gistfile1.txt

<form novalidate="" action="#" method="post">
    <div id="form">
        <div>
            <label for="form_name" class="required">Name</label>
            <input type="text" id="form_name" name="form[name]" required="required" />
        </div>
        <div><label for="form_surname" class="required">Surname</label><input type="text" id="form_surname" name="form[surname]" required="required" /></div>
        <div><label for="form_email" class="required">Email</label><input type="text" id="form_email" name="form[email]" required="required" /></div>
        <div><label for="form_terms" class="required">Terms</label><input type="checkbox" id="form_terms" name="form[terms]" required="required" value="1" /></div>
        <div><label for="form_terms_info" class="required">Terms info</label><input type="checkbox" id="form_terms_info" name="form[terms_info]" required="required" value="1" /></div>
        <input type="hidden" id="form__token" name="form[_token]" value="03948203943347bf56fead3ef390d416adc6ac3a" />
    </div>
    <input type="submit" name="submit" />
</form>