placeholder="Enter Child's Name">
            </div>
        </div>
        <div class="form-group-c row">
            <div class="col-md-6">
                <label for="father-name">Father's Name</label>
                <input type="text" class="form-control" name="father-name" placeholder="Enter Father's Name">
            </div>
            <div class="col-md-6">
                <label for="father-email">Father's Email</label>
                <input type="text" class="form-control" name="father-email" placeholder="Enter Father's Name">
            </div>
            <div class="col-md-6">
                <label for="father-phone-one">Father's Phone</label>
                <input type="text" class="form-control" name="father-phone-one" placeholder="Enter Father's Name">
            </div>
            <div class="col-md-6">
                <label for="father-phone-two">Father's Phone</label>
                <input type="text" class="form-control" name="father-phone-two" placeholder="Enter Father's Name">
            </div>
        </div>
        <div class="form-group-c row">
            <div class="col-md-6">
                <label for="father-name">Mother's Name</label>
                <input type="text" class="form-control" name="mother-name" placeholder="Enter Father's Name">
            </div>
            <div class="col-md-6">
                <label for="father-name">Mother's Email</label>
                <input type="text" class="form-control" name="mother-email" placeholder="Enter Father's Name">
            </div>
            <div class="col-md-6">
                <label for="mother-phone-one">Mother's Phone</label>
                <input type="text" class="form-control" name="mother-phone-one" placeholder="Enter Father's Name">
            </div>
            <div class="col-md-6">
                <label for="mother-phone-two">Mother's Phone</label>
                <input type="text" class="form-control" name="mother-phone-two" placeholder="Enter Father's Name">
            </div>
        </div>

        <div class="form-group-c row">
            <div class="col-md-6">
                <label for="street-address">Street Address</label>
                <input type="text" class="form-control" name="street-address" placeholder="Enter Street Address">
            </div>
            <div class="col-md-6">
                <label for="city">City</label>
                <input type="text" class="form-control" name="city" placeholder="Enter City">
            </div>
            <div class="col-md-6">
                <label for="zipcode">Zipcode</label>
                <input type="text" class="form-control" name="zipcode" placeholder="Enter Zipcode">
            </div>
            <div class="col-md-6">
                <label for="state">State</label>
                <input type="text" class="form-control" name="state" placeholder="Enter State">
            </div>
        </div>
        <div class="form-group-c regular-options row">
            <div class="col-md-3">
                <input type="radio" id="5-week" name="sign-up-option" value="5">
                <label for="5-week">5 Days/week</label>
            </div>
            <div class="col-md-3">
                <input type="radio" id="4-week" name="sign-up-option" value="4">
                <label for="4-week">4 Days/week</label>
            </div>
            <div class="col-md-3">
                <input type="radio" id="3-week" name="sign-up-option" value="3">
                <label for="3-week">3 Days/week</label>
            </div>
            <div class="col-md-3">
                <input type="radio" id="2-week" name="sign-up-option" value="2">
                <label for="2-week">2 Days/week</label>
            </div>
        </div>

        <div class="form-group-c regular-options row">
            <div class="col-md-3">
                <label for="weekly-rate">Weekly Rate</label>
                <input type="text" class="form-control" id="weekly-rate" name="weekly-rate" placeholder="Enter Weekly Rate">
            </div>
        </div>
        <div class="form-group-c drop-in-options row">
            <div class="col-md-3">
                <label for="daily-rate">Daily Rate</label>
                <input type="text" class="form-control" name="daily-rate" placeholder="Enter Value">
            </div>
            <div class="col-md-3">
                <label for="hourly-rate">Hourly Rate</label>
                <input type="text" class="form-control" name="hourly-rate" placeholder="Enter Value">
            </div>
        </div>
        <div class="form-group-c row">
            <div class="col-md-12">
                <div class="row">
                    <div class="col-md-12">
                        <label for=" comments">Misc Charges/Extra Charges</label>
                    </div>
                        <div class="col-md-12">
                            <textarea id="comments" name="comments" rows="5" placeholder="Enter Comments"></textarea>
                        </div>
                    </div>
                </div>
            </div>
            <div class="form-group-c">
                <input type="submit" id="add_child_btn" class="" value="Add Child">
    </form>
</div>