{% csrf_token %} first name last name Password Password not entered Email address Your Birth Date: 1990 1991 1992 1993 1994 1995 1996 1- January 2- February 3- March 4- April 5- May 6- June 7- July 8- August 9- September 10- October 11- November 12- December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Male Female