<div class="input_price" style="margin-top: 10px;">

<div class="form-group input-group ar">

    <select name="genderc" id="genderc" class="form-control ccm-input-select" title="Sexe " ccm-passed-value="" required>
        <option value="" selected="selected">Sexe </option>
        <option value="Mr">Homme</option>
        <option value="Mme">Femme</option>
    </select>
    <div id="error_input_gender" style="color:red; font-size: 12px;" hidden> * Required field</div>
</div>
<div class="form-group input-group ar">

    <input id="ln" type="text" name="ln" value="" class="form-control ccm-input-text" placeholder="Prénom" title="Prénom" required>

    <div id="error_input_ln" style="color:red; font-size: 12px;" hidden> * Required field</div>
</div>
<div class="form-group input-group ar">

    <input id="fn" type="text" name="fn" value="" class="form-control ccm-input-text" placeholder="Nom" title="Nom" required>

     <div id="error_input_fn" style="color:red; font-size: 12px;" hidden> * Required field</div>
</div>


 <div class="form-group input-group ar">

    <input id="price_gift_card" type="integer" name="price_gift_card" value="" class="form-control ccm-input-text" placeholder="Prix" title="Prix" required>

    <div id="error_input_price" style="color:red; font-size: 12px;" hidden> * Required number field</div>
</div>