<div class="ecp-component ecp_JoinClub__CreateCustomer">
  <h2 aria-describedby="ecpi_jc__cc_info">{message:club_tier_name}</h2>
  <div data-ecp-handle="progress_bar">
    <!-- | JoinClub__ProgressBar template | -->
  </div>
  <p id="ecpi_jc__cc_info" class="ecp-summary">{message:JoinClub/CreateCustomer/Summary}</p>
  <form class="ecp-form">
    <div class="ecp-form-fieldset-scrunched">
      <input type="text" name="first_name" placeholder="{message:JoinClub/CreateCustomer/FirstNameInput}" aria-label="{message:JoinClub/CreateCustomer/FirstNameInputLabel}" autocomplete="given-name" required>
      <input type="text" name="last_name" placeholder="{message:JoinClub/CreateCustomer/LastNameInput}" aria-label="{message:JoinClub/CreateCustomer/LastNameInputLabel}" autocomplete="family-name" required>
    </div>
    <p class="ecp-form-tip">{message:JoinClub/CreateCustomer/CredentialsTip}</p>
    <div class="ecp-form-fieldset-scrunched">
      <input type="text" name="email_address" placeholder="{message:JoinClub/CreateCustomer/EmailInput}" aria-label="{message:JoinClub/CreateCustomer/EmailInputLabel}" autocomplete="email" required>
      <input type="password" name="password_1" placeholder="{message:JoinClub/CreateCustomer/PasswordInput1}" aria-label="{message:JoinClub/CreateCustomer/PasswordInput1Label}" autocomplete="new-password" required>
      <input type="password" name="password_2" placeholder="{message:JoinClub/CreateCustomer/PasswordInput2}" aria-label="{message:JoinClub/CreateCustomer/PasswordInput2Label}" autocomplete="new-password" required>
    </div>
    <ul class="ecp-form-checkboxes">
      <li><label><input type="checkbox" name="is_ok_to_email">{message:JoinClub/CreateCustomer/OKToEmail}</label></li>
    </ul>
    <p class="ecp-form-tip">{message:JoinClub/CreateCustomer/PhoneAndBirthDateTip}</p>
    <div class="ecp-form-fieldset-scrunched">
      <input type="text" name="birth_date" placeholder="{message:JoinClub/CreateCustomer/BirthDateInput}" aria-label="{message:JoinClub/CreateCustomer/BirthDateInputLabel}" autocomplete="bday" required>
      <input type="text" name="phone_1" placeholder="{message:JoinClub/CreateCustomer/PhoneInput}" aria-label="{message:JoinClub/CreateCustomer/PhoneInputLabel}" autocomplete="mobile tel">
    </div>
    <button data-ecp-handle="continue" data-ecp-action="continue" aria-label="{message:JoinClub/CreateCustomer/ContinueButtonLabel}">{message:JoinClub/CreateCustomer/ContinueButton}</button>
  </form>
</div>