healthchecks/templates/front/signup_modal.html

<div id="signup-modal" class="modal">
    <div class="modal-dialog">
        <div class="modal-content">
            <div class="modal-header">
                <button type="button" class="close" data-dismiss="modal">&times;</button>
            </div>
            <div class="modal-body">
                <div class="title">Create Your Account</div>

                <label for="signup-email">
                    Enter your <strong>email address</strong>.
                </label>
                <input
                    type="email"
                    class="form-control input-lg"
                    id="signup-email"
                    value="{{ magic_form.email.value|default:"" }}"
                    placeholder="[email protected]"
                    autocomplete="off">

                <p id="link-instruction">
                    We will email you a magic sign in link.
                </p>

                <button id="signup-go" class="btn btn-lg btn-primary btn-block">
                    Email Me a Link
                </button>

                <div id="signup-result"></div>
            </div>
        </div>
    </div>
</div>