<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Domain')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-domain" class="form-control" name="row[domain]" type="text" value="{$row.domain|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Weigh')}:</label