<div class="col_full">
    <label for="email">email*</label>
    <input type="text" id="email" name="email" value="" class="form-control form-control-pill" />
</div>
<div class="clear"></div>
<div class="col_half">
    <label for="nome">Nome*</label>
    <input type="text" id="nome" name="first_name" value="" class="form-control form-control-pill" />
</div>
<div class="col_half col_last">
    <label for="sobrenome">Sobrenome*</label>
    <input type="text" id="sobrenome" name="last_name" value="" class="form-control form-control-pill" />
</div>
<div class="clear"></div>
<div class="col_half">
    <label for="nome">Nascimento*</label>
    <input type="text" id="date" name="datebirth" value="" class="form-control form-control-pill mask-date"  data-mask="date" />
</div>
<div class="col_half col_last">
    <label for="RG">RG</label>
    <input type="text" id="RG" name="document2" value="" class="form-control form-control-pill" placeholder="RG"/>
</div>
<div class="clear"></div>
<div class="col_half">
    <label for="telefone">Telefone*</label>
    <input type="text" id="telefone" name="phone" value="" class="form-control form-control-pill mask-phone" data-mask="phone" />
</div>
<div class="col_half col_last">
    <label for="celular">Celular</label>
    <input type="text" id="celular" name="celular" value="" class="form-control form-control-pill mask-phone" data-mask="phone" />
</div>
<div class="clear"></div>
<div class="col_half">
    <label for="code">Senha*</label>
    <input type="password" id="code" name="password" value="" class="form-control form-control-pill" />
</div>
<div class="col_half col_last">
    <label for="code2">Repita a Senha*</label>
    <input type="password" id="code2" name="verify_password" value="" class="form-control form-control-pill" />
</div>
<div class="clear"></div>
<input type="hidden" name="type" value="individual">


<div class="col_full nobottommargin">
    <button class="button button-circle button-black nomargin" id="register-form-submit" name="register-form-submit" value="register">Cadastrar</button>
</div>